Department of Interventional Ultrasound, The Fifth Medical Center, Chinese PLA General Hospital, NO.28 Fuxing Road, Beijing, 100853, China.
Department of Ultrasound, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China.
Eur Radiol. 2022 Nov;32(11):7743-7754. doi: 10.1007/s00330-022-08851-y. Epub 2022 May 20.
To prospectively investigate the efficacy and safety of ultrasound (US)-guided microwave ablation (MWA) and radiofrequency ablation (RFA) for primary hyperparathyroidism (PHPT).
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.
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%).
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.
• 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).
前瞻性研究超声引导微波消融（MWA）和射频消融（RFA）治疗原发性甲状旁腺功能亢进症（PHPT）的疗效和安全性。
我们在五家中心进行了一项关于 MWA 和 RFA 治疗 PHPT 的前瞻性多中心研究，研究时间为 2017 年 8 月至 2020 年 10 月。在消融术前和术后进行实验室检测，并至少随访 6 个月。主要结局是治愈率。次要结局是消融后血清甲状旁腺激素（PTH）、钙、磷和碱性磷酸酶水平的动态变化和并发症。
共纳入 132 名（平均年龄 57.33±13.90 岁）接受 MWA 或 RFA 治疗的 141 个甲状旁腺结节（最大直径中位数 1.55cm）的参与者。该技术的成功率为 99.29%（140/141）。随访时间为 6-36 个月（中位数 12 个月）。治愈率为 80.30%（106/132）。术前 PTH 水平是与治愈率相关的独立因素（优势比（OR），0.22；95%可信区间，0.07-0.69；p=0.0090）。MWA 组与 RFA 组的治愈率无差异（80.22% vs. 80.49%，p=0.971）。唯一的主要并发症是声音嘶哑（5.30%）。
超声引导下 MWA 和 RFA 治疗 PHPT 是治疗 PHPT 的一种有效、安全的方法。术前 PTH 水平是影响 MWA 和 RFA 后治愈率的关键因素。
