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Percutaneous Ablation of Parathyroid Adenomas: A Systematic Review and Meta-Analysis
Cem Bilgin1, Rebecca Hibbert1, Firat Oztepe2
1Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
Summary
Percutaneous ablation for parathyroid adenomas is a safe and effective treatment for primary hyperparathyroidism. Radiofrequency, microwave, and ethanol ablation techniques show comparable outcomes within the first year post-procedure.
Area of Science:
- Endocrinology
- Minimally Invasive Surgery
Background:
- Primary hyperparathyroidism is often treated with surgery, but minimally invasive options are emerging.
- Percutaneous ablation offers a less invasive approach for parathyroid adenomas.
- The comparative effectiveness and safety of different ablation techniques require further investigation.
Purpose of the Study:
- To evaluate the effectiveness and safety of percutaneous ablation techniques for parathyroid adenomas.
- To compare radiofrequency (RF), microwave (MWA), and ethanol ablation methods.
- To assess outcomes including biochemical control and complication rates.
Main Methods:
- A systematic literature search was conducted following PRISMA guidelines.
- Included studies provided separate data for RF, MWA, and ethanol ablation.
- Meta-analysis using a random-effects model to pool data on efficacy and safety outcomes.
Main Results:
- The study included 20 studies with 815 patients.
- A 85.6% normocalcemia rate was observed at 6-12 months post-ablation.
- Significant reductions in parathyroid hormone (PTH) and calcium levels were noted, with low rates of major complications and permanent hoarseness.
Conclusions:
- Percutaneous ablation of parathyroid adenomas is a safe and effective treatment within the first year.
- RF, MWA, and ethanol ablation demonstrate comparable safety and efficacy profiles.
- Treatment choice can be individualized based on patient needs.
