Radiofrequency Ablation of Parathyroid Adenomas: Safety and Efficacy in a Study of 10 Patients

Khandelwal, Anubhav; Batra, Smarth; Jajodia, Surabhi; Gupta, Saurabh; Khandelwal, Rohit; Kapoor, Ankur; Mishra, Sunil Kumar; Baijal, Sanjay Saran

doi:10.4103/ijem.ijem_671_20

Cited by 16 publications

(3 citation statements)

References 42 publications

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“…RFA has been recently introduced as an alternative treatment modality for PHPT ( technical success and 100% (10 of 10) biochemical remission for a short-term follow-up, and that the complication rate was 10% (1 of 10) with voice change. The complication was spontaneously resolved within three weeks (11). Previous studies, however, had some limitations, including small sample sizes (< 30 cases) and short-term follow-up periods (< 1 year).…”

Section: Discussionmentioning

confidence: 92%

Combination Therapy of Ethanol Ablation and Radiofrequency Ablation to Treat Parathyroid Adenoma in a Case with Primary Hyperparathyroidism

Lee

Jeong

2022

Iran J Radiol

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Introduction: Ethanol ablation (EA) and radiofrequency ablation (RFA) are minimal invasive therapeutic modalities to treat primary hyperparathyroidism (PHPT). Case Presentation: A 77-year-old man presented a 3.5-cm parathyroid adenoma with mixed cystic and solid components. He was ineligible for parathyroidectomy because of his age and the surgical history of the coronary artery bypass graft. First, EA was performed to remove cystic component. After that, the volume of parathyroid adenoma was decreased (volume reduction rate: 94%); however, the level of serum parathyroid hormone (PTH) was persistently high (88 pg/mL). Subsequent RFA was performed to remove the remaining parathyroid adenoma. Further, it was completely disappeared on the following ultrasound examination, and PTH was normalized. The results during a 2-year follow-up confirmed clinical success, and no relevant complication was reported. Conclusion: The combination therapy of EA and subsequent RFA is safe and effective as an alternative therapeutic method to treat PHPT in patients ineligible for parathyroidectomy.

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Section: Discussionmentioning

confidence: 92%

Combination Therapy of Ethanol Ablation and Radiofrequency Ablation to Treat Parathyroid Adenoma in a Case with Primary Hyperparathyroidism

Lee

Jeong

2022

Iran J Radiol

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“…Since US-guided RFA was first used successfully in 2002 by Hänsler et al [ 17 ]. as a treatment for single parathyroid adenoma in humans, RFA has emerged as a novel method for managing PHPT [ 16 18 19 ]. However, to the best of our knowledge, no prospective studies have reported on patients who underwent RFA for PHPT.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Ultrasound-Guided Radiofrequency Ablation for Primary Hyperparathyroidism: A Prospective Study

et al. 2022

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Objective To assess the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) in patients with primary hyperparathyroidism (PHPT). Materials and Methods This prospective study enrolled 39 participants (14 male, 25 female; mean age, 59.5 ± 15.3 [range, 18–87] years) between September 1, 2018, and January 31, 2021. All participants had parathyroid lesions causing PHPT, proven biochemically and through imaging. The imaging features of the PHPT nodules, including the shape, margin, size, composition, and location, were evaluated before treatment. Serum intact parathyroid hormone, calcium, and phosphorus levels; parathyroid nodule volume; and PHPT-related symptoms were recorded before and after treatment. We calculated the technical success, biochemical cure, and clinical cure rates for these patients. Complications were evaluated during and after the ablation. Results Complete ablation was achieved in 38 of the 39 nodules in the 39 enrolled participants. All the patients were treated in one session. The technical success rate was 97.4% (38/39). The mean follow-up duration was 13.2 ± 4.6 (range, 6.0–24.9) months. At 6 and 12 months post-RFA, the biochemical cure rates were 82.1% (32/39) and 84.4% (27/32), respectively, and the clinical cure rates were 100% (39/39) and 96.9% (31/32), respectively. Only 2.6% (1/39) of the patients had recurrent PHPT. At 1, 3, 6, and 12 months after technically successful RFA, 44.7% (17/38), 34.3% (12/35), 15.8% (6/38), and 12.5% (4/32) of participants, respectively, had elevated eucalcemic parathyroid hormone levels. Recurrent laryngeal nerve paralysis occurred in 5.1% (2/39) of the patients, who recovered spontaneously within 1–3 months. Conclusion US-guided RFA was effective and safe for PHPT patients. RFA may be an alternative treatment tool for patients who cannot tolerate or refuse to undergo surgery.

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“…Radiofrequency ablation (RFA) was rst reported in 2002 by Hänsler et al for the treatment of single parathyroid adenoma in humans, producing satisfactory biochemical results and leading to improvements in clinical symptoms (14). To date, only a limited number of studies have reported on patients undergoing RFA for PHPT (15,16,17). Ultrasound-guided (US-guided) RFA has been used for the treatment of secondary hyperparathyroidism in our department since 2013.…”

Section: Introductionmentioning

confidence: 99%

Analyses of Predictive Factors Associated with Hypocalcemia and Elevated iPTH with Normocalcemia after Ultrasound-guided Radiofrequency Ablation for Primary Hyperparathyroidism

Chai

Zhao

et al. 2021

Preprint

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Purpose To assess the feasibility of ultrasound-guided (US-guided) radiofrequency ablation (RFA) for primary hyperparathyroidism (PHPT) and determine predictive factors for hypocalcemia and elevated serum intact parathyroid hormone(ePTH) with normocalcemia after ablation. Materials and Methods Between January 2015 and January 2021, data from 44 patients with PHPT who were treated with US-guided RFA were retrospectively evaluated. Serum intact parathyroid hormone(iPTH), total calcium (Ca), phosphorus, alkaline phosphatase (ALP), and 25-hydroxyvitamin D3 (25(OH)D3) levels and the volume of the abnormal enlarged parathyroid glands were recorded before RFA. Changes in iPTH and Ca levels at 1 and 3 days, and, 1, 3, and 6 months after ablation were recorded. Results Overall, thirteen patients developed hypocalcemia 1–3 days after RFA. ePTH with normocalcemia developed in 17 patients 1 month after RFA. Thirty-two patients were followed up for more than 6 months, and 27 of these patients had sustained normalized values for both serum iPTH and Ca levels more than 6 months after RFA. There were significantly more patients who developed hypocalcaemia, when the baseline ALP was greater than 261.5 U/L (sensitivity 61.5%, specificity 100.0%). The risk of ePTH decreased by 21.7% for every 1 ng/mL increase in 25 (OH) D3. The risk of ePTH was increased when a patient's serum iPTH was higher than 172.4 pg/mL (sensitivity 88.2%, specificity 76.2%). Conclusions US-guided RFA is feasible for clinical management of PHPT patients. Hypocalcaemia following RFA was associated with higher pre-RFA serum ALP levels. Elevated iPTH levels with normocalcemia at 1 month after RFA were associated with pre-RFA vitamin D deficiency and higher baseline iPTH levels. Patients with higher serum ALP and iPTH and lower 25 (OH) D3 levels before RFA need to be managed carefully and monitored closely after RFA of PHPT.

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Radiofrequency Ablation of Parathyroid Adenomas: Safety and Efficacy in a Study of 10 Patients

Cited by 16 publications

References 42 publications

Combination Therapy of Ethanol Ablation and Radiofrequency Ablation to Treat Parathyroid Adenoma in a Case with Primary Hyperparathyroidism

Combination Therapy of Ethanol Ablation and Radiofrequency Ablation to Treat Parathyroid Adenoma in a Case with Primary Hyperparathyroidism

Efficacy and Safety of Ultrasound-Guided Radiofrequency Ablation for Primary Hyperparathyroidism: A Prospective Study

Analyses of Predictive Factors Associated with Hypocalcemia and Elevated iPTH with Normocalcemia after Ultrasound-guided Radiofrequency Ablation for Primary Hyperparathyroidism

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