Radiofrequency ablation in primary hyperparathyroidism: A prospective argentine experience
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Abstract
In selected patients, ultrasound-guided ablation radiofrequency (RFA) has emerged as a minimally invasive alternative to control hypercalcemia and reduce disease burden in primary hyperparathyroidism (PHPT). The aim of this study was to evaluate the efficacy and safety of RFA in patients with PHPT caused by a single inferior parathyroid adenoma, highlighting the importance of patient selection, the role of ultrasound, and specialized operator training. Materials and Methods: This prospective single-center study included 43 patients with biochemically confirmed PHPT. All had accessible inferior parathyroid adenomas identified by high-resolution cervical ultrasound and confirmed by sestamibi scintigraphy or choline PET-CT. Patients underwent RFA between June 2020 and November 2025. Follow-up included biochemical assessment (serum calcium and parathyroid hormone) and ultrasound evaluation at 6, 12, 24, and 36 months. Results: The overall biochemical cure rate was 83% (36/43), with normalization of calcium and parathyroid hormone. In the time-based analysis, complete response at 6 months was 70% (25/36), increasing to 74% (23/31) at 12 months and reaching 60% (10/17) at 24 months, reflecting the lower number of patients available in later follow-up. Complications were transient and included dysphonia in 7% and hypocalcemia in 5% of cases, with no permanent adverse events. Mean adenoma volume reduction was 79% at 6 months, confirmed by Doppler ultrasound. Ultrasound-guided RFA is a safe and effective minimally invasive option for selected patients with PHPT. Ultrasound is essential for patient selection, procedural guidance, and follow-up, and specialized training is key to safe and reproducible implementation.
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