High-intensity focused ultrasound as an alternative to the surgical approach in primary hyperparathyroidism: A preliminary experience

• Published in: Journal of endocrinological investigation 2011-10, Vol.34 (9), p.655-659
• Main Authors: Ambrosini, C. E., Cianferotti, L., Picone, A., Torregrossa, L., Segnini, G., Frustaci, G., Cetani, F., Basolo, F., Marcocci, C., Miccoli, P.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Endocrinology; Female; High-Intensity Focused Ultrasound Ablation - adverse effects; High-Intensity Focused Ultrasound Ablation - utilization; Humans; Hyperparathyroidism, Primary - diagnostic imaging; Hyperparathyroidism, Primary - pathology; Hyperparathyroidism, Primary - surgery; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Parathyroid Glands - diagnostic imaging; Parathyroid Glands - pathology; Parathyroid Glands - surgery; Parathyroid Hormone - blood; Pilot Projects; Prospective Studies; Rapid Communication; Treatment Outcome; Ultrasonography; Vocal Cord Paralysis - etiology
• ISSN: 0391-4097; 1720-8386
• DOI: 10.1007/BF03345404

Background : Surgery is the therapy of choice in primary hyperparathyroidism (PHPT), although other less invasive techniques have been used in the attempt to cure the disease. Recently, high-intensity focused ultrasound (HIFU), a totally non-invasive technique, has become available to cure solid tumors. Aim : The aim of this pilot study has been to assess the safety and efficacy of HIFU in symptomatic patients with PHPT. Material and methods : Four out of 31 patients with surgical indications within a cohort of 47-screened patients with PHPT were considered eligible for the study. All patients accepted to participate and were submitted to HIFU treatment in a single session. One patient was submitted to surgery after HIFU treatment. Patients were followed-up for 12 months after the procedure. Results : A persistent or a partial remission of the disease, respectively, were obtained in 2 patients (50%), including the one who underwent surgery after HIFU treatment. Safety was assessed performing laryngoscopy in all patients after HIFU procedure. A transient vocal cord paralysis was observed in all patients treated by HIFU only. No permanent side effects were observed in the long term. Conclusions : HIFU might be a promising technique in treating PHPT, provided that further development of the software decreases the rate of side effects and improves the short- and long-term efficacy.