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

J Endocrinol Invest. 2011 Oct;34(9):655-9. doi: 10.1007/BF03345404.

Abstract

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.

MeSH terms

  • Adult
  • Aged
  • Female
  • High-Intensity Focused Ultrasound Ablation / adverse effects
  • High-Intensity Focused Ultrasound Ablation / statistics & numerical data*
  • Humans
  • Hyperparathyroidism, Primary / diagnostic imaging*
  • Hyperparathyroidism, Primary / pathology
  • Hyperparathyroidism, Primary / surgery*
  • Male
  • Middle Aged
  • Parathyroid Glands / diagnostic imaging*
  • Parathyroid Glands / pathology*
  • Parathyroid Glands / surgery
  • Parathyroid Hormone / blood
  • Pilot Projects
  • Prospective Studies
  • Treatment Outcome
  • Ultrasonography
  • Vocal Cord Paralysis / etiology

Substances

  • Parathyroid Hormone