Bone Turnover Markers in Response to Ultrasound-Guided Microwave Ablation for Primary Hyperparathyroidism

Ni, Wenjing; Yuan, Yue; Chu, Xiaoqiu; Chen, Guofang; Han, Xue; Li, Jie; Wu, Xinping; Wang, Jianhua; Liu, Chao; Xu, Shuhang

doi:10.3389/fendo.2021.782050

Cited by 5 publications

(6 citation statements)

References 40 publications

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“…The therapeutic efficacy of MWA on PHPT is comparable to that of surgery. The success rate of MWA in the treatment of PHPT is low in some reports, ranging 62.5-63.6% ( 9 , 36 ). In addition, the incidence of complication of MWA (6.7%) is lower than that of surgery ( 35 ).…”

Section: Discussionmentioning

confidence: 97%

“…In addition, the incidence of complication of MWA (6.7%) is lower than that of surgery ( 35 ). In our previous study, we assessed PTH, serum calcium and VRR in 20 PHPT patients treated with ultrasound-guided MWA from May 2019 to March 2021, and the technical and clinical success rates were 100% and 63.6%, respectively ( 9 ). All PHPT-related symptoms were cured after MWA, and severe complications like permanent nerve damage and permanent hypoparathyroidism were not reported.…”

Section: Discussionmentioning

confidence: 99%

“…The patient was intervened by MWA for supplementary therapy after being fully informed of therapeutic efficacy and potential risks. The MWA for bilateral parathyroid glands was guided by intraoperative ultrasound, as previously reported ( 9 ). The MWA system (KY-2000) was produced by Canyon Medical Inc. (Nanjing, China).…”

Section: Case Presentationmentioning

confidence: 99%

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Ultrasound-guided microwave ablation in the treatment of recurrent primary hyperparathyroidism in a patient with MEN1: a case report

Liu,

Zhao,

Han

et al. 2023

Front. Endocrinol.

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BackgroundMultiple endocrine neoplasia type 1 (MEN1) is an inherited endocrine syndrome caused by the mutation in the tumor suppressor gene MEN1. The recurrence rate of primary hyperparathyroidism (PHPT) in patients with MEN1 after parathyroidectomy remains high, and the management of recurrent hyperparathyroidism is still challenging.Case presentationWe reported a 44-year-old woman with MEN1 combined with PHPT who was diagnosed through genetic screening of the patient and her family members. After parathyroidectomy to remove one parathyroid gland, the patient suffered from persistent high levels of serum calcium and parathyroid hormone, which returned to normal at up to 8 months after ultrasound-guided microwave ablation (MWA) for bilateral parathyroid glands, suggesting an acceptable short-term prognosis.ConclusionUltrasound-guided MWA for parathyroid nodules may be an effective therapeutic strategy for recurrent PHPT in MEN1 patients.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Ultrasound-guided microwave ablation in the treatment of recurrent primary hyperparathyroidism in a patient with MEN1: a case report

Liu,

Zhao,

Han

et al. 2023

Front. Endocrinol.

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“…Due to the controllable power, ablation time, and ablation range, electromagnetic microwaves remarkably reduce the stimulation and damage to the normal thyroid and surrounding tissues. Our previous studies have shown the acceptable efficacy and safety of MWA on benign thyroid nodules, papillary thyroid microcarcinoma (PTMC), and primary hyperparathyroidism (PHPT) (5,20,21). The median VRR of benign thyroid nodules at 6 months and 12 months of MWA reaches 75.9% and 86.67%, respectively (5).…”

Section: Discussionmentioning

confidence: 99%

The influence of nodule size on clinical efficacy of ethanol ablation and microwave ablation on cystic or predominantly cystic thyroid nodules

Zhang

Chu

Liu

et al. 2022

Endocrine Connections

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Objective: To compare the efficacy and safety of ethanol ablation (EA) and microwave ablation (MWA) in the treatment of cystic or predominantly cystic thyroid nodules. Methods: Patients with cystic or predominantly cystic thyroid nodules intervened with EA or MWA were retrospectively enrolled and divided into EA group (n=30) and MWA group (n=31). The volume and volume reduction rate (VRR) of thyroid nodules before ablation, and at 3 months and 12 months after ablation were compared between the two groups. The effective rate (ER) and incidence of adverse events in both groups were recorded. Results: The median VRR and ER at 3 months after ablation were significantly higher in EA group than in MWA group (81.30% vs. 75.76%, P=0.011; 76.67% [23/30] vs. 51.61% [16/31], P=0.040), while no significant difference was detected at 12 months (93.39% vs. 88.78%, P=0.141; 86.67% [26/30] vs. 87.10% [27/31], P=0.960). The median VRR of small nodules in EA group was significantly higher than that in MWA group (81.30% vs. 71.18%, P=0.006; 93.40% vs. 83.14%, P=0.032). There was no significant difference of median VRR of medium nodules at final follow-up between MWA and EA group (93.01% vs. 89.68%, P=0.482). Serious adverse events were not reported in both groups. Conclusion: EA and MWA are both effective and safe in the treatment of cystic or predominantly cystic thyroid nodules. EA is more cost-effective and effective than MWA for small nodules, but it requires more cycles of treatment and may pose a higher risk of postoperative pain compared with MWA.

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“…Only a limited number of studies have examined the changes in bone turnover markers and BMD improvement in patients with PHPT treated with microwave ablation (MWA) ( 9 , 10 ), and its treatment effect has not yet been fully investigated. In light of this, we conducted an open-label prospective study to evaluate the effects of radiofrequency ablation (RFA) using observations of bone turnover markers and BMD in patients with mild PHPT.…”

Section: Introductionmentioning

confidence: 99%

Changes in bone turnover markers and bone mineral density after radiofrequency ablation for mild primary hyperparathyroidism: a prospective cohort study

Han,

Xue,

Liang

et al. 2024

Quant Imaging Med Surg

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Background The application of radiofrequency ablation (RFA) is becoming increasingly widespread in the treatment of primary hyperparathyroidism (PHPT). However, the effect of RFA treatment on the skeleton in mild PHPT remains unclear. Therefore, the aim of this study was to investigate the change in bone turnover markers and bone mineral density (BMD) before and 2 years after RFA in patients with mild PHPT. Methods In this open-label, prospective study, 81 patients with mild PHPT including 36 treated with RFA and 45 observed without intervention (OBS), along with 81 age-matched healthy controls, were enrolled from November 2018 to September 2021 at Gansu Provincial Hospital. The main outcome measures were levels of serum calcium, serum intact parathyroid hormone (iPTH), and bone turnover markers, including bone-specific alkaline phosphatase (ALP), C-terminal cross-linking telopeptides of type I collagen (β-CTx), and osteocalcin (OC). BMD (femoral neck and lumbar spine) was measured with dual-energy X-ray absorptiometry, and spine radiographs were obtained for vertebral fracture assessment. Paired and unpaired two-tailed t -tests and Spearman rank correlation coefficient were used for statistical analyses. Results Normalized outcomes for both iPTH and calcium levels were achieved in 32 of 36 (88.9%) patients with mild PHPT treated with RFA. There was a significant treatment effect of RFA on bone turnover biomarkers compared with OBS before the treatment (P=0.04) and at the end of follow-up or (P=0.03). BMD of the lumbar spine increased by 1.8% (P=0.03) and remained stable in the femoral neck (P=0.17) after RFA. However, there was an obvious treatment effect of RFA on BMD compared with OBS (P 0.04). The only compartment with a T-score increase in the RFA group was the lumbar spine in (P<0.001). There was no difference in fracture frequency between groups during the follow-up period. Conclusions RFA can improve serum bone turnover markers in patients with mild PHPT and can be expected to increase BMD in the L1–L4 vertebrae and preserve BMD in the femoral neck. Whether RFA can reduce fracture risk in the long-term is a clinical concern for patients with mild PHPT.

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Bone Turnover Markers in Response to Ultrasound-Guided Microwave Ablation for Primary Hyperparathyroidism

Cited by 5 publications

References 40 publications

Ultrasound-guided microwave ablation in the treatment of recurrent primary hyperparathyroidism in a patient with MEN1: a case report

Ultrasound-guided microwave ablation in the treatment of recurrent primary hyperparathyroidism in a patient with MEN1: a case report

The influence of nodule size on clinical efficacy of ethanol ablation and microwave ablation on cystic or predominantly cystic thyroid nodules

Changes in bone turnover markers and bone mineral density after radiofrequency ablation for mild primary hyperparathyroidism: a prospective cohort study

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