Image‐guided chemical and thermal ablations for thyroid disease: Review of efficacy and complications

Nixon, Iain J.; Angelos, Peter; Shaha, Ashok R.; Rinaldo, Alessandra; Williams, Michelle D.; Ferlito, Alfio

doi:10.1002/hed.25181

Cited by 41 publications

(28 citation statements)

References 163 publications

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“…A needle-guided attachment with adjustable angle selection can be used to help the operator with needle insertion to achieve a homogeneous distribution of up to five fibers in the nodule. The procedure is generally performed with local anaesthesia (2-5 mg of 2% lidocaine) and/or under conscious sedation, even though some authors prefer not to use any kind of anaesthesia, in order to better monitor the procedure during ablation [39]. Once the procedure has been planned, one or more 21-G introducer needles are placed in the deeper portion of the target nodule under real-time ultrasound guidance.…”

Section: Methodsmentioning

confidence: 99%

Percutaneous laser ablation for benign and malignant thyroid diseases

et al. 2019

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Minimally invasive image-guided thermal ablation is becoming increasingly common as an alternative to surgery for the treatment of benign thyroid nodules. Among the various techniques for thermal ablation, laser ablation (LA) is the least invasive, using the smallest applicators available on the market and enabling extremely precise energy deposition. However, in some cases, multiple laser fibers must be used simultaneously for the treatment of large nodules. In this review, the LA technique is described, and its main clinical applications and results are discussed and illustrated.

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Section: Methodsmentioning

confidence: 99%

Percutaneous laser ablation for benign and malignant thyroid diseases

et al. 2019

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“…In cystic thyroid nodules, aspiration alone may be of therapeutic value, but the effect varies considerably, and recurrence is very prevalent and seen in up to 80% of patients (1). Levothyroxine is without effect (1) and ethanol sclerotherapy, although efficacious (1), carries the risk of seepage of the ethanol along the needle-tract and potential side effects based on extrathyroidal fibrosis and/or affection of the recurrent laryngeal nerves (26). The effect of LT in solid nodules is well documented but only few studies have reported the outcome in cystic-solid (mixed) nodules (26).…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome following laser therapy of benign cystic-solid thyroid nodules

Døssing

Bennedbæk

2019

Endocrine Connections

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Objective Laser therapy (LT) is considered a safe and effective procedure for inducing thyroid nodule necrosis, fibrosis and shrinkage. Little is known about long-term efficacy of LT in benign complex thyroid nodules, which we report here. Design and methods One hundred and ten euthyroid outpatients (28 men and 82 women; median age 48 years (range 17–82)) with a recurrent cytologically benign cystic (≥2 mL cyst volume) thyroid nodule causing local discomfort were assigned to LT. LT was performed after complete cyst aspiration and under continuous ultrasound (US) guidance. Nineteen patients (17 within 6 months) had surgery after LT. The median follow-up for the remaining 91 patients was 45 months (range: 12–134). Results The overall median nodule volume in the 110 patients decreased from 9.0 mL (range: 2.0–158.0) to 1.2 mL (range: 0.0–85.0) (P < 0.001) at the final evaluation, corresponding to a median reduction of 85% (range: −49 to 100%). Remission of the cystic part (volume ≤1 mL) was obtained in 82 of 110 (75%) patients after LT. The median cyst volume decreased from 6.3 mL (range: 2.0–158.0) to 0.0 mL (range: 0.0–85.0) (P < 000.1), corresponding to a median reduction of 100% (range: −49 to 100%). These results correlated with a significant decrease in pressure as well as cosmetic complaints. Side effects were restricted to mild local pain. Conclusion US-guided aspiration and subsequent LT of benign recurrent cystic thyroid nodules results in a satisfactory long-term clinical response in the majority of patients. LT constitutes a clinically relevant alternative to surgery in such patients.

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“…The incidence of vocal cord paralysis on malignant lesions may be expected around 5% of the cases. 27 …”

Section: Malign Lesionsmentioning

confidence: 99%

Radiofrequency for benign and malign thyroid lesions

Rangel

Volpi

Stabenow³

et al. 2020

World j. otorhinolaryngol.-head neck surg.

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Background Thermal ablation of thyroid nodules is new modality for the management of the benign and malign lesions. This minimally invasive treatment is performed as an outpatient, local anesthetic, single professional procedure that can treat neoplastic lesions without removing normal thyroid tissue and thus avoiding hypothyroidism. Method A comprehensive review of the most relevant literature regarding the thermal ablation of benign and malign nodules was performed in order to currently define its role on the management of the nodular thyroid disease. The data was divided into benign and malign literature. Results The benign nodules can be effectively treated by radiofrequency ablation (RFA) but some limitation exists regarding the nodule's size but not nodules characteristics. The RFA of primary malign tumors of the thyroid recently demonstrated positive and safe long-term follow-up and encouraged additional investigation and possibly a definitive role in the management of these low risk nodules. Conclusion RFA is a safe, cost-effective minimally invasive procedure that avoids thyroid tissue removal while destroying neoplastic one thus, preventing hypothyroidism.

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Image‐guided chemical and thermal ablations for thyroid disease: Review of efficacy and complications

Cited by 41 publications

References 163 publications

Percutaneous laser ablation for benign and malignant thyroid diseases

Percutaneous laser ablation for benign and malignant thyroid diseases

Long-term outcome following laser therapy of benign cystic-solid thyroid nodules

Radiofrequency for benign and malign thyroid lesions

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