Efficacy of Radiofrequency Ablation-Guided by Ultrasound in Primary Hyperparathyroidism: A Systematic Review and Meta-Analysis.

Abstract

Radiofrequency ablation guided by ultrasound (RFA-USG) is an alternative treatment for primary hyperparathyroidism (PHPT) patients. Despite showing accurate precision and minimal invasion, its efficacy remains questionable. We searched PubMed, Embase, Scopus, Cochrane Library, Portal Regional da Biblioteca Virtual em Saúde (BVS), Web of Science databases for randomized controlled trials (RCTs) and observational studies evaluating RFA-USG in PHPT patients. Statistical analysis was performed with R software, version 4.4.3. Eight studies were included with 208 patients with PHPT undergoing RFA-USG treatment. After 3 months of treatment, parathyroid volume was 0.31 mL (0.16-0.61), Parathyroid hormone (PTH) level was 60.71 pg/mL (53.87-68.42), and calcium level was 5.43 mEq/L (2.63-11.23). The occurrence of hoarseness among the patients was 4.4% (1.64-11.02). RFA-USG is safe for PHPT patients, with associated parathyroid volume reduction and decrease in PTH. However, further study is needed to compare RFA-USG to the gold standard of surgery for PHPT.