RFA for Structural Abnormality of Parathyroid Gland : A Novel Entity and Technique Advances

Wei-Che LinTaiwan Speaker RFA for Structural Abnormality of Parathyroid Gland : A Novel Entity and Technique AdvancesTitle: Radiofrequency Ablation for Structural Abnormality of Parathyroid Gland: A Novel Entity and Technique Advances Background: Traditional management of parathyroid structural abnormalities, primarily primary or secondary hyperparathyroidism and symptomatic parathyroid adenomas, has historically centered on surgical excision. However, the emergence of minimally invasive image-guided interventions has introduced Radiofrequency Ablation (RFA) as a potent alternative. As we define this "novel entity" of non-surgical structural correction, understanding the technical nuances and clinical outcomes is paramount. Objective: This study evaluates the efficacy, safety, and recent technical advancements of RFA in treating structural parathyroid abnormalities, focusing on volume reduction and biochemical normalization. Methods: A comprehensive review of recent clinical cohorts was conducted, focusing on patients undergoing ultrasound-guided RFA. Key technical advancements—including hydrodissection for thermal protection of the recurrent laryngeal nerve and the moving-shot technique for precise energy delivery—were analyzed. Success was measured by the reduction in parathyroid hormone (PTH) levels, serum calcium stabilization, and nodule volume shrinkage. Results: Current data indicate that RFA achieves a significant volume reduction rate (VRR) often exceeding 80% within 12 months. Procedural success, defined by the resolution of hypercalcemia or significant PTH drops, was observed in over 90% of cases. Notably, the integration of real-time contrast-enhanced ultrasound (CEUS) has significantly reduced incomplete ablation rates. Complication rates remained low, with transient voice changes occurring in less than 3% of patients, most of which resolved spontaneously. Conclusion: RFA represents a paradigm shift in the treatment of parathyroid structural abnormalities. With refined techniques like hydrodissection and improved imaging guidance, it offers a high-safety profile and excellent cosmetic outcomes. As a "novel entity" in endocrine intervention, RFA stands as a viable alternative for patients who are poor surgical candidates or those seeking a nephron-sparing, minimally invasive approach.

Chia-Luen HuangTaiwan Moderator Group instructions Thyroid tumor is one of the most common endocrine abnormalities, and its incidence has been steadily rising over recent decades. While traditional treatments often involve surgery and active surveillance, advancements in minimally invasive techniques have introduced radiofrequency ablation (RFA) and microwave ablation (MWA) as a viable alternative. The workshop delves into the role of radiofrequency ablation and other minimally intervention therapies in treating thyroid tumors, highlighting its benefits, procedures, and considerations.