Can Liu1, Bin Wu2, Pintong Huang3, Qian Ding1, Lei Xiao1, Mei Zhang1, Jing Zhou4. 1. Department of Ultrasound, First People's Hospital of Jingzhou, Yangtze University, Jingzhou, China. 2. Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 3. Department of Ultrasound, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. 4. Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Rd., Wuhan, Hubei 430022, China. Electronic address: drtinazhou@gmail.com.
Abstract
PURPOSE: To test the feasibility, safety, and efficacy of microwave (MW) ablation for primary hyperparathyroidism (pHPT) in patients who are unsuited or unwilling to undergo surgery. MATERIALS AND METHODS: Fifteen patients with benign parathyroid nodules were treated with MW ablation. Ultrasound, laboratory data, and clinical symptoms were evaluated before treatment; 1 week and 1, 3, 6, and 12 months after treatment; and every 6-12 months thereafter. RESULTS: All patients were followed up for more than 1 year, with an average duration of 32.8 months ± 17.9. Eleven patients underwent successful ablation in a single session, and two patients with bilateral disease and two patients with residual disease were treated with two sessions each. The rate of complete nodule disappearance was 17.6%. Nodule volume and serum parathyroid hormone (PTH) and calcium levels were significantly lower at the last follow-up than before treatment (volume, 0.39 cm(3) ± 0.69 vs 2.62 cm(3) ± 3.32; PTH, 54.5 pg/mL ± 24.1 vs 592.5 pg/mL ± 579.1; and calcium, 2.32 mmol/L ± 0.12 vs 2.93 mmol/L ± 0.47; P < .01). Treatment was well tolerated. Minor complications included transient voice change in one patient. CONCLUSIONS: MW ablation is a safe and effective technique for the treatment of pHPT. It is a good alternative for patients who do not meet surgery criteria or decline surgery.
PURPOSE: To test the feasibility, safety, and efficacy of microwave (MW) ablation for primary hyperparathyroidism (pHPT) in patients who are unsuited or unwilling to undergo surgery. MATERIALS AND METHODS: Fifteen patients with benign parathyroid nodules were treated with MW ablation. Ultrasound, laboratory data, and clinical symptoms were evaluated before treatment; 1 week and 1, 3, 6, and 12 months after treatment; and every 6-12 months thereafter. RESULTS: All patients were followed up for more than 1 year, with an average duration of 32.8 months ± 17.9. Eleven patients underwent successful ablation in a single session, and two patients with bilateral disease and two patients with residual disease were treated with two sessions each. The rate of complete nodule disappearance was 17.6%. Nodule volume and serum parathyroid hormone (PTH) and calcium levels were significantly lower at the last follow-up than before treatment (volume, 0.39 cm(3) ± 0.69 vs 2.62 cm(3) ± 3.32; PTH, 54.5 pg/mL ± 24.1 vs 592.5 pg/mL ± 579.1; and calcium, 2.32 mmol/L ± 0.12 vs 2.93 mmol/L ± 0.47; P < .01). Treatment was well tolerated. Minor complications included transient voice change in one patient. CONCLUSIONS: MW ablation is a safe and effective technique for the treatment of pHPT. It is a good alternative for patients who do not meet surgery criteria or decline surgery.