Effect of ultrasound parameters of benign thyroid nodules on radiofrequency ablation efficacy

Abstract

Background and aim Ultrasound-guided radiofrequency ablation (RFA) is a minimally invasive therapy for thyroid nodules (TNs). Understanding the determinants of RFA efficacy can improve treatment and prognosis. This study aims to investigate the relationship between ultrasound parameters of benign TNs and the efficacy of RFA. Methods A pretest–posttest interventional study was conducted in 2021 on 250 randomly sampled patients with benign TNs, receiving RFA. For this purpose, the volume reduction (VR) and the VR ratio (VRR) of the nodules were measured at the 1-, 3-, 6-, and 12-month follow-up periods after the RFA completion. The technical success rate (TSR) of this procedure was then categorized into four states, including low (VRR < 25%), moderate (VRR = 25–49%), high (VRR = 50–74%), and very high (VRR ≥ 75). Ordered logistic regression (OLR) was further utilized to investigate the effect of the ultrasound parameters of TNs on the TSR. The analyses were notably performed using Stata 14.2. Results The VRR at the 1-, 3-, 6-, and 12-month follow-up periods were 38.7%, 53.6%, 59.3%, and 59.9%, respectively. The mean VR was also statistically significant at all follow-ups (p < 0.001). At the 1-, 3-, and 6-month follow-up periods, the VR of over 50% was observed in 28.2%, 52.1%, and 65.2% of the nodules, respectively. The odds ratios (ORs) of the RFA success were found to be 4.3 times higher for the nodules in the left lobe compared to the right lobe (OR: 4.31, p = 0.002), 6.3 times greater for isoechoic nodules compared to hyperechoic nodules (OR: 6.39, p < 0.001), 6.2 times higher for hyper-vascular nodules compared to hypo-vascular nodules (OR: 6.25, p = 0.005), and 2.3 times greater for mixed nodules compared to solid ones (OR: 2.37, p = 0.049). Conclusion The ultrasound parameters of TNs had a statistically significant effect on the efficacy of RFA. Small-sized, isoechoic, and hyper-vascular nodules, as well as those with mixed tissue, were observed to respond better to RFA, leading to a better prognosis in terms of VR after treatment.

Comparative Efficacy and Safety of Radiofrequency Ablation and Microwave Ablation in the Treatment of Benign Thyroid Nodules: A Systematic Review and Meta-Analysis

“…Elderly individuals frequently experience frailty and multimorbidity, which increase the likelihood of procedural complications or diminish their response to medical intervention [ 29 30 31 ]. In addition to age, sex is a significant factor that is frequently considered while performing medical procedures [ 31 32 ]. Prior researches indicate that sex exerts a notable influence on the efficacy of RFA procedures, with male exhibiting a higher likelihood of success than female [ 32 ].…”

“…In addition to age, sex is a significant factor that is frequently considered while performing medical procedures [ 31 32 ]. Prior researches indicate that sex exerts a notable influence on the efficacy of RFA procedures, with male exhibiting a higher likelihood of success than female [ 32 ]. Additionally, prior research has substantiated the impact of the initial volume of nodules on the increase in the VRR [ 32 33 ].…”

“…Prior researches indicate that sex exerts a notable influence on the efficacy of RFA procedures, with male exhibiting a higher likelihood of success than female [ 32 ]. Additionally, prior research has substantiated the impact of the initial volume of nodules on the increase in the VRR [ 32 33 ]. These studies have demonstrated that RFA is more likely to achieve success in nodules with smaller dimensions than in those with larger dimensions [ 32 33 ].…”

“…Additionally, prior research has substantiated the impact of the initial volume of nodules on the increase in the VRR [ 32 33 ]. These studies have demonstrated that RFA is more likely to achieve success in nodules with smaller dimensions than in those with larger dimensions [ 32 33 ]. Unfortunately, the precise mechanism by which these factors affect the response to RFA and MWA remains unknown and warrants further investigation in future studies.…”