Tom Kurzawinski

Tom Kurzawinski

Mr Kurzawinski is an Endocrine Surgeon in London.

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IOPTH monitoring in the 21st century; A validation study in progress!

Dear Ultrafast Hormones Followers

 

A few months ago I posted a message about a new instrument able to measure parathormone (PTH) concentration during parathyroid surgery in 5 minutes using whole blood rather than plasma samples. The machine is small, fast, precise and most importantly simple to operate, which opens the possibility of PTH measurements being performed by medical staff already present in operating theatres. Current methods of intraoperative PTH monitoring (IOPTH) require the involvement of biochemists performing measurements either in the main laboratory or in theatres. The new NBCL platform offers an opportunity to change this paradigm. Simplifying the logistics of IOPTH should encourage more surgeons to use this technique routinely to the benefit of their patients.

Two of the NBCL instruments are now installed in London and are undergoing thorough laboratory and clinical validation at the University College Hospital and London Clinic. The initial results of the precision and accuracy studies are very encouraging and further assessments of linearity, limits of detection and quantitation are ongoing. Eight members of our team at University College Hospital and London Clinic including biochemists, nurses, surgeons and anaesthetists are now trained and certified to use it. We have already performed parathyroidectomies using the NBCL system in parallel with our “gold standard” methods (Future Diagnostics and main Roche platforms). A correlation graph of our first patient is shown below. As you can see, although absolute concentrations of PTH are slightly different on each of the platforms (as expected), there is a good correlation between changes in PTH concentration and a 50% reduction in circulating PTH, main (Miami) criteria confirming biochemical cure, were similar for all 3 platforms.

 

A big thanks to the laboratory and clinical teams at both hospitals, especially to Christina Soromani and Sujiwa Morley, for performing the validation study. We hope to present a full report of our work at the next annual conference of the British Association of Endocrine and Thyroid Surgeons (BAETS) in Leeds in October.

 

Watch this space and please contact us if you require more information

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