Document Detail


High-intensity focused ultrasound to treat primary hyperparathyroidism: a feasibility study in four patients.
MedLine Citation:
PMID:  20858805     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Many patients with primary hyperparathyroidism either decline or are not candidates for surgical parathyroidectomy. There are drawbacks to medical therapy as well as percutaneous ethanol injection as alternative therapies for primary hyperparathyroidism. Therefore, in this pilot study, our aim was to test the feasibility, safety, and efficacy of a newly developed noninvasive high-intensity focused ultrasound (HIFU) technique for the nonsurgical management of primary hyperparathyroidism. SUBJECTS AND METHODS: We treated four menopausal women with biochemical, sonographic, and cytologic evidence of benign primary hyperparathyroidism. HIFU treatment was performed in two sessions using TH-One under sonographic guidance and with the patient under conscious sedation. Parathyroid volume and function were evaluated at baseline and repeatedly until 12 months after the second HIFU session. RESULTS: Serum parathyroid hormone levels decreased in all four patients and normalized 1 and 8 months after the second HIFU session in two patients. Serum calcium levels decreased in all patients and normalized in three patients. Three of four parathyroid tumors had decreased in size by 11%, 43%, and 79%, respectively, 12 months after the second HIFU session. All adverse events related to HIFU were transient: mild subcutaneous edema in three patients and impaired vocal cord mobility in one patient that resolved 40 days later. CONCLUSION: HIFU is a promising procedure for patients with primary hyperparathyroidism that may become an alternative to established options, especially in elderly patients with comorbidities, or in patients who decline surgery. Large-scale long-term studies including patients with secondary and tertiary hyperparathyroidism are warranted.
Authors:
Roussanka D Kovatcheva; Jordan D Vlahov; Alexander D Shinkov; Anna-Maria Borissova; Joo Ha Hwang; Françoise Arnaud; Laszlo Hegedüs
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  195     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-22     Completed Date:  2010-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  830-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Thyroid and Bone Mineral Diseases, Clinical Center of Endocrinology, Sofia Medical University, 1431 Sofia, Bulgaria. roussanka_kov@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Feasibility Studies
Female
High-Intensity Focused Ultrasound Ablation* / adverse effects
Humans
Hyperparathyroidism, Primary / therapy*
Middle Aged
Pilot Projects

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