Wu Shu-Ting, Lin Wei-Che, Lee Chih-Ying, Wang Cheng-Kang, Lin An-Ni, Chang Yen-Hsiang, Chi Shun-Yu, Chou Chen-Kai
Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2025 Jul;41(7):e70022. doi: 10.1002/kjm2.70022. Epub 2025 May 19.
Radiofrequency ablation (RFA) is increasingly recognized as a minimally invasive option for primary hyperparathyroidism (PHPT). This study aimed to evaluate the effectiveness and safety of ultrasound (US)-guided RFA for the treatment of PHPT in Taiwan. We conducted a retrospective study of patients with PHPT who underwent RFA at a single medical center between March 2020 and January 2023. Serum biochemical samples, changes in parathyroid nodule volume, symptomatic scores, and complications were analyzed at follow-up after RFA. The volume reduction ratio (VRR) and treatment response at 1 year were evaluated. Among the 31 patients, 93.55% achieved a complete response with a VRR of 97.48% at 12 months post-RFA. Serum calcium and intact parathyroid hormone (iPTH) levels were significantly lower immediately after treatment than at baseline. However, a difference in phosphorus levels was noted 1 week later, and the alkaline phosphatase (ALP) level was significantly decreased after 3 months (p < 0.05). Transient hoarseness occurred in three patients and resolved spontaneously within 6 months. US-guided RFA is effective and safe for treating PHPT, with a satisfactory VRR and treatment response. This approach could be an alternative to surgery for ineligible patients.
射频消融术（RFA）越来越被认为是原发性甲状旁腺功能亢进症（PHPT）的一种微创治疗选择。本研究旨在评估超声（US）引导下的RFA治疗台湾地区PHPT的有效性和安全性。我们对2020年3月至2023年1月在单一医疗中心接受RFA治疗的PHPT患者进行了一项回顾性研究。在RFA后的随访中分析血清生化样本、甲状旁腺结节体积变化、症状评分和并发症。评估1年时的体积缩小率（VRR）和治疗反应。在31例患者中，93.55%在RFA后12个月达到完全缓解，VRR为97.48%。治疗后血清钙和完整甲状旁腺激素（iPTH）水平立即显著低于基线水平。然而，1周后磷水平出现差异，3个月后碱性磷酸酶（ALP）水平显著降低（p<0.05）。3例患者出现短暂性声音嘶哑，并在6个月内自行缓解。超声引导下的RFA治疗PHPT有效且安全，VRR和治疗反应令人满意。这种方法可以作为不符合手术条件患者的替代治疗方法。
