Localization of Parathyroid Adenomas by Selective Venous Catheterization and Radioimmunoassay

We have successfully applied the radioimmunoassay for parathyroid hormone (PTH) to the localization of parathyroid adenomas by measurements of hormone concentration in multiple blood samples obtained by selective catheterization of the major veins draining the neck and thorax. During venous catheterization, blood samples collected from the left and right jugular, left and right subclavian and left and right innominate veins and superior and inferior vena cava showed a definite localized increase in PTH concentration in six patients. In five patients the increase was found in either the right or the left jugular vein; in the sixth patient a mediastinal location of the adenoma was indicated. The location of the tumor was in agreement with findings at surgery in all patients. The application of these technics can greatly facilitate efforts to remove all abnormal parathyroid tissue at a single operation.