{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T17:50:10Z","timestamp":1783792210077,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,8,3]],"date-time":"2018-08-03T00:00:00Z","timestamp":1533254400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Minimally invasive surgery is an alternative surgical approach for primary hyperparathyroidism with less surgical trauma and anaesthesia complications. When combined with intraoperative measurement of parathyroid hormone (<jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content>), cure rates are exceeding 97%. Preoperative intact <jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content> determination in washout samples is really very useful when parathyroid lesions cannot be easily distinguished from thyroid lesions or sometimes lymph nodes. Herein, we aimed to report our institutional experience about parathyroid fine\u2010needle aspiration (<jats:styled-content style=\"fixed-case\">FNA<\/jats:styled-content>) method and suggest a cut\u2010off ratio for this purpose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In our clinic, we performed ultrasonography (<jats:styled-content style=\"fixed-case\">USG<\/jats:styled-content>)\u2010guided parathyroid <jats:styled-content style=\"fixed-case\">FNA<\/jats:styled-content> procedure for 131 patients diagnosed with primary hyperparathyroidism between January 2005 and January 2016. Both cytologic evaluation and intact <jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content> determination were performed in washout samples. Eighty\u2010seven of the study group also had a parathyroid scintigraphy. Both demographic features and laboratory results were all recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median serum <jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content> level was 142 (113\u2010197), while mean <jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content> washout level was 1824 (0\u20103953). When three of the localization techniques are compared with each other, <jats:styled-content style=\"fixed-case\">FNA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content> washout group had a better diagnostic accuracy (90.8%) when compared to cytology (7.92%) and <jats:styled-content style=\"fixed-case\">MIBI<\/jats:styled-content> (67.8%) groups. Both <jats:styled-content style=\"fixed-case\">MIBI<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">FNA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content> washout group had 100% positive predictive value (<jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content>) and 100% specificity. We found values greater than 436.5\u00a0pg\/mL for <jats:styled-content style=\"fixed-case\">FNA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content> washout with a sensitivity of 90.3% and specificity of 88.9% (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01 and <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> 94.3 (87.8\u2010100)) and a cut\u2010off for <jats:styled-content style=\"fixed-case\">FNA<\/jats:styled-content>\/serum <jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content> greater than 3.05 with a sensitivity of 91.2% and specificity of 89% (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02 and <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> 94.5 (88.8\u2010100)) which implicate parathyroid lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>According to the literature, <jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content> determination in washout samples has a specificity of 75%\u2010100% and sensitivity of 70%\u2010100%. This approach has better results than both cytology and scintigraphy in case of concomitant multinodular thyroid disease in experienced hands. Although there is not a definite cut\u2010off for <jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content> levels in washout samples, we agree with the need of ratios rather than cut\u2010offs in this issue.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13812","type":"journal-article","created":{"date-parts":[[2018,7,13]],"date-time":"2018-07-13T11:48:24Z","timestamp":1531482504000},"page":"489-495","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Diagnostic accuracy of parathyroid hormone levels in washout samples of suspicious parathyroid adenomas: A single\u2010centre retrospective cohort study"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1186-2960","authenticated-orcid":false,"given":"Asena","family":"G\u00f6k\u00e7ay Canpolat","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism Ankara University School of Medicine  Ankara 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