Ultrasound-guided ethanol injection for the treatment of parathyroid adenoma: A prospective self-controlled study

(2020) Ultrasound-guided ethanol injection for the treatment of parathyroid adenoma: A prospective self-controlled study. Journal of Research in Medical Sciences. ISSN 1735-1995

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Abstract

Background: Parathyroidectomy, the standard treatment of primary hyperparathyroidism (PHP) due to parathyroid adenoma, is not suitable for all patients. We evaluated the efficacy of ultrasound-guided ethanol ablation of parathyroid adenoma in a group of patients with PHP. Materials and Methods: In a prospective self-controlled trial, 39 patients with parathyroid adenoma, who were not candidates for surgery, were enrolled. Ethanol injections were performed by two experienced interventional radiologists under the guidance of real-time ultrasonography. Adenoma size changes were assessed at about 1 month later. Serum levels of parathyroid hormone, calcium, phosphate, 25-OH Vitamin D, and alkaline phosphatase were evaluated at the baseline, 1, 3, 6, and 12 months after the injections. The treatment effects on outcome variables were assessed by repeated measures analysis. Results: Volume of the adenomas decreased during the study period from 1.87 +/- 6.45 cm3 to 0.38 +/- 0.48cm3 (P < 0.001). Corrected serum calcium levels decreased from 10.40 +/- 0.96 mg/dl to 8.82 +/- 0.58 mg/dl (P < 0.001), and remained stable during one year follow-up. Serum levels of parathyroid hormone decreased gradually from 129.85 +/- 63.37 to 72.58 +/- 53.86 pg/mL after 3 months and to 44.78 +/- 28.04 pg/mL after 1 year (P < 0.001). Overall, 46 of the patients improved after 1 month of ethanol ablation therapy which increased to 84.5 during 1-year follow-up. No major complications were observed. Conclusion: The current study showed the efficacy of ultrasound-guided ethanol injection in PHP and may be considered as a suitable alternative treatment in patients who are not candidates for the surgery. It has also a good safety profile without major complications if performed by experienced hands.

Item Type: Article
Keywords: Ethanol ablation hypercalcemia parathyroid adenoma primary hyperparathyroidism PRIMARY HYPERPARATHYROIDISM ABLATION MANAGEMENT THERAPY
Subjects: WD Disorders of Systemic, Metabolic or Environmental Origin, etc. > WD 200-226 Metabolic Diseases
Divisions: Faculty of Medicine > Departments of Clinical Sciences > Department of Internal
Isfahan Endocrine and Metabolism Research Center
Research Institute for Primordial Prevention of Non-communicable Disease > Child Growth and Development Research Center
Journal or Publication Title: Journal of Research in Medical Sciences
Journal Index: ISI
Volume: 25
Identification Number: https://doi.org/10.4103/jrms.JRMS₅₅₃₁₉
ISSN: 1735-1995
Depositing User: Zahra Otroj
URI: http://eprints.mui.ac.ir/id/eprint/13871

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