Interventional radiology of the thyroid gland: critical review and state of the art

Barile, Antonio; Quarchioni, Simone; Bruno, Federico; Ierardi, Anna Maria; Giordano, Aldo Victor; Carducci, Sergio; Varrassi, Marco; Carrafiello, G.; Caranci, Ferdinando; Splendiani, Alessandra; Cesare, Ernesto Di; Masciocchi, Carlo

doi:10.21037/gs.2017.11.17

Cited by 34 publications

(18 citation statements)

References 125 publications

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“…These results are confirmed by only few past experiences, in which the "earliest" delayed scans (8-12 min) were considered suitable to evaluate the lesion enhancement (8,19). Moreover, these results have a remarkable technical implication because allow optimizing the scanning protocols reducing the CT acquisitions and improving the diagnosis of parotid gland lesions, especially where the biopsy is not easy to perform (23)(24)(25)(26)(27)(28)(29)(30)(31)(32). However, we did not find a correlation between the lesion attenuation ratio of pleomorphic adenomas and the malignant tumours in our study population.…”

Section: A B Cmentioning

confidence: 65%

Delayed enhancement in differential diagnosis of salivary gland neoplasm

et al. 2019

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Background: Multi-phasic Computed Tomography (CT) evaluation allows to study the enhancement features of parotid gland masses. The aim of our study was to evaluate the role of delayed enhancement in the characterization of different histologic types of parotid tumours. Methods: Forty-eight patients (22 male and 26 female) with at least one parotid gland tumor, were included in our study. Multi-phase CT images were obtained before and 30, 120 s and 8 minutes after intravenous contrast injection. The images were evaluated by two radiologists for lesion enhancement degree. A quantitative assessment was performed using a region of interest on each lesion and density changes between different phases were compared. The tumoral enhancement ratio was calculated between the 8 minutes delayed and the early (30 s) phase. The pathological diagnosis was confirmed in all patients after surgery. Results: All patients had unilateral lesion for a total of 48 lesions. Twenty-eight were pleomorphic adenomas, 15 Warthin's tumours and 5 carcinomas. All Warthin tumours showed a rapid contrast enhancement at the early phase (30 sec) followed by a progressive wash-out during the delayed scans. Most of pleomorphic adenomas (89.2%) showed the highest density at the 8-minutes delayed phase. Malignant tumours showed slower contrast enhancement and 3 out of 5 (60%) showed a marked decrease at the 8 minutes delayed phase while the remaining 2 (40%), did not show any density reduction. The tumoral enhancement ratio was significantly different between Warthin tumours and pleomorphic adenomas and between Warthin's and malignant tumours. Conclusions: Multi-phasic CT examination with 8 minutes delayed acquisition has shown to be useful in parotid gland lesion differentiation.

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Section: A B Cmentioning

confidence: 65%

Delayed enhancement in differential diagnosis of salivary gland neoplasm

et al. 2019

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“…It prevents the leakage of hot material from the thyroid parenchyma during the procedure. This approach also allows continuous ultrasound monitoring to minimize the risk of complications or side effects due to thermal injuries in surrounding structures (recurrent laryngeal nerve, carotid artery, internal jugular vein, trachea and esophagus) ( 5 – 7 , 15 – 17 ). Moreover, the use of Color Doppler (CD) and/or Power Doppler (PD) prevents serious bleeding, identifying the blood vessels along the path of the electrode.…”

Section: Methodsmentioning

confidence: 99%

“…A solution with lidocaine 2% is injected and appears as an anechoic band, which gradually disappears deeply into antero-superior mediastinum, and laterally tools the main vessels of the neck. The risk of major complications decreases with local anesthesia, because the operator can monitor the pain, an early indicator of heat propagation, while a moderate sedation or a general anesthesia prevent the patients’ active collaboration and the early manifestation of complications such as changes in tone of voice, cough or pain ( 10 , 15 , 23 ).…”

Section: Methodsmentioning

confidence: 99%

The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data

Offi¹,

Garberoglio²,

Antonelli³

et al. 2021

Front. Endocrinol.

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Induced radiofrequency thermal ablation is the cytoreductive treatment of symptomatic benign thyroid nodules, metastatic and recurrent thyroid tumors and papillary thyroid microcarcinomas. It is a safe and effective alternative to surgery and it allows to obtain satisfactory results in terms of volumetric reduction of the nodule with significant improvement in the quality of life. The trans-isthmic approach and the moving shot technique are the two basic techniques; however, an advanced technique, artery-first feeding radiofrequency ablation, has been developed and validated. We have prospectively included 29 consecutive patients who have undergone radiofrequency ablation (Group A) or artery- first vRFA (Group B). All included patients had a diagnosis of benign nodular goiter and they underwent a single session of radiofrequency ablation. All patients followed a follow-up program at 1 month, 3 months, and 6 months. Continuous variables (age, TSH value, basal volume of nodule, used Joule, time in second of the procedure, nodules’ volume at 1-, 3-, and 6- months of follow-up and percentage of volume reduction at 1-, 3-, and 6- months of follow-up) were described as mean, standard deviation and range, while categorical variables (gender, nodule structure and nodule vascularization) were described as number of cases and percentage. Independent samples t-test were performed to compare the continuous variables. A Test of Proportions was applied to the categorical variables. The Fisher’s exact test was used to analyze the gender. Statistical significance was considered in case of p-value <0.05. Solid structure and spongiform structure showed statistic differences with p-values of 0.022 and 0.023 respectively between two groups. The percentage of reduction at 1 month did not show a significant difference between two groups; instead, the percentage of volume reduction was decreased mostly in the Group B at 3 months and 6 months of follow-up with a p-value of 0.003 and 0.013, respectively. The Joules/energy used showed a statistically significant difference (p-value=0.05), more energy must be used in vascular radiofrequency ablation. These data allow us to hypothesize that vRFA may improve the effectiveness of the procedure, allowing for a reduction in volume more quickly. They were preliminary but promising results, clearly a larger series of cases and prolonged follow-up are needed to clarify and confirm our observations.

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“…It consists of an internally cooling electrode measuring 17‐gauge, 15 cm length with an active tip of 1 cm. There have been new developments to make the electrodes smaller (7 cm length) and thinner (18‐19 gauge) with variations in the active tip (ranging between 3.8 mm and 20 mm) 15 . The target tissue in this technique is divided into different zones.…”

Section: Introductionmentioning

confidence: 99%

RFA and benign thyroid nodules: Review of the current literature

Muhammad

Santhanam

Russell

et al. 2021

Laryngoscope Investig Oto

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Benign thyroid nodules (BTNs) are commonly found in the general population. They are usually asymptomatic and their incidence has increased as a result of wide‐spread use of ultrasound. Benign nodules are typically monitored clinically until they increase in size, resulting in compressive symptoms warranting surgery. However, although surgery is generally well‐tolerated and of low‐risk, it is associated with a small risk for several complications including hypothyroidism, nerve injury, hematoma, injury to other structures and wound infection. Recently, newer image‐guided ablation techniques including radiofrequency ablation (RFA) have been introduced. RFA has a similar safety profile when compared to surgery and has shown promising results in challenging surgical candidates. Though several studies have been published in Asian and European countries on the efficacy of RFA, limited data is available on the North American population. The aim of the study is to review the current literature establishing the clinical outcomes and safety of RFA for benign nodules. Level of evidence V.

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Interventional radiology of the thyroid gland: critical review and state of the art

Cited by 34 publications

References 125 publications

Delayed enhancement in differential diagnosis of salivary gland neoplasm

Delayed enhancement in differential diagnosis of salivary gland neoplasm

The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data

RFA and benign thyroid nodules: Review of the current literature

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