US-Guided Percutaneous Microwave Ablation for Primary Hyperparathyroidism with Parathyroid Nodules: Feasibility and Safety Study.
OBJECTIVE
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.


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.
Department of Ultrasound, First People's Hospital of Jingzhou, Yangtze University, Jingzhou, China.
Can
C
Liu
Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Bin
B
Wu
Department of Ultrasound, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Pintong
P
Huang
Department of Ultrasound, First People's Hospital of Jingzhou, Yangtze University, Jingzhou, China.
Qian
Q
Ding
Department of Ultrasound, First People's Hospital of Jingzhou, Yangtze University, Jingzhou, China.
Lei
L
Xiao
Department of Ultrasound, First People's Hospital of Jingzhou, Yangtze University, Jingzhou, China.
Mei
M
Zhang
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.
Jing
J
Zhou
D055011:Ablation Techniques / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery*; D010281:Parathyroid Hormone / Q000097:blood; D011183:Postoperative Complications / Q000209:etiology; D012074:Remission Induction; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional
D015415:Biomarkers; C470125:PTH protein, human; D010281:Parathyroid Hormone; D002118:Calcium