Intraoperative vs central laboratory PTH testing during parathyroidectomy surgery

Abstract

Intact parathyroid hormone (PTH) testing can be performed rapidly, directly in the operating room, using the QuiCK-Pak System (Nichols Institute Diagnostics, San Juan Capistrano, CA) or in a central laboratory using the IMMULITE Immunoassay System and Turbo PTH assay (Diagnostic Products, Los Angeles, CA). Correlation between parathyroid hormone values obtained on EDTA plasma samples using these systems was good (r = 0.84); at 20-minutes after excision of a suspected hyperfunctioning parathyroid gland, diagnostic agreement between the two systems was 100%. Based on 50 parathyroid gland surgeries for each of a 3-year contract period, the cost of intraoperative vs central laboratory PTH testing per surgery was $760 and $360, respectively. Intraoperative parathyroid hormone testing using the QuiCK-Pak System provides faster, more reliable turnaround time for intraoperative PTH results and has other advantages over central laboratory PTH testing during parathyroid gland surgery.