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Thermal Ablation for the Treatment of Abdominal Tumors

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Published on: March 7, 2011

US-Guided Thermal Ablation for Secondary Hyperparathyroidism: A Prospective Multicenter Study.

Yang Liu¹, Cheng-Zhong Peng¹, Hui-Hui Chai¹

¹From the Department of Interventional Ultrasound, the Fifth Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Rd, Beijing 100853, China (Y.L., F.Y.L., J.Y., P.L.); Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China (C.Z.P.); Graduate Department, Bengbu Medical College, Bengbu, Anhui, China (H.H.C.); Department of Ultrasound, Capital Medical University, Beijing Friendship Hospital, Beijing, China (L.X.Q.); Department of Ultrasonography, Fujian Provincial Hospital, Fuzhou, Fujian, China (S.S.W.); Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); Department of Ultrasound, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China (S.P.L., J.T.Z.); Department of Ultrasound, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China (Y.S.); Weifang Peoples Hospital, Weifang, Shandong, China (C.B.S.); Daqing Oilfield General Hospital, Daqing, Liaoning, China (Z.W.Y., R.Z.); and Department of Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (Y.C., S.H.G.).

|January 8, 2025

Summary

Ultrasound-guided thermal ablation, including microwave ablation (MWA) and radiofrequency ablation (RFA), effectively treats secondary hyperparathyroidism (SHPT). These procedures significantly reduce parathyroid hormone (PTH), calcium, phosphorus, and alkaline phosphatase (ALP) levels with good safety profiles.

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Area of Science:

Interventional Radiology
Endocrinology
Nephrology

Background:

Growing interest in microwave ablation (MWA) and radiofrequency ablation (RFA) for secondary hyperparathyroidism (SHPT).
Limited characterization of ablation outcomes in SHPT patients.
Need to evaluate the efficacy and safety of US-guided thermal ablation for SHPT.

Purpose of the Study:

To assess the effectiveness of US-guided microwave ablation (MWA) and radiofrequency ablation (RFA) in treating secondary hyperparathyroidism (SHPT).
To evaluate the impact of these ablations on parathyroid hormone (PTH), calcium, phosphorus, and alkaline phosphatase (ALP) levels.
To determine the safety and complication rates associated with these thermal ablation techniques in SHPT patients.

Main Methods:

Prospective multicenter cohort study (September 2017 - March 2022) including participants with SHPT.
Primary endpoint: proportion of participants achieving target PTH level (≤585 pg/mL).
Secondary endpoints: changes in PTH, calcium, phosphorus, ALP; complication rates; technical success; mixed-effects logistic regression for failure predictors.

Main Results:

85.1% of 215 participants achieved target PTH levels.
Significant reductions observed at 24 months post-ablation: PTH (85.9%), calcium (6.3%), phosphorus (15.3%), and ALP (37.4%).
Low rate of major complications (0.5% persistent hoarseness); severe hypocalcemia occurred in 34.4%.

Conclusions:

US-guided thermal ablation (MWA and RFA) is an effective treatment for SHPT.
These techniques successfully reduce key biochemical markers (PTH, calcium, phosphorus, ALP).
The procedures demonstrate a favorable safety profile for managing SHPT.