Korean J Radiol.  2020 Apr;21(5):572-581. 10.3348/kjr.2019.0593.

Clinical Study on Safety and Efficacy of MicrowaveAblation for Primary Hyperparathyroidism

• Wei Y
• Peng L
• Li Y
• Zhao Zl
• Yu Ma

• KMID: 2500039
• DOI: http://doi.org/10.3348/kjr.2019.0593

Abstract

Objective
To evaluate the safety, feasibility, and efficacy of microwave ablation (MWA) for the treatment of primary hyperparathyroidism (PHPT).
Materials and Methods
This study enrolled 67 PHPT patients (22 men, 45 women; mean age, 56.0 ± 16.3 years; range, 18– 83 years) from January 2015 to December 2018. The laboratory data, including the serum intact parathyroid hormone (iPTH), calcium, phosphorus, and alkaline phosphatase (ALP) levels, were evaluated before MWA and again 2 hours, 1 day, 7 days, 1 month, 3 months, 6 months, 12 months, 18 months, and 24 months after.
Results
Complete ablation was achieved with all 72 hyperplastic parathyroid glands found on the 67 patients enrolled, 64 of whom were treated in one session and 3 were treated over two sessions. The technical success rate was 100%. The median follow-up time was 13.6 months (range, 10.0–31.1 months). The clinical success rate was 89.4%. The volume reduction rate was 79.4% at 6 months. Compared to pre-MWA, the serum iPTH, calcium, phosphorus, and ALP levels had significantly improved 6 months post-MWA (iPTH, 157.3 pg/mL vs. 39.2 pg/mL; calcium, 2.75 ± 0.25 mmol/L vs. 2.34 ± 0.15 mmol/L; phosphorus, 0.86 ± 0.20 mmol/L vs. 1.12 ± 0.22 mmol/L; ALP, 79 U/L vs. 54 U/L, respectively; all, p < 0.01). Hoarseness was a major complication in 4 patients (6.0%), but it improved spontaneously within 2–3 months.
Conclusion
MWA is safe, feasible, and effective for the treatment of PHPT.

Keyword

Microwave ablation; Primary hyperparathyroidism; Intact parathyroid hormone