Efficacy and Safety of Radiofrequency Thermal Ablation in the Treatment of Thyroid Nodules With Pressure Symptoms in Elderly Patients

Spiezia, Stefano; Garberoglio, R; Somma, Carolina Di; Deandrea, Maurilio; Basso, Edoardo; Limone, Paolo Piero; Milone, Francesco; Ramundo, Valeria; Macchia, Paolo Emidio; Biondi, Bernadette; Lombardi, Gaetano; Colao, Annamaria; Faggiano, Antongiulio

doi:10.1111/j.1532-5415.2007.01306.x

Cited by 52 publications

(35 citation statements)

References 7 publications

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“…First RF ablation studies on thyroid nodules were performed with a 17-gauge internally cooled electrode needle [19][20][21] or with a 14-gauge device, equipped with expandable hooks to obtain a more extended ablation area [22][23][24]. After local anesthesia, the needle is inserted into the target nodule through a small incision.…”

Section: Radiofrequency Ablation In Thyroid Pathologymentioning

confidence: 99%

“…Using both approaches, the fixed-electrode procedure and the moving shot technique, a significant nodule shrinkage is obtained in nonfunctioning thyroid nodules, coupled with a marked clinical improvement in nodule-related symptoms. In all series [19,20,[22][23][24][26][27][28][29][30][31][32], volume shrinkage gradually occurs during the first months after treatment, when necrotic tissue within nodule is reabsorbed. Following one or more RF sessions, a significant, sometimes impressive, nodule size reduction (46-93 % in different studies) is reached after 6 months and seems to be stable during a four-year follow-up [29].…”

Section: Radiofrequency Ablation In Thyroid Pathologymentioning

confidence: 99%

See 1 more Smart Citation

Radiofrequency ablation for thyroid nodules: which indications? The first Italian opinion statement

Garberoglio

Aliberti

Appetecchia³

et al. 2015

J Ultrasound

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111

139

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Nodular thyroid disease is a very common finding in\ud clinical practice, discovered by ultrasound (US) in about\ud 50 % of the general population, with higher prevalence in\ud women and in the elderly [1–4].\ud Whereas therapeutic flowchart is quite established and\ud shared for malignant lesions, multiple options are now\ud available for patients presenting with benign thyroid nod-\ud ules, ranging from simple clinical and US follow-up to\ud thyroid surgery. The majority of thyroid nodules, benign by\ud fine-needle aspiration, are asymptomatic, stable, or slow-\ud growing over time and require no treatmen

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Section: Radiofrequency Ablation In Thyroid Pathologymentioning

confidence: 99%

Section: Radiofrequency Ablation In Thyroid Pathologymentioning

confidence: 99%

Radiofrequency ablation for thyroid nodules: which indications? The first Italian opinion statement

Garberoglio

Aliberti

Appetecchia³

et al. 2015

J Ultrasound

Self Cite

111

139

View full text Add to dashboard Cite

show abstract

“…On average, nodule size has been reduced by 50% after 6 months and by nearly 80% 1 year after therapy, and accompanied by amelioration of anterior neck symptoms (111,115,116). The efficacy using the 'moving shot' technique in a selected series of non-randomised patients with solid and cystic nodules has been reported (56,109,112).…”

Section: Radiofrequency Ablationmentioning

confidence: 99%

“…Hyperfunctioning thyroid nodules " Hyperfunctioning nodules have been treated with either the fixed-electrode procedure (111,115,116,117) or the moving shot technique (110,112). A significant improvement in thyroid hyperfunction, as well as nodule volume reduction, has been reported in non-controlled series of patients (111,112,115,116).…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: Thyroid ultrasound (US) and US-assisted procedures: from the shadows into an array of applications

Papini

Pacella

Hegedűs

2014

European Journal of Endocrinology

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In patients with thyroid nodules, ultrasound (US) imaging represents an indispensable tool for assessment of the risk of malignancy. Over approximately four decades, innovative technology and successive improvements have facilitated its entry into the routine management and greatly improved its predictive value. When US features cannot reliably rule out thyroid cancer, US guidance allows a correct and safe sampling also of small or deeply located thyroid lesions. Obtained in this way, cytological or microhistological specimens may reliably define the nature of most thyroid nodules, and the information from histochemical or molecular markers shows promise in the classification of the remaining indeterminate cases. While a prompt surgical treatment can be offered in the minority of suspicious or definitely malignant cases, most individuals warrant only a follow-up. However, at initial evaluation, or over the years, a fraction of these benign lesions may grow and/or become symptomatic. Such cases may benefit from US-guided minimally invasive procedures as an alternative to surgery. Image-guided percutaneous treatments most often achieve relief of neck complaints, are inexpensive, and can be performed on an outpatient basis. The risk of major complications, after adequate training, is very low. Importantly, thyroid function is preserved. Currently, percutaneous ethanol injection for cystic lesions and thermal ablation, with laser or radiofrequency, for solid nodules are increasingly used and disseminated beyond the initial core facilities. In centres with expertise and high patient volume, their use should be considered as first-line treatment alternatives to surgery for selected patients with benign enlarging or symptomatic thyroid lesions.

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“…Radiofrequency (RF) is another technique used for thermal ablation. Its nodule volume-reducing effect varies (8)(9)(10)(11)(12)(13)(14), but largely the effect is comparable to that of interstitial laser photocoagulation (ILP) and PEI.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules

Døssing¹,

Bennedbæk²,

Hegedűs³

2011

European Journal of Endocrinology

114

102

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Aim: To evaluate the long-term efficacy of interstitial laser photocoagulation (ILP) in solitary benign thyroid nodules. Design and methods: A total of 78 euthyroid outpatients (45 participating in randomized trials) with a benign solitary solid and scintigraphically cold thyroid nodule causing local discomfort were assigned to ILP. ILP (using one laser fiber) was performed under continuous ultrasound (US) guidance and with an output power of 1.5-3.5 W. Thyroid nodule volume was assessed by US and thyroid function determined by routine assays, before and during follow-up. Pressure symptoms and cosmetic complaints were evaluated on a visual analogue scale (0-10 cm). Of the total patients, six had thyroid surgery 6 months after ILP and three were lost to follow-up. The median follow-up for the remaining 69 patients was 67 months (range 12-114). Results: The overall median nodule volume decreased from 8.2 ml (range 2.0-25.9) to 4.1 ml (range 0.6-33.0; P!0.001) at the final evaluation, corresponding to a median reduction of 51% (range: K194 to 95%). This correlated with a significant decrease in pressure as well as cosmetic complaints. After 12-96 months (median 38 months) of ILP, 21 patients (29%) had thyroid surgery because of an unsatisfactory result. All had benign histology. Thyroid function was unaltered throughout and side effects were restricted to mild local pain. Conclusion: US-guided ILP results in a satisfactory long-term clinical response in the majority of patients with a benign solitary solid cold thyroid nodule. Further large-scale studies should aim at optimizing selection criteria for ILP, preferably in randomized studies.

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Efficacy and Safety of Radiofrequency Thermal Ablation in the Treatment of Thyroid Nodules With Pressure Symptoms in Elderly Patients

Cited by 52 publications

References 7 publications

Radiofrequency ablation for thyroid nodules: which indications? The first Italian opinion statement

Radiofrequency ablation for thyroid nodules: which indications? The first Italian opinion statement

DIAGNOSIS OF ENDOCRINE DISEASE: Thyroid ultrasound (US) and US-assisted procedures: from the shadows into an array of applications

Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules

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