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Ultrasound-guided microwave and radiofrequency ablation for primary hyperparathyroidism: a prospective, multicenter study

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Abstract

Objectives

To prospectively investigate the efficacy and safety of ultrasound (US)-guided microwave ablation (MWA) and radiofrequency ablation (RFA) for primary hyperparathyroidism (PHPT).

Methods

We performed a prospective multicenter study of MWA and RFA for PHPT between August 2017 and October 2020 at five centers. Laboratory testing was performed pre- and post-ablation and followed for at least 6 months. The primary outcome was the cure rate. Secondary outcomes were complications and dynamic changes in serum levels of PTH, calcium, phosphorus, and ALP after ablation.

Results

A total of 132 participants (mean age, 57.33 ± 13.90 years), with 141 parathyroid nodules (median maximal diameter, 1.55 cm) undergoing either MWA or RFA, were enrolled in the study. The technique success rate was 99.29% (140/141). The follow-up period was 6–36 months (median, 12 months). The cure rate was 80.30% (106/132). Pre-ablation PTH level was the independent factor associated with cure rate (Odds ratio (OR), 0.22; 95% CI, 0.07–0.69; p = 0.0090). There was no difference in cure rate between the MWA group and the RFA group (80.22% vs. 80.49%, p = 0.971). The only main complication was hoarseness (5.30%).

Conclusions

US-guided MWA and RFA for PHPT is an effective and safe procedure in the treatment of PHPT. Pre-ablation PTH level is the key factor affecting the cure rate after MWA and RFA.

Key Points

• To our knowledge, this is the first prospective multicenter clinical trial with ultrasound-guided MWA and RFA for primary hyperparathyroidism.

• There was no difference in cure rate between the MWA and RFA groups for primary hyperparathyroidism. The overall cure rate was 80.30%.

• Pre-ablation PTH level was the independent factor associated with cure rate (odds ratio (OR), 0.22; 95% CI, 0.07–0.69; p = 0.0090).

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Abbreviations

CNB:

Core needle biopsy

CT:

Computed tomography

DXA:

Dual-emission X-ray absorptiometry

HIFU:

High intensity focus ablation

MR:

Magnetic resonance

MWA:

Microwave ablation

PEI:

Percutaneous ethanol injection

PHPT:

Primary hyperparathyroidism

RFA:

Radiofrequency ablation

RLN:

Recurrent laryngeal nerve

US:

Ultrasound

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Acknowledgments

We thank all the participants in this study. We thank all the clinical staff who made sample collection possible.

Funding

This study was funded by the National Key R&D Program of China (2017YFC01) and the National Scientific Foundation Committee of China (grant number 81871375).

Author information

Authors and Affiliations

  1. Department of Interventional Ultrasound, The Fifth Medical Center, Chinese PLA General Hospital, NO.28 Fuxing Road, Beijing, 100853, China

    Fangyi Liu, Yang Liu, Zhiyu Han, Jie Yu & Ping Liang

  2. Department of Ultrasound, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China

    Chengzhong Peng

  3. Department of Interventional Medicine, China-Japan Friendship Hospital, No. 2 Ying-hua-yuan East Street, Chao-yang district, Beijing, 100029, China

    Mingan Yu

  4. Shengli Clinical Medical College of Fujian Medical University, Department of Ultrasonography, Fujian Provincial Hospital, Fuzhou, 350001, China

    Songsong Wu

  5. Department of Ultrasound, Capital Medical University, Beijing Friendship Hospital, Beijing, China

    Linxue Qian

  6. Graduate Department, Bengbu Medical College, Bengbu, 233000, Anhui, China

    Huihui Chai

Authors
  1. Fangyi Liu
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  2. Yang Liu
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  3. Chengzhong Peng
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  4. Mingan Yu
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  5. Songsong Wu
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  6. Linxue Qian
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  7. Zhiyu Han
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  8. Jie Yu
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  9. Huihui Chai
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  10. Ping Liang
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Corresponding author

Correspondence to Ping Liang.

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Guarantor

The scientific guarantor of this publication is Ping Liang.

Conflict of interest

The authors declare no competing interests.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

The research protocol was approved by the medical ethics boards of PLA General Hospital (S2017-058-03).

Methodology

• Prospective

• observational

• multicenter study

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Liu, F., Liu, Y., Peng, C. et al. Ultrasound-guided microwave and radiofrequency ablation for primary hyperparathyroidism: a prospective, multicenter study. Eur Radiol 32, 7743–7754 (2022). https://doi.org/10.1007/s00330-022-08851-y

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  • DOI: https://doi.org/10.1007/s00330-022-08851-y

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