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US-guided microwave ablation for primary hyperparathyroidism: a safety and efficacy study
Bo-Qiang Fan1, Xiao-Wei He2, Huan-Huan Chen3
1Cancer Center, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
European Radiology
|March 20, 2019
Summary
Microwave ablation with cool saline injection safely and effectively treats primary hyperparathyroidism, normalizing parathyroid hormone and calcium levels in most patients. This minimally invasive procedure offers a promising alternative for managing hyperparathyroidism.
Area of Science:
- Endocrinology
- Minimally Invasive Surgery
- Oncology
Background:
- Primary hyperparathyroidism (PHPT) is a condition characterized by excessive parathyroid hormone (PTH) production.
- Elevated PTH leads to hypercalcemia and other complications.
- Current treatment options for PHPT include surgery and medication, each with potential risks and limitations.
Purpose of the Study:
- To evaluate the safety and efficacy of ultrasound-guided microwave ablation (MWA) assisted by continuous cool saline injection (CCSI) for treating PHPT.
- To assess the impact of MWA on parathyroid hormone (PTH) and serum calcium levels.
- To determine the long-term outcomes and potential side effects of this novel therapeutic approach.
Main Methods:
- A prospective study involving 22 patients diagnosed with PHPT.
- Ultrasound-guided MWA with CCSI was performed on all participants.
- Serum calcium and PTH levels were monitored pre- and post-treatment, with follow-up up to 12 months.
Main Results:
- Successful normalization of PTH and calcium levels was achieved in 86.36% of patients.
- Sustained normalization of PTH levels was observed for up to 12 months in the successfully treated group.
- A significant decrease in mean PTH and calcium levels was noted at 6 months post-MWA (p < 0.05).
- Transient voice changes occurred in 8 patients, and one patient experienced temporary hypocalcemia.
Conclusions:
- Ultrasound-guided MWA with CCSI is a safe and effective treatment for primary hyperparathyroidism.
- This technique demonstrates efficacy in ablating parathyroid gland tissue.
- MWA offers a viable therapeutic alternative for patients with PHPT, including those with hypercalcemic or normocalcemic presentations.
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