Benign thyroid nodules treatment using percutaneous laser ablation (PLA) and radiofrequency ablation (RFA)

Abstract

PurposeTo evaluate the reduction over time of benign thyroid nodules treated using percutaneous laser ablation (PLA) and radiofrequency ablation (RFA) by the same equipe. Materials and MethodsNinety patients (age 55.6±14. 34,662.7±15,812.3 J in PLA vs. RFA group. Mean volume reduced from 20.3±16.4 ml to 13.17±10.74 ml (42%±17% reduction) at 1 month, 8.7±7.4 ml (60%±15% reduction) at 6 months and 7.1±7.7 ml (70%%±16% reduction) at 12 months In PLA group, and from 32.7±19.5 ml to 17.2±12.9 ml (51%±15% reduction) at 1 month, 12.8±9.6 ml (64±14% reduction) at 6 months and 9.9±9.2 ml (74%±14% reduction) at 12 months in RFA group. No difference in time course of the relative volume reduction between the two techniques was found. ConclusionsRFA and PLA are similarly feasible, safe and effective in treating benign thyroid nodules when performed by the same equipe. RFA is faster than PLA but require significantly higher energy.

Solid benign thyroid nodules (>10 ml): a retrospective study on the efficacy and safety of sonographically guided ethanol ablation combined with radiofrequency ablation

“…In addition to the above methods, other alternative therapies to treat mainly solid nodules include US-guided LA and MWA. Laser ablation has the advantages of accurate positioning, a low power requirement, minimal impact on the surrounding tissues and a favorable safety profile [28][29][30]. Although laser ablation requires up to 4 fibers to treat large nodules, it does not increase invasiveness (even lower complications), and the costs in most of the countries are similar to those of RFA [29][30][31].…”

2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology

“…In terms of nodule size or volume, there have been no definite criteria for thyroid RFA. The need for treatment of thyroid nodules depends on each patient's symptoms or cosmetic problems, which vary according to personal neck circumference or location of the thyroid nodule ( 1 19 ). Patients with smaller neck circumference tend to complain of cosmetic problems significantly earlier than do those with thicker necks.…”

Clinical Approach for Thyroid Radiofrequency Ablation

“…압박 증상과 외견상 문제를 이렇게 점수로 표현하는 것은 비교적 객관적인 지표를 제공하지만, 점수에 따라서 치료를 결정하는 것은 아니다. 실제로는 환자가 얼마나 치료를 필요로 하느냐 또는 결절의 위치 등이 판단에 중요한 영향을 미친다( 32 33 ). 그러나 증상에 점수를 매기면 환자가 얼마나 심하게 증상을 겪고 있는지 의사가 이해하는데 되움이 되며, 치료를 선택하도록 조언하는데 도움이 된다.…”