European journal of radiology · 2026
Superb microvascular imaging for evaluating the efficacy of microwave ablation in primary Hyperparathyroidism: A prospective study.
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Vurgun Sercan, Arslan Muhammet, Alver Kadir Han, Demirci Mahmut, Eraydın Ayten, Fenkci Semin Melahat
Аннотация
OBJECTIVES: To evaluate the utility of superb microvascular imaging (SMI) for assessing ablation completeness and predicting clinical outcomes after microwave ablation (MWA) in patients with primary hyperparathyroidism (PHPT).
METHODS: This prospective study included 57 patients (10 men, 47 women; mean age, 58.0 ± 11.3 years) who underwent MWA for PHPT between September 2023 and January 2025. SMI examinations were performed before and 1 month after ablation. Complete ablation was defined as the absence of intranodular vascularity on follow-up SMI. Clinical success was defined as maintenance of normocalcemia during the 6-month follow-up.
RESULTS: The clinical success rate was 73.7 %. At 1 month, SMI identified incomplete ablation in 12 of 57 nodules. Clinical success was achieved in 1 of 12 incompletely ablated nodules (8.3 %) compared with 41 of 45 completely ablated nodules (91.1 %). Incomplete ablation was independently associated with reduced odds of clinical success (OR 0.016; 95 % CI 0.001-0.092; p < 0.001). For predicting clinical outcome, SMI-defined ablation completeness yielded a sensitivity of 73.3 %, specificity of 97.6 %, positive predictive value of 91.7 %, and negative predictive value of 91.1 %.
CONCLUSION: SMI showed promising performance in assessing ablation completeness and predicting clinical outcomes after MWA for PHPT. Early detection of incomplete ablation on follow-up SMI may help identify patients at risk for clinical failure and support decisions regarding additional treatment.
METHODS: This prospective study included 57 patients (10 men, 47 women; mean age, 58.0 ± 11.3 years) who underwent MWA for PHPT between September 2023 and January 2025. SMI examinations were performed before and 1 month after ablation. Complete ablation was defined as the absence of intranodular vascularity on follow-up SMI. Clinical success was defined as maintenance of normocalcemia during the 6-month follow-up.
RESULTS: The clinical success rate was 73.7 %. At 1 month, SMI identified incomplete ablation in 12 of 57 nodules. Clinical success was achieved in 1 of 12 incompletely ablated nodules (8.3 %) compared with 41 of 45 completely ablated nodules (91.1 %). Incomplete ablation was independently associated with reduced odds of clinical success (OR 0.016; 95 % CI 0.001-0.092; p < 0.001). For predicting clinical outcome, SMI-defined ablation completeness yielded a sensitivity of 73.3 %, specificity of 97.6 %, positive predictive value of 91.7 %, and negative predictive value of 91.1 %.
CONCLUSION: SMI showed promising performance in assessing ablation completeness and predicting clinical outcomes after MWA for PHPT. Early detection of incomplete ablation on follow-up SMI may help identify patients at risk for clinical failure and support decisions regarding additional treatment.