Current status and perspectives of ultrasound-guided ablation techniques in patients with primary hyperparathyroidism

Primary hyperparathyroidism (PHPT) is an endocrine disorder characterized by elevated or inappropriately parathormone levels. The most common cause of PHPT is solitary parathyroid adenoma (80-85%). Parathyroid surgery generally encompasses symptomatic PHPT and asymptomatic patients who meet the surgical guideline criteria. If surgery is contraindicated, several non-surgical ablative techniques can be conducted to eliminate the pathological parathyroid tissue, which causes tissue necrosis in the affected gland. This review aims to look into the most recent studies on the efficacy of percutaneous ethanol injection therapy (PEIT), laser ablation (LA), radiofrequency ablation (RFA), microwave ablation (MWA), and high-intensity focused ultrasound (HIFU) in treatment of PHPT and analyze their application prospects. PEIT is a classic method that is less commonly used nowadays. The analysis of thermal ablation methods revealed that LA is inefficient and requires considerable repetition. Meanwhile, the MWA and RFA have a cure rate of over 85% and fewer complications; it seems that they have the potential to replace surgical methods in the future.