Magnetic forces are used to transport the nanoparticles to the sensor surface, which is also coated with antibodies where they can bind. using a surface-sensitive optical imaging technique. Results ioPTH test could be performed with a turnaround time of less than 10?min and could detect low intact-PTH concentrations (picomolar). Integrated cartridge contains a blood separation filter and dry reagents for the assay. Conclusion The next magnotech ioPTH assay will be the only POC test able to give accurate results in less than 10?min, using 25?L of whole blood. Thanks to the ease-of-use, magnotech ioPTH could be performed in the operating theater by any member of surgical staff. strong class=”kwd-title” Keywords: Intraoperative PTH, Point-of-care test, Turnaround time, Operating theater, Magnotech, Minimal invasive parathyroidectomy Introduction Main hyperparathyroidism (PHPT) is usually caused by a single-gland disease in more than 80% of patients, for whom unilateral cervical exploration would be beneficial compared with a four-gland exploration [1]. The improvement in imaging with 99mTc-labeled sestamibi scintigraphy and ultrasonography of the neck to Mlst8 localize a single adenoma preoperatively, has made minimally invasive parathyroidectomy (MIP) the preferred approach to PHPT for most endocrine surgeons [2, 3]. Upto 92% of patients with positive localization studies undergo MIP [4]. MIP is usually often coupled with intraoperative parathyroid hormone (ioPTH) monitoring during surgery to confirm the completeness of resection of the hyperfunctioning parathyroid gland and to reveal cases of multiple-gland parathyroid disease not acknowledged on imaging [5, 6]. Such methods can reduce the costs of medical care by decreasing the duration of the surgery and lengths of stay, changing from an inpatient to an outpatient procedure [7]. Patient satisfaction is also greater with respect to cosmetic result and postoperative pain. Intact-PTH consists of a single polypeptide chain, made up of 84 amino acids with amino and carboxy terminals, which is usually produced only in the parathyroid glands and secreted into the WAY-600 bloodstream. The circulating (1C84) PTH molecule has a half-life of only 5?min. Blood concentrations of intact-PTH rapidly decrease after removal of hypersecreting parathyroid gland. Typically, PTH concentrations are measured at baseline, before exploration, and then at 5C10?min post-excision, with a WAY-600 50% decrease in PTH values from the highest baseline observed if all hypersecreting tissue has been removed [8]. Since the mid-1990s, the development of quick ioPTH assays, improving WAY-600 the turnaround time of the result, allowed for its practical use in the surgical management of PHPT [9, 10]. Rapid ioPTH assays have incubation times ranging from 10 to 30?min, giving turnaround occasions of up to 1?h. Most of the laboratories performing quick PTH screening are carrying out screening in the central laboratory on an automated analyzer [11]. An on-site approach, i.e., operating theater screening requires additional instrument and operator training and a dedicated laboratory technician. Royal Philips Electronics has developed a handheld immunoassay system called magnotech for the point-of-care (POC) screening that can measure picomolar concentrations of analytes in 10?min or less [12C14]. We worked on the development of an ioPTH assay around the magnotech system with a turnaround time of less than 10?min [15, 16]. Such an assay would have the potential to be used in the operating theater. We present here the preliminary results obtained internally with an in-house magnotech ioPTH assay. Materials and methods Magnotech technology The diagnostic system is based on Philips’ proprietary magnotech WAY-600 immunoassay technology (http://www.philips.com/magnotech) [13, 14]. The system consists of a handheld analyzer instrument and a disposable self-contained cartridge. Magnetic nanoparticles that have been functionalized with antibodies are used to capture and to detect the analyte molecules. Magnetic forces are used to transport the nanoparticles to the sensor surface, which is also coated with antibodies where they can bind. By collecting all magnetic particles near the sensor surface, a significant increase in analyte concentration is usually achieved, which speeds up the binding kinetics, shortening the assay time. All assay reagents are stored inside the cartridge in a dry form; therefore, once the sample liquid has been added to the cartridge, no further operator interaction is required. The short measurement time, in combination with the high ease-of-use, makes the test very suitable for ioPTH screening use, enabling the surgical staff to perform the measurement during the operation without the need for a laboratory technician. The magnotech system uses the theory of frustrated total internal reflection (FTIR) to detect the presence of any magnetic nanoparticles bound to the sensor surface. The FTIR theory is WAY-600 usually illustrated in Fig.?1. Light is usually projected on the surface of the cartridge at an position that is somewhat shallower compared to the important angle, leading to a reflection that’s imaged on the camcorder sensor. In the lack of any magnetic contaminants, the laser beam is certainly reflected at complete intensity, producing a shiny picture. When nanoparticles do bind in the sensor surface area, a number of the light is certainly dispersed and shown with the nanoparticles, producing a reduced intensity from the reflected.