Minimally invasive local ablative therapies in combination with radioiodine therapy in benign thyroid disease: preparation, feasibility and efficiency – preliminary results

Mader, Alexander; Gröner, Daniel; Korkusuz, Yücel; Shadi, Ahmad; Grünwald, Frank; Kranert, W. T.; Happel, Christian

doi:10.1080/02656736.2017.1320813

Cited by 9 publications

(13 citation statements)

References 55 publications

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“…Furthermore, there is a potential that RFA may be used in combination with RI, especially for AFTNs. This will help to achieve greater volume reductions, limit the dose and number of RI sessions, and effectively treat nodules with inhomogeneous uptake 88 …”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Randomized trials will be needed to validate this new combined procedure. Procedures combined with the administration of iodine 131 (in particular in the context of solid AFTN) have already demonstrated their effectiveness ( 49 ), extend to develop in particular for large AFTN. Moreover, the achievement of about fifty RFA is necessary to obtain good clinical and ultrasound results (significant reduction of the initial symptomatology and significant reduction of the nodular volume) corresponding to the learning curve ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Results of Ultrasound-Guided Radiofrequency Ablation of Benign Thyroid Nodules: State of the Art and Future Perspectives—A Systematic Review

2021

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BackgroundNearly 20 years after the first feasibility study, minimally invasive ultrasound (US)-guided therapeutic techniques are now considered as a safe and effective alternative to surgery for symptomatic benign thyroid nodules. Radiofrequency ablation (RFA) is one of the most widely used treatment in specialized thyroid centers but, due to the relatively recent introduction into clinical practice, there are limited long-term follow-up studies. Aim of our work was to review the outcomes of RFA on solid nonfunctioning and on autonomous thyroid nodules (AFTN) on a long-time period for assessing the results in term of efficacy, complications, and costs and to compare them to the current indications of RFA.MethodsA systematic review was performed using EMBASE and Medline library data between 2008 and 2021. Seventeen studies evaluated RFA for the treatment of benign solid (nonfunctioning or autonomous) thyroid nodules, with an at least 18 months of follow-up. Data extraction and quality assessment were performed by two endocrinologist according to PRISMA guidelines. Anthropometric data, safety and efficacy parameters were collected.ResultsThe majority of the studies was retrospective study and reported 933 nodules, mostly solid. Baseline volume ranged between 6.1 ± 9.6 and 36.3 ± 59.8 ml. Local analgesia was used and the time duration of the treatment was between 5 ± 2 and 22.1 ± 10.9 min. The volume reduction rate at 12 months ranged from 67% to 75% for the nodule treated with a single procedure and reached to 93.6 ± 9.7% for nodules treated with repeat ablations. The regrowth rate at 12 months ranged from 0% to 34%.ConclusionAll the studies under examination consistently validated the long-term clinical efficacy and the substantial safety of RFA for the treatment of benign thyroid nodules. Thermal ablation, however, is an operator-dependent technique and should be performed in centers with specific expertise. The selection of the patients should be rigorous because the nodule size and the structural and functional characteristics influence the appropriateness and the outcomes of the treatment. Future perspectives as the treatment of micro-papillary thyroid cancer or cervical recurrence need further investigations.

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“…Radiofrequency ablation is usually performed under local anesthesia. perithyroidal hemorrhage, recurrent nerve damage, nodule rupture, and skin burns are some of the common consequences which have been reported secondary to the radiofrequency ablation [20,28]. However, the complication rate is low, and it is reported only in 3.3%of patients [29,30].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Ethanol Injection, Radiofrequency Ablation, and Levothyroxine Therapy in the Management of Benign Thyroid Nodules

Arefzadeh

Avankai

Abrishami

et al. 2020

Preprint

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Background: Thyroid nodules are a common clinical finding. Even though there are various accepted treatments for the benign thyroid nodules, there are alternative methods for managing these patients with fewer expenses and also minimum complications. This study aims to compare the volume decline of radiofrequency (RF) ablation and single-session ethanol ablation (EA) and the effects of levothyroxine therapy for benign thyroid nodule treatment.Materials: In this clinical trial, 90 patients with benign thyroid nodules in different centers in Tehran, Iran, from December 6, 2018, to December 6, 2019, were included. Patients who had met the inclusion criteria were selected and randomly allocated into three groups (each of 30) of a single session of radiofrequency ablation (Group 1), a single session of ethanol injection (Group 2), or a 6-month LT4 treatment (Group 3). Thyroid tests, including TSH, T4, T3, anti-TPO, T3RU, and serum Calcitonin level, were recorded at baseline and again at 1, 3, and six months. Nodule volume was also assessed through sonography at baseline and the other checkpoints.Results: The mean volume reduction after 6 months of intervention for ethanol injection group, radiofrequency ablation group, and LT4 treatment group were 72.2%, 83.4%, and 21.8%, respectively. There was a significant relationship between mean volume reduction and months (1, 3, and six) (P<0.001).Conclusions: Although radiofrequency ablation therapy is the best modality for managing benign thyroid nodules in our study, it is more expensive than the other modalities despite comparable therapeutic effects.

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Minimally invasive local ablative therapies in combination with radioiodine therapy in benign thyroid disease: preparation, feasibility and efficiency – preliminary results

Cited by 9 publications

References 55 publications

RFA and benign thyroid nodules: Review of the current literature

RFA and benign thyroid nodules: Review of the current literature

Long-Term Results of Ultrasound-Guided Radiofrequency Ablation of Benign Thyroid Nodules: State of the Art and Future Perspectives—A Systematic Review

Evaluation of Ethanol Injection, Radiofrequency Ablation, and Levothyroxine Therapy in the Management of Benign Thyroid Nodules

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