Ultrasound-guided parathyroid aspiration to diagnose parathyroid adenomas

SUMMARY Aim To ascertain the accuracy of ultrasound-guided fine needle aspiration and parathyroid hormone assay in the identification of parathyroid adenomas. Design Case study. Setting Tertiary referral clinic. Patients 12 subjects, consisting of 10 female and two male patients, with documented primary hyperaparathyroidism. Intervention Ultrasonography of the parathyroid glands was performed using an Acuson XP 128 machine with a linear array 7.5 MHz multihertz probe. Following accurate localization of the parathyroid lesion, fine needle aspiration was performed using a 23 gauge needle, and parathyroid hormone assay was performed on the aspirate. Preoperative localization was compared with intra-operative findings. Results Ultrasound examination detected 10 out of a possible 12 parathyroid adenomas (83% sensitivity), while ultrasound-guided fine needle aspiration only confirmed nine out of the 12 adenomas (75% sensitivity). Conclusions While ultrasound-guided fine needle aspiration may be simple and with minimal morbidity, it does not appear to provide any advantage over ultrasound examination alone for the localization of parathyroid adenomas. It has a potential role in defining the nature of ultrasonically localized nodules.