Efficacy and safety of ultrasound-guided microwave ablation for primary hyperparathyroidism: a dual-centre study

This study aimed to evaluate the efficacy and safety of ultrasound-guided microwave ablation (MWA) for the treatment of primary hyperparathyroidism (PHPT). This study enrolled 46 patients with PHPT from two centers between July 2019 and January 2024. The primary end point was clinical success, defined as the achievement of normal levels of both intact parathyroid hormone (iPTH) and serum calcium at 6 months post-MWA (40/46). Secondary end points were technical success and procedure-related complications, with the former defined as the achievement of complete ablation. The clinical and technical success rate were 87.0% (40/46) and 100.0% (56/56), respectively. Serum iPTH, calcium and phosphorus showed significant improvement within the 6 months post-MWA [iPTH, 156.6 (114.3-241.0) pg/mL vs. 58.3 (49.0-62.4) pg/mL; calcium, 2.70 ± 0.30 mmol/L vs. 2.38 ± 0.11 mmol/L; phosphorus, 0.86 ± 0.19 mmol/L vs. 1.01 ± 0.17 mmol/L, respectively; all, p < 0.01]. The 6-month volume reduction rate (VRR) was 79.0%, and no long-term complications were observed during follow-up. These results suggest that ultrasound-guided MWA is a safe and effective non-surgical alternative for the management of PHPT.