Ultrasound-guided laser ablation for local control of neck recurrences of medullary thyroid cancer. A feasibility study

Persichetti, Agnese; Bizzarri, Giancarlo; Guglielmi, Rinaldo; Barnabei, Agnese; Bianchini, A.; Coccaro, Carmela; Appetecchia, Marialuisa; Papini, Enrico

doi:10.1080/02656736.2018.1508759

Cited by 11 publications

(10 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Compared with these previous studies, this study enrolled a larger population and achieved 100% complete disappearance in 54 patients after 4 years. Furthermore, the local tumor control ability of thermal ablations for recurrent thyroid cancers has been well documented (9242526).…”

Section: Discussionmentioning

confidence: 99%

US-Guided Radiofrequency Ablation for Low-Risk Papillary Thyroid Microcarcinoma: Efficacy and Safety in a Large Population

et al. 2019

View full text Add to dashboard Cite

ObjectiveTo evaluate the efficacy and safety of radiofrequency ablation (RFA) for low-risk papillary thyroid microcarcinoma (PTMC) in a large population.Materials and MethodsCases of 152 biopsy-proven PTMCs from 133 patients who had undergone RFA for PTMC between May 2008 and January 2017 were included in this study. All patients were either of high surgical risk or refused to undergo surgery. They were followed up for at least 6 months after initial RFA. Ultrasonography (US) and computed tomography were performed to evaluate the PTMC and the presence of neck metastasis before treatment. RFA was conducted using an internally cooled thyroid-dedicated electrode system. Follow-up US was performed at 1 week, and 2, 6, and 12 months, after the initial RFA, and then at every 6–12 months. We evaluated serial changes of ablated tumors, newly developed cancers, lymph node (LN) or distant metastasis and complications.ResultsComplete disappearance was found in 91.4% (139/152) of ablated tumors. Among the 13 tumors in patients who did not show complete disappearance, no tumor displayed any regrowth of the residual ablated lesion during the follow-up period. The mean follow-up period was 39 months. During the follow-up period, there were no local recurrence, no LN or distant metastasis, and no newly developed thyroid cancers. No patients were referred to surgery. The overall complication rate was 3% (4/133) of patients, including one voice change. There were no life-threatening complications or procedure-related deaths.ConclusionOur results suggest that RFA is an effective and safe option for treating low-risk PTMC patients who are of high surgical risk or refuse surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

US-Guided Radiofrequency Ablation for Low-Risk Papillary Thyroid Microcarcinoma: Efficacy and Safety in a Large Population

et al. 2019

View full text Add to dashboard Cite

show abstract

“…As a consequence, other methods for the assessment of treatment outcome have been developed. Intraoperative contrast-enhanced ultrasound (CEUS) (or CEUS fused with CT [12]) led to good results [26][27][28][29], but it suffers from the low spatial resolution of sonography and the lack of 3 D representation. Registration and fusion of other imaging techniques (e.g.…”

Section: Discussionmentioning

confidence: 99%

A novel software platform for volumetric assessment of ablation completeness

Solbiati

Muglia

Goldberg

et al. 2019

International Journal of Hyperthermia

View full text Add to dashboard Cite

Purpose: To retrospectively evaluate the accuracy of a novel software platform for assessing completeness of percutaneous thermal ablations. Materials & methods: Ninety hepatocellular carcinomas (HCCs) in 50 patients receiving percutaneous ultrasound-guided microwave ablation (MWA) that resulted in apparent technical success at 24-h post-ablation computed tomography (CT) and with !1-year imaging followup were randomly selected from a 320 HCC ablation database (2010-2016). Using a novel volumetric registration software, pre-ablation CT volumes of the HCCs without and with the addition of a 5 mm safety margin, and corresponding post-ablation necrosis volumes were segmented, co-registered and overlapped. These were compared to visual side-by-side inspection of axial images. Results: At 1-year follow-up, CT showed absence of local tumor progression (LTP) in 69/90 (76.7%) cases and LTP in 21/90 (23.3%). For HCCs classified by the software as "incomplete tumor treatments", LTP developed in 13/17 (76.5%) and all 13 (100%) of these LTPs occurred exactly where residual non-ablated tumor was identified by retrospective software analysis. HCCs classified as "complete ablation with <100% 5 mm ablative margins" had LTP in 8/49 (16.3%), while none of 24 HCCs with "complete ablation including 100% 5 mm ablative margins" had LTP. Differences in LTP between both partially ablated HCCs vs completely ablated HCCs, and ablated HCCs with <100% vs with 100% 5 mm margins were statistically significant (p < .0001 and p ¼ .036, respectively). Thus, 13/21 (61.9%) incomplete tumor treatments could have been detected immediately, were the software available at the time of ablation. Conclusions: A novel software platform for volumetric assessment of ablation completeness may increase the detection of incompletely ablated tumors, thereby holding the potential to avoid subsequent recurrences.

show abstract

“…Recently, TA of thyroid tissue, that is destruction by heating and subsequent coagulative necrosis and fibrosis, was proven effective for the local control of papillary thyroid microcarcinomas (PTMC) and metastatic lymph nodes in patients at surgical risk [8,9]. Furthermore, a few centres have used TA for palliative purposes in thyroid cancer, neither amenable to surgical resection nor radioiodine ablation (RAI), with promising results [10,11]. In addition to LA and RFA, other techniques, like high intensity focused US (HIFU) and microwave ablation (MWA), are being tested for ablation of benign and malignant thyroid nodules [12,13].…”

Section: Introductionmentioning

confidence: 99%

European Thyroid Association Survey on Use of Minimally Invasive Techniques for Thyroid Nodules

Hegedűs¹,

Frasoldati²,

Negro³

et al. 2020

Eur Thyroid J

Self Cite

View full text Add to dashboard Cite

Objective: Image-guided interventional ultrasound (US) techniques represent diagnostic and therapeutic tools for non-surgical management of thyroid nodular disease. We sought to investigate the attitude of European Thyroid Association (ETA) members towards the use of minimally invasive techniques (MIT) in diagnosis/therapy of symptomatic nodular goitre. Methods: ETA members were invited to participate in an online survey investigating the use of MIT in benign and malignant thyroid nodular disease. Of 865 invited members, 221 (25.5%) completed the survey. The respondents were from 40 countries; 139 (74.7%) were from European countries. Results: Respondents personally performed thyroid US (91.6%), Fine needle aspiration (FNA; 75.3%), ethanol ablation (EA; 22.1%), core needle biopsy (CNB; 11%) and thermal treatments (4.8%). When skills and/or technology were unavailable, only 13.4% referred patients "often" or "always" to other centres with specific expertise in this field. Surgery was the preferred first option in patients with recurrent cysts, 4.0 cm benign nodules, local (radioiodine-avid or non-avid) lymph node metastases, or papillary cancers < 1.0 cm. For autonomously functioning nodules radioactive iodine treatment was the preferred choice, followed by surgery. Thermal ablation (TA) was the preferred option only for a 4 cm benign nodule in old patients with comorbidities. Conclusions: US, US-guided FNA and surgery were available to nearly all respondents, while MIT was not. CNB and EA were employed only by about 1/3 of the respondents and TA procedures were available and personally performed only by a minority. For most thyroid lesions, surgery was the preferred option versus thermal therapies. The ETA needs to develop guidelines and establish teaching to overcome geographic inequality and promote the use of MIT as a valid therapy option in appropriate cases.

show abstract

Ultrasound-guided laser ablation for local control of neck recurrences of medullary thyroid cancer. A feasibility study

Cited by 11 publications

References 18 publications

US-Guided Radiofrequency Ablation for Low-Risk Papillary Thyroid Microcarcinoma: Efficacy and Safety in a Large Population

US-Guided Radiofrequency Ablation for Low-Risk Papillary Thyroid Microcarcinoma: Efficacy and Safety in a Large Population

A novel software platform for volumetric assessment of ablation completeness

European Thyroid Association Survey on Use of Minimally Invasive Techniques for Thyroid Nodules

Contact Info

Product

Resources

About