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Scientific Oral Presentations

Endocrine Surgery

Session: Scientific Oral Presentations – Endocrine Surgery

Density Test for the Rapid Intraoperative Identification of "Normal vs Hyperplastic" Parathyroid Gland

Sunday, September 29, 2024
3:00 PM – 3:06 PM EDT
Location: MBCC, 209
Disclosure(s):
William H. Weir, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

V Peyton Pinkus, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Soroush Farsi:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

James R. Gardner, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Courtney J. Hunter, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Primary hyperparathyroidism (PHPT) entails autonomous PTH secretion, commonly treated surgically. Despite improved pre-operative methods, identifying patients at risk for residual disease remains a challenge. It's proposed that density differences, like the 'float test' can distinguish hyperplastic from adenomas based on fat content distribution. This study seeks to confirm if density-based differentiation can distinguish normal or hyperplastic parathyroid glands from adenomas.

Methods: This retrospective chart review included 322 adult patients diagnosed with primary hyperparathyroidism who underwent parathyroidectomy between 2015 and 2020. The study analyzed patient demographics, pathology measurements and laboratory markers.

Results: Our cohort comprised 52 men and 270 women, averaging 65 years of age. Of these, 69.6% had only one gland retrieved, while 30.4% had two or more. Among the retrieved parathyroid glands, 87% were categorized as hypercellular or adenoma, and 13% as normal or normocellular. Our study revealed that both weight and volume were predictive of pre-operative PTH levels (r=0.33 and 0.34, respectively), whereas density showed no significant correlation (r=-0.03). Glands described as hypercellular tended to be larger and heavier (MWU p< 1e-5 for both), but we found no significant differences in density between normal and hypercellular glands. We did not find an association between gland cellularity and resolution of disease as measured by ionized calcium or PTH (p=0.76 and p=0.32, respectively).

Conclusions: While gland size was predictive of increased cellularity in parathyroid glands, density did not prove to be an indicative factor for distinguishing between hypercellular and normocellular glands. Furthermore, gland pathological categorization was not predictive of disease resolution.

    Presenting Author(s)

  • William H. Weir, MD, PhD

    Resident
    University of Arkansas for Medical Sciences (UAMS)
    Little Rock, Arkansas, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • V Peyton Pinkus, BS

    Medical Student
    University of Arkansas for Medical Sciences (UAMS)
    Little Rock, Arkansas, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Presenting Author(s)

  • Soroush Farsi

    Medical Student
    Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences
    El Paso, Texas, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • James R. Gardner, MD

    Resident Physician
    University of Arkansas for Medical Sciences
    Little Rock, AR, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Courtney J. Hunter, MD

    Resident Physician
    University of Arkansas for Medical Sciences
    Little Rock, AR, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Mauricio A. Moreno, MD

    Professor
    University of Arkansas for Medical Sciences (UAMS)
    Little Rock, AR, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • DB

    Donald Bodenner, MD, PhD

    University of Arkansas for Medical Sciences (UAMS), United States

    Disclosure information not submitted.