Abstract
PURPOSE: The present study aimed to evaluate changes in renal stiffness in primary hyperparathyroidism (PHPT) using shear-wave elastography (SWE), and to assess treatmentrelated improvements following microwave ablation (MWA). METHODS: This retrospective study included 53 PHPT patients (mean age, 56.4±10.8 years; 48 women, 5 men) and 70 healthy controls (mean age, 54.5±9.7 years; 58 women, 12 men). Baseline renal SWE values (measured in the renal cortex) and biochemical parameters (parathyroid hormone [PTH], calcium, phosphate) were compared between groups. The control group served only for baseline comparisons and was not followed longitudinally. In the patient group, posttreatment SWE and biochemical changes were assessed at 1 day, 1 month, 3 months, 6 months, and 1 year. Statistical analysis included paired and independent t-tests, while regression analysis identified predictors of renal stiffness. RESULTS: Baseline SWE values were higher in PHPT patients than in controls (9.16±2.64 kPa vs. 5.02±0.63 kPa, P<0.01). After MWA, SWE values significantly decreased (1-year mean, 5.15±1.19 kPa; P<0.01). PTH and calcium levels also improved post-treatment (P<0.01). Regression analysis showed that PTH (β=0.02, P<0.01) and calcium (β=1.82, P=0.018) independently predicted renal stiffness. CONCLUSION: Reductions in renal stiffness and improvements in biochemical parameters were observed in PHPT patients following MWA. These preliminary findings suggest that SWE may have potential as a non-invasive tool for assessing and monitoring renal involvement in PHPT.