Claudio Maurizio Pacella MD, Abstract Co-Author: Nothing to Disclose

Giancarlo Bizzarri MD, Presenter: Nothing to Disclose

Antonio Bianchini MD, Abstract Co-Author: Nothing to Disclose

Sara Pacella MD, Abstract Co-Author: Nothing to Disclose

Rinaldo Guglielmi MD, Abstract Co-Author: Nothing to Disclose

Enrico Papini MD, Abstract Co-Author: Nothing to Disclose

To evaluate the feasibility of percutaneous laser thermal ablation (LTA) in the treatment of hyperfuntioning parathyroid adenomas in patients at poor surgical risk.

Five patients (5 females; age range, 30-81 years; mean 55.0) with primary hyperparathyroidism (HPT) underwent laser thermal ablation (LTA). A commercially available US scanner with a 10-MHz linear transducer was used for all procedures. Up to two 75-mm 21-gauge spinal needles were inserted under US guidance into the parathyroid gland along its longest axis. Laser light was delivered via a 300 m plane-cut quartz optical fiber advanced through the sheath of the needle, which was then withdrawn 5 mm leaving the fiber tip in direct contact with the tissue. A continuous-wave Nd-YAG laser source operating at 1.064 nm was used with output power of 3 W and exposure time ranging from 5 to 12 minutes reaching a total energy ranging from 1000 to 3600 Joules.

After a single LTA procedure, mean calcium level decreased from a baseline value of 11.3 ±0.8 to 9.9 ±0.5 at six months (normal values: 8.5-10.5 mg/dl). Mean serum parathyroid hormone (PTH) levels decreased from 236.1 ±189.0 to 69.7 ±45.4 (normal values: 9-55 pg/mL). LTA induced a mild burning cervical pain, which rapidly disappeared as the laser energy was turned off. Two patients experienced temporary dysphonia, which spontaneously resolved with complete recovery of vocal cord palsy within 1 month. No patient experienced skin burns or local infection.

LTA is a minimally invasive procedure for the debulking of parathyroid adenomas in patients at poor surgical risk.

Pacella, C, Bizzarri, G, Bianchini, A, Pacella, S, Guglielmi, R, Papini, E, Laser Thermal Ablation of Hyperfunctioning Parathyroid Adenomas: Preliminary Experience in Five Cases.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4403276.html