Percutaneous Laser Ablation of Cold Benign Thyroid Nodules: A 3-Year Follow-Up Study in 122 Patients

Valcavi, Roberto; Riganti, Fabrizio; Bertani, Angelo; Formisano, Debora; Pacella, Claudio M.

doi:10.1089/thy.2010.0189

Cited by 223 publications

(242 citation statements)

References 44 publications

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“…The rate of permanent hypothyroidism was low (only three patients) [63,65]. Valcavi et al have found that thyroid pericapsular bleeding developed in almost 2 % of patients, but this disappeared in 3-4 weeks.…”

Section: Complicationsmentioning

confidence: 94%

“…Corticosteroids were administered and the patients recovered completely after 6-10 weeks. Nerve compression because of perinodular edema is probably the cause of dysphonia [57,59,63]. Spiezia et al also reported transient dysphonia, lasting 24 h, which spontaneously resolved [73].…”

Section: Complicationsmentioning

confidence: 99%

“…The patient is placed in a supine position with neck hyperextended. The procedure is performed under ultrasound system guidance [59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74]. In most studies, a 21-G needle is inserted into the lesion along its longest axis.…”

Section: La Devices and Proceduresmentioning

confidence: 99%

“…A laser source, a continuous-wave Nd-YAG laser operating at 1.064 lm, is used with an optical beam-splitting device with as many as four separate fibers that can be illuminated separately or concurrently [12]. The total energy applied is usually between 1.200 and 1.800 Joules [57,59,63,67,73], with a continuous output power of 1.5 and 3.5 W [57, 59-61, 64-72, 74].…”

Section: La Devices and Proceduresmentioning

confidence: 99%

“…Five patients experienced dysphonia within 24-48 h of LA ablation, with cord palsy at direct laryngoscopy [57,59,63]. Corticosteroids were administered and the patients recovered completely after 6-10 weeks.…”

Section: Complicationsmentioning

confidence: 99%

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Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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Benign thyroid nodules are a common disease in the general population. Most often, they are completely asymptomatic and discovered occasionally during routine ultrasound examinations, and do not require any treatment. When thyroid nodules become symptomatic, surgical excision is still considered standard treatment. In the last few years, several experiences in the treatment of benign thyroid nodules through image-guided percutaneous thermal ablation have been reported with encouraging results, so that currently, these treatments are often proposed as first-choice options for patients with symptomatic benign thyroid nodules. In this paper, we discuss the present literature on the topic, focusing on different techniques available for image-guided percutaneous ablation, particularly radiofrequency (RFA), laser (LA), microwave (MWA), and high-intensity-focus ultrasound (HIFU). Little evidence about the efficacy of MWA and HIFU is now available. According to the literature, good results have been obtained with RFA and LA. Regarding RFA, volume reduction after ablative treatment has been found to range from 47 to 84 % at 3-6 months, and from 62 to 93 % at 1 year; LA also seems to be effective in achieving shrinkage of thyroid nodules, with volume reduction from 37 to 81 % at 3-6 months, and from 13 to 82 % at 1-year follow-up. Moreover, applications of advanced image-guidance modality, such as contrast-enhanced ultrasound and virtual navigation with fusion imaging, are discussed.Keywords Laser Á Radiofrequency Á Microwave Á Highintensity focused ultrasound Á Thyroid nodule SOMMARIO I noduli benigni della tiroide sono una evenienza comune nella popolazione generale. Più spesso vengono scoperti occasionalmente durante un esame ecografico fatto per altri motivi, sono asintomatici e non richiedono alcun trattamento. Qualora i noduli diventino sintomatici, l'escissione chirurgica è ancora considerato il trattamento standard. Tuttavia, negli ultimi anni, è cresciuta l'esperienza circa il trattamento di tali noduli tramite ablazione percutanea sotto guida ecografica tanto che, attualmente, questo viene spesso proposto come trattamento di scelta. Lo scopo del nostro lavoro è fare una revisione della letteratura riguardante l'argomento, con un particolare focus sulle differenti tecniche attualmente a disposizione, in particolare radiofrequenza (RFA), laser (LA), microonde (MWA) e high-intensity-focus ultrasound (HIFU). Al momento ci sono ancora poche evidenze sull'efficacia di MWA e HIFU. Secondo quanto riportato in letteratura, buoni risultati sono stati ottenuti con RFA e LA. Riguardo la radiofrequenza, la riduzione volumetrica dopo la procedura ablativa va da 47 a 84 % a 3-6 mesi e da 62 a 93 % a 1 anno; anche il laser sembra essere efficace nel causare la riduzione del nodulo, con percentuali che vanno da 37 a 81 % a 3-6-mesi a da 13 a 82 % a 1 anno di follow-up Abbiamo poi discusso brevemente le

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Section: Complicationsmentioning

confidence: 94%

Section: Complicationsmentioning

confidence: 99%

Section: La Devices and Proceduresmentioning

confidence: 99%

Section: La Devices and Proceduresmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

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Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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A rare complication or coincidental event

Gilchrist

2009

Cathet Cardio Intervent

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Ultrasound‐guided percutaneous laser ablation in treating symptomatic solid benign thyroid nodules: Our experience in 45 patients

Achille¹,

Zizzi²,

Stasio

et al. 2015

Head & Neck

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Background Laser ablation may be useful in debulking of benign thyroid nodules. Methods In order to retrospectively evaluate the effectiveness and safety of laser ablation, 45 patients with benign solid thyroid nodules, with a fluid component ≤20%, were included in our series between October 2009 and January 2011. All reported pressure and/or cosmetic complaints. Nd:YAG laser at 1064 nm was used, with a fix‐power (3W), changing the application time. All patients were evaluated at baseline, 6 months, and 12 months and any complications were recorded. Results Mean nodule volume reduction decreased from 24.2 mL ± 19.4 to 4.5 ± 5.2 at 12 months (p < .001). Mean nodule volume reduction was 84% ± 13. Cosmetic signs were completely resolved in 87%, reduced in 9%, unchanged in 2%, and pressure symptoms were resolved in 88%. One patient experienced transient dysphonia. Conclusion Ultrasound‐guided laser ablation is an effective tool for treatment of symptomatic benign thyroid nodules in patients not eligible for surgery. © 2015 Wiley Periodicals, Inc. Head Neck 38: 677–682, 2016

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Percutaneous Laser Ablation of Cold Benign Thyroid Nodules: A 3-Year Follow-Up Study in 122 Patients

Cited by 223 publications

References 44 publications

Image-guided thermal ablation of benign thyroid nodules

Image-guided thermal ablation of benign thyroid nodules

A rare complication or coincidental event

Ultrasound‐guided percutaneous laser ablation in treating symptomatic solid benign thyroid nodules: Our experience in 45 patients

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