Download PDF
CC BY 4.0 · The Arab Journal of Interventional Radiology 2023; 07(01): 039-043
DOI: 10.1055/s-0043-1764436
Original Article

Effectiveness and Safety of Microwave Ablation Therapy in Parathyroid Adenomas

Furkan Ertürk Urfali 
1   Deparment of Interventional Radiology, Kutahya Health Science University, Istiklal, Kutahya, Turkey
,
Bünyamin Aydin
2   Deparment of Endocrinology and Metabolic Diseases, Kutahya Health Science University, Istiklal, Kutahya, Turkey
,
Sezgin Zeren
3   Deparment of General Surgery, Kutahya Health Science University, Istiklal, Kutahya, Turkey
,
Güven Barış Cansu 
2   Deparment of Endocrinology and Metabolic Diseases, Kutahya Health Science University, Istiklal, Kutahya, Turkey
,
Mustafa Cem Algin
3   Deparment of General Surgery, Kutahya Health Science University, Istiklal, Kutahya, Turkey
,
Mehmet Korkmaz
1   Deparment of Interventional Radiology, Kutahya Health Science University, Istiklal, Kutahya, Turkey
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Objective We report the effectiveness and safety of ultrasound (US) guided microwave ablation (MWA) treatment of parathyroid adenomas.

Materials and Methods A total of 35 patients underwent US-guided MWA therapy of parathyroid adenomas. Before the procedure, blood parathyroid hormone (PTH; mean: 202.32 ± 158.46 ng/L) level, calcium (mean: 11.65 ± 0.53 mg/dL) level, and parathyroid adenoma volume (mean: 1.76 ± 0.73 cm3) were recorded. Blood parameters and US-guided follow-up evaluations were performed at 1 and 3 months after the procedure.

Results Technical success was 91% for the first session. There was a statistically significant decrease in parathyroid adenoma size and calcium and PTH levels at 3 months of follow-up (p < 0.001). A perfect positive correlation (r: 0.927; p < 0.001) was found between the ablation time and the adenoma size. Transient vocal cord paralysis occurred in two (5.7%) patients and short-term (<2 hours) local pain occurred in four (11.4%) patients after the procedure.

Conclusion US-guided MWA is effective in the treatment of parathyroid adenomas with low complication risk. Our preliminary results showed that MWA treatment resulted in an effective improvement in blood tests and adenoma size.

Keywords

ablation - parathyroid - ultrasound


Publication History

Article published online:
11 April 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Liu F, Yu X, Liu Z. et al. Comparison of ultrasound-guided percutaneous microwave ablation and parathyroidectomy for primary hyperparathyroidism. Int J Hyperthermia 2019; 36 (01) 835-840
    PubMedGoogle Scholar
  • 2 Erturk MS, Cekic B, Sarı IK, Pamuk BO. Microwave ablation as an efficient therapy for primary hyperparathyroidism: efficacy and predictors of treatment success. Int J Clin Pract 2021; 75 (10) e14580
    CrossrefPubMedGoogle Scholar
  • 3 Hamdy NA. Parathyroid gland: is parathyroidectomy safe and beneficial in the elderly?. Nat Rev Endocrinol 2009; 5 (08) 422-423
    CrossrefPubMedGoogle Scholar
  • 4 Bilezikian JP, Brandi ML, Eastell R. et al. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. J Clin Endocrinol Metab 2014; 99 (10) 3561-3569
    CrossrefPubMedGoogle Scholar
  • 5 Liu F, Zang L, Liu Y. et al. Risk factors influencing cure of ultrasound-guided microwave ablation for primary hyperparathyroidism. Int J Hyperthermia 2022; 39 (01) 258-264
    CrossrefPubMedGoogle Scholar
  • 6 Zhuo L, Peng LL, Zhang YM. et al. US-guided microwave ablation of hyperplastic parathyroid glands: safety and efficacy in patients with end-stage renal disease-a pilot study. Radiology 2017; 282 (02) 576-584
    CrossrefPubMedGoogle Scholar
  • 7 Wang G, Liu S, Liu X, Qian L, Diao Z, Liu W. Microwave ablation: an effective treatment for mild-to-moderate secondary hyperparathyroidism in patients undergoing haemodialysis. Int J Hyperthermia 2017; 33 (08) 946-952
    PubMedGoogle Scholar
  • 8 Zhuo L, Zhang L, Peng LL. et al. Microwave ablation of hyperplastic parathyroid glands is a treatment option for end-stage renal disease patients ineligible for surgical resection. Int J Hyperthermia 2019; 36 (01) 29-35
    CrossrefPubMedGoogle Scholar
  • 9 Fan BQ, He XW, Chen HH, Zhang WM, Tang W. US-guided microwave ablation for primary hyperparathyroidism: a safety and efficacy study. Eur Radiol 2019; 29 (10) 5607-5616
    CrossrefPubMedGoogle Scholar
  • 10 Liu C, Wu B, Huang P. et al. US-guided percutaneous microwave ablation for primary hyperparathyroidism with parathyroid nodules: feasibility and safety study. J Vasc Interv Radiol 2016; 27 (06) 867-875
    CrossrefPubMedGoogle Scholar
  • 11 Wahl DA, Cooper C, Ebeling PR. et al. A global representation of vitamin D status in healthy populations. Arch Osteoporos 2012; 7: 155-172
    CrossrefPubMedGoogle Scholar
  • 12 Rolighed L, Rejnmark L, Sikjaer T. et al. Vitamin D treatment in primary hyperparathyroidism: a randomized placebo controlled trial. J Clin Endocrinol Metab 2014; 99 (03) 1072-1080
    CrossrefPubMedGoogle Scholar
  • 13 Ying W, Zhen-Long Z, Xiao-Jing C, Li-Li P, Yan L, Ming-An Y. A study on the causes of operative failures after microwave ablation for primary hyperparathyroidism. Eur Radiol 2021; 31 (09) 6522-6530
    CrossrefPubMedGoogle Scholar
  • 14 Baloch ZW, LiVolsi VA. Pathology of the parathyroid glands in hyperparathyroidism. Semin Diagn Pathol 2013; 30 (03) 165-177
    CrossrefPubMedGoogle Scholar
  • 15 Insogna KL. Primary hyperparathyroidism. N Engl J Med 2018; 379 (11) 1050-1059
    CrossrefPubMedGoogle Scholar
  • 16 Carsello CB, Yen TW, Wang TS. Persistent elevation in serum parathyroid hormone levels in normocalcemic patients after parathyroidectomy: does it matter?. Surgery 2012; 152 (04) 575-581 , discussion 581–583
    CrossrefPubMedGoogle Scholar
  • 17 Diao Z, Liu X, Qian L, Liu J, Liu S, Liu W. Efficacy and its predictor in microwave ablation for severe secondary hyperparathyroidism in patients undergoing haemodialysis. Int J Hyperthermia 2016; 32 (06) 614-62
    CrossrefPubMedGoogle Scholar