Purpose: To retrospectively evaluate the outcomes of ultrasonography (US)-guided radiofrequency ablation (RFA) of parathyroid adenoma in patients who were ineligible for surgery
Materials and method: Between October 2010 and June 2016, six parathyroid adenomas (mean diameter, 2.0 cm; range, 1.2-3.8 cm) in six patients with primary hyperparathyroidism were treated with US-guided RFA by two radiologists in two hospitals. The inclusion criteria for this study were (1) primary hyperparathyroidism, (2) pathologically confirmed parathyroid adenoma on US-guided fine-needle aspiration, and (3) refusal- or ineligibility- for surgery. RFA was performed using a RF generator and 19-gauge internally cooled electrode. The hydrodissection technique using the 5% dextrose water was applied in all patients. The medical records were reviewed and analysed, focusing on the procedural profiles of RFA, symptoms and complications during and after RFA, and changes in hormone levels on follow-up US.
Results: Before RFA, the mean nodule volume was 1.0 ± 0.5 mL. The mean parathyroid hormone (PTH) level was 210.4 ± 283.9 pg/mL and calcium level was 10.4 ± 0.9 mg/dL. At 1- and 6- month follow-up after RFA, a significant reduction in the mean volume (78.4 ± 3.7% and 89.1 ± 8.4 %, respectively) was noted and five ablation zones (5/6, 83.3%) near completely disappeared (<=0.1mL). The mean PTH level was decreased to the normal range (50.9 ± 6.5 pg/mL) at 1-month follow-up and were progressively decreased at 6-month follow-up in 5 patients (40.1 ± 7.3 pg/mL). The PTH level in one patient was re-increased from 48 pg/mL to the 241 pg/mL at 6-month follow-up. The mean calcium level was decreased to 9.3 ± 0.8 mg/dL at 6-month follow-up. There was no immediate complication during- and after- the procedure.
Conclusion: RFA might represent an effective and a safe alternative for managing parathyroid adenomas, especialy in patients ineligible for surgery