Evaluation and comparison of ethanol ablation and radiofrequency ablation therapeutic effects on parathyroid adenoma

Parathyroidectomy, the standard treatment for primary hyperparathyroidism (PHPT), is associated with complications and may not be feasible for patients with significant comorbidities. This study aims to evaluate and compare the efficacy of ethanol ablation (EA) and radiofrequency ablation (RFA) in the treatment of parathyroid adenoma.

This retrospective study included 133 patients with PHPT, 76 of whom underwent RFA and 57 underwent EA. Serum calcium, phosphorus, and parathyroid hormone (PTH) levels were evaluated after one and six months of follow-up. A follow-up ultrasound exam was conducted after one month to assess adenoma volume.

RFA resulted in significant reductions in serum PTH, calcium levels, and adenoma size, as well as a significant increase in serum phosphorus levels (all P<0.001). Similarly, EA led to substantial reductions in serum PTH, calcium, and adenoma volume (all P<0.001), while the changes in phosphorus levels were borderline significant (P=0.063). At the end of the follow-up period, 95.2% of patients in the RFA group and 97.6% in the EA group achieved normocalcemia. Both treatments showed comparable effectiveness in reducing serum PTH, calcium levels, and adenoma volume (P=0.35, P=0.22, and P=0.76, respectively). However, RFA was significantly more effective in increasing phosphorus levels (P=0.005).

Both RFA and EA are highly effective alternatives to parathyroidectomy for treating PHPT. These minimally invasive techniques offer similar outcomes in terms of reducing serum PTH, calcium, and adenoma volume, with RFA showing a superior effect on phosphorus levels.