Nodule size as predictive factor of efficacy of radiofrequency ablation in treating autonomously functioning thyroid nodules

Cesáreo, R.; Naciu, Anda Mihaela; Iozzino, Mario; Pasqualini, Valerio; Simeoni, Carla; Casini, Alessandro; Campagna, Giuseppe; Manfrini, Silvia; Tabacco, Gaia; Palermo, Andrea

doi:10.1080/02656736.2018.1430868

Cited by 63 publications

(60 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the January 2018 issue of IJH, Cesareo's study [26] confirms these results obtained with a single session of RFA in nodules with a volume 12 ml. This was a 24-month prospective monocentric open parallel-group trial in which 29 patients with AFTN were divided into 2 groups based on thyroid volume: 15 patients with small nodules (<12 ml) in group A and 14 patients with medium nodules (>12 ml) in group B.…”

Section: Letter To the Editormentioning

confidence: 53%

Is there a role for minimally invasive thermal ablations in the treatment of autonomously functioning thyroid nodules?

Pacella

Mauri

2018

International Journal of Hyperthermia

View full text Add to dashboard Cite

Section: Letter To the Editormentioning

confidence: 53%

Is there a role for minimally invasive thermal ablations in the treatment of autonomously functioning thyroid nodules?

Pacella

Mauri

2018

International Journal of Hyperthermia

View full text Add to dashboard Cite

“…Indeed, in young hyperthyroid patients, both males and females, the RFA can have advantages: (a) rapid efficacy of the therapy without wash‐out period in which it is not possible to attempt conception. As demonstrated by Sung et al, no postprocedural aggravation of symptoms was experienced, and, because of the RFA efficacy, the ATDs can be interrupted or significantly reduced immediately after the procedure; (b) low risk of major complications, which include permanent voice change (0%‐2.3%), nodule rupture (0.1%), Horner syndrome (0.1%) and spinal accessory nerve injury (0%‐2.3%); (c) finally, the absence of postprocedural scars . At the same time, in patients affected by cardiovascular comorbidities, RFA allows the ATDs administration until the day before the procedure.…”

Section: Discussionmentioning

confidence: 85%

“…These disadvantages lead to seeking alternative treatments to RI therapy, especially in these selected groups of patients. The RFA is a possible alternative therapy to RI in the treatment of AFTNs, showing efficacy in restoring euthyroidism, especially in nodules of small dimension . Indeed, in young hyperthyroid patients, both males and females, the RFA can have advantages: (a) rapid efficacy of the therapy without wash‐out period in which it is not possible to attempt conception.…”

Section: Discussionmentioning

confidence: 99%

Comparison between radioiodine therapy and single‐session radiofrequency ablation of autonomously functioning thyroid nodules: A retrospective study

Cervelli

Mazzeo

Boni

et al. 2019

Clinical Endocrinology

View full text Add to dashboard Cite

Objective:To compare the efficacy of Radioiodine (RI) and Radiofrequency ablation (RFA) in the treatment of autonomously functioning thyroid nodules (AFTNs). Endpoints: nodule volume reduction (NVR) and thyroid function normalization.Design, patients and measurements: Twenty-two patients (2:20 M:F; 51.9 ± 13.9 years) affected by 25 AFTNs, treated by RFA were retrospectively compared with 25 patients (8:17 M:F; 57.2 ± 12.8 years) affected by a single AFTN treated by RI. Both group showed analogous characteristics as to age, gender, toxic/ pretoxic phase and pretreatment nodule volume (calculated by the ellipsoid formula).Thyroid hormone levels and autoimmune thyroid profile were assessed before treatment. A fixed RI activity of 555 MBq (15 mCi) was administered. RFA was performed with an 18G, single-tipped electrode, by the "modified moving shot technique." Thyroid hormones were assessed and the nodule post-treatment volume calculated 12 months after treatment. Results:No statistical difference was found between the post-treatment NVR by comparing RI and RFA (P = 0.69). The volume reduction rates were 68.4 ± 28.9% and 76.4 ± 16.9% after RI and RFA, respectively. As to the thyroid function, 5/25 patients developed clinical hypothyroidism after RI. After RFA, all the 22 patients silenced their AFTN and normalized the thyroid hormones. Subclinical hypothyroidism was recorded in two patients after both RI and RFA. Thus, the functional therapeutic success, defined as the restoration of euthyroidism, was achieved in 18/25 (72%) patients treated by RI and in 20/22 (90.9%) treated by RFA. Conclusions:No statistical difference in NVR was found between RI and RFA. All patients responded to RI but 5/25 were "over-treated" developing hypothyroidism.RFA was effective in all patients with no case of post-treatment clinical hypothyroidism. No radiation exposure and lower risk of post-treatment hypothyroidism might make RFA the favourite option especially for young patients. | 609CERVELLI Et aL.

show abstract

“…Overall, the mean technical efficacy, defined for AFTN as restoration of normal thyroid function associated with a ≥80% reduction of initial volume, is around 50% at 12 months, but the larger the nodule the poorer the likelihood of achieving durable control of thyroid function. Based on the available data, TA may achieve near-complete normalization of serum thyroid hormones in small size (e.g., ≤10 mL) AFTN, accompanied by a substantial (> 80%) volume reduction, while thyroid function is controlled only in a small fraction of larger AFTN [94,97]. Thus, TA may be best employed for patients with small AFTNs who decline or are not suitable -due to iodine repletion, comorbidities or pregnancy -for RAI therapy or thyroid surgery.…”

Section: Benign Autonomously Functioning Thyroid Nodulesmentioning

confidence: 99%

2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules

et al. 2020

View full text Add to dashboard Cite

Standard therapeutic approaches for benign thyroid lesions that warrant intervention are surgery for cold and either surgery or radioiodine for autonomously functioning thyroid nodules (AFTN). Image-guided thermal ablation (TA) procedures are increasingly proposed as therapy options for selected clinical conditions. Due to mounting scientific evidence and widening availability, ETA considered it appropriate to develop guidelines for the use of TA in adult patients. TA procedures are well tolerated, but a dedicated training of the operators is required and information on possible complications needs to be shared with the patients. The following factors should be considered when weighing between observation, surgery, and TA for benign thyroid nodules. In solid non-hyperfunctioning nodules, TA induces a decrease in thyroid nodule volume, paralleled by improvement in symptoms. Nodule re-growth is possible over time and may necessitate repeat treatment, or surgery, in a dialogue with the patient. In AFTN, radioactive iodine is the first-line treatment, but TA may be considered in young patients with small AFTN due to higher probability of restoring normal thyroid function and avoidance of irradiation. In cystic nodules, ethanol ablation (EA) is the most effective and least expensive treatment. TA may be considered for cystic lesions that relapse after EA or have a significant residual solid component following drainage and EA. TA should be restricted to benign lesions that cause symptoms or cosmetic concern. Presently, laser and radiofrequency ablation are the most thoroughly assessed techniques, with similar satisfactory clinical results. Microwaves and high-intensity focused ultrasound therapy options remain to be fully evaluated.© 2020 European Thyroid Association Published by S. Karger AG, Basel Recommendation 1. In adult patients with benign thyroid nodules that cause pressure symptoms and/or cosmetic concerns and decline surgery, image-guided TA should be considered as a costand risk-effective alternative option to surgical treatment or observation alone (1, ØØOO).Recommendation 2. We recommend against the use of TA for asymptomatic lesions (1, ØØØO).

show abstract

Nodule size as predictive factor of efficacy of radiofrequency ablation in treating autonomously functioning thyroid nodules

Abstract: A single session of RFA was effective in restoring euthyroidism in patients with small AFTNs. Nodule volume seems to be a significant predictive factor of the efficacy of RFA in treating AFTN.

Cited by 63 publications

References 34 publications

Is there a role for minimally invasive thermal ablations in the treatment of autonomously functioning thyroid nodules?

Is there a role for minimally invasive thermal ablations in the treatment of autonomously functioning thyroid nodules?

Comparison between radioiodine therapy and single‐session radiofrequency ablation of autonomously functioning thyroid nodules: A retrospective study

2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules

Contact Info

Product

Resources

About