Availability of this fully automated method may enable laboratories to justify bringing PTH assays in-house onto their routine immunoassay system for the first time
Intact parathyroid hormone (iPTH) is the latest addition to Bayer Diagnostics' metabolic assay panel for the Advia Centaur and Bayer ACS:180T immunoassay systems, enabling laboratories to confirm the completeness of parathyroid surgery.
Due to the extremely small size of the parathyroid glands, it can be difficult for surgeons to be certain that a suspect adenoma (tumour) has been removed completely.
Availability of this test for use on Bayer's automated systems enables accurate iPTH measurements to be obtained from plasma samples post-operatively in the laboratory, taking full advantage of the analysers' rapid result generation and Stat capabilities.
"There is currently a lot of interest in the possibility of measuring iPTH intra-operatively in the theatre, but the near-patient testing equipment that's needed to do this is extremely expensive", says Peter Wood, consultant clinical biochemist and director of the department of chemical pathology at Southampton General Hospital.
"Now that it's possible to obtain iPTH results from automated analysers in the laboratory, this is proving to be a much more cost-effective option.
For example, at this hospital, the surgeon is quite happy for us to analyse pre- and post-surgery samples from a patient in the immediate post-operative period.
Comparison of the results enables him to confirm whether or not he has successfully removed the tumour." "We do have plans to undertake intra-operative testing in future in 'difficult' cases where patients come in for surgery a second time", he continues.
"The surgeon plans to book all these patients in on the same afternoon and undertake an intensive intra-operative testing session to make sure that all the operations are successful as he is doing them.
This will involve transportation of the sample between the theatre and the lab but the benefits to the patient are enormous." In addition to post-surgical testing, results from the iPTH assay can also help clinicians distinguish between patients suffering from hyperparathyroidism, hypoparathyroidism or hypercalcaemia of malignancy, when used in conjunction with the measurement of ionised calcium.
Intact PTH levels are also used to assess and manage other metabolic bone disorders, including osteoporosis and renal osteodystrophy.
iPTH is the latest in a range of metabolic tests which can be run on Bayer's automated immunoassay systems.
This range also includes cortisol, C-peptide and insulin.
These tests can all be run in random access mode alongside any of the other methods in the analysers' comprehensive disease state assay groups, enabling users to consolidate a significant proportion of their workload onto a single analytical system.
High productivity is assured, with a throughput of up to 240 tests per hour on the Advia Centaur.
"The release of the iPTH assay for the Advia Centaur is a welcome addition to the already extensive assay menu for this analyser, creating further opportunities for test consolidation", comments product manager Fiona Howe. "Requests for this particular analyte are increasing, and the availability of this fully automated method enables laboratories to justify bringing PTH assays in-house onto their routine immunoassay system for the first time."
