title: High-intensity focused ultrasound as an alternative to the surgical approach in primary hyperparathyroidism: a preliminary experience.
abstract: BACKGROUND
  Surgery is the therapy of choice in primary hyperparathyroidism (PHPT), although other less invasive techniques have been used in the attempt to cure the disease. Recently, high-intensity focused ultrasound (HIFU), a totally non-invasive technique, has become available to cure solid tumors.
  
  
  OBJECTIVE
  The aim of this pilot study has been to assess the safety and efficacy of HIFU in symptomatic patients with PHPT.
  
  
  METHODS
  Four out of 31 patients with surgical indications within a cohort of 47-screened patients with PHPT were considered eligible for the study. All patients accepted to participate and were submitted to HIFU treatment in a single session. One patient was submitted to surgery after HIFU treatment. Patients were followed-up for 12 months after the procedure.
  
  
  RESULTS
  A persistent or a partial remission of the disease, respectively, were obtained in 2 patients (50%), including the one who underwent surgery after HIFU treatment. Safety was assessed performing laryngoscopy in all patients after HIFU procedure. A transient vocal cord paralysis was observed in all patients treated by HIFU only. No permanent side effects were observed in the long term.
  
  
  CONCLUSIONS
  HIFU might be a promising technique in treating PHPT, provided that further development of the software decreases the rate of side effects and improves the short- and long-term efficacy.
authors.affiliation: Department of Surgery, University of Pisa, Via Paradisa, Pisa, Italy.
authors.forename: C E
authors.initials: CE
authors.lastname: Ambrosini
authors.forename: L
authors.initials: L
authors.lastname: Cianferotti
authors.forename: A
authors.initials: A
authors.lastname: Picone
authors.forename: L
authors.initials: L
authors.lastname: Torregrossa
authors.forename: G
authors.initials: G
authors.lastname: Segnini
authors.forename: G
authors.initials: G
authors.lastname: Frustaci
authors.forename: F
authors.initials: F
authors.lastname: Cetani
authors.forename: F
authors.initials: F
authors.lastname: Basolo
authors.forename: C
authors.initials: C
authors.lastname: Marcocci
authors.forename: P
authors.initials: P
authors.lastname: Miccoli
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D010281:Parathyroid Hormone / Q000097:blood; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D014826:Vocal Cord Paralysis / Q000209:etiology
chemical_list: D010281:Parathyroid Hormone