Percutaneous Laser Ablation of Metastatic Lymph Nodes in the Neck From Papillary Thyroid Carcinoma: Preliminary Results

Mauri, Giovanni; Cova, Luca; Tondolo, T.; Ierace, Tiziana; Baroli, Alberto; Mauro, Enzo Di; Pacella, Claudio M.; Goldberg, S. Nahum; Solbiati, Luigi

doi:10.1210/jc.2013-1140

Cited by 81 publications

(79 citation statements)

References 18 publications

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“…As ablations are widely applied to malignant tumors in other regions, such as the liver, the kidneys, or even the lungs, and good results have been reported in the treatment of benign thyroid disease, a few authors have started investigating the feasibility and effectiveness of imageguided thermal ablations in malignant diseases in the neck [111][112][113][114][115]. LA and RFA, in particular, seem to offer a possible curative treatment in the case of recurrent thyroid nodules and in metachronous lymph-node metastases from papillary thyroid carcinoma [111][112][113][114][115].…”

Section: Clinical Resultsmentioning

confidence: 99%

“…LA and RFA, in particular, seem to offer a possible curative treatment in the case of recurrent thyroid nodules and in metachronous lymph-node metastases from papillary thyroid carcinoma [111][112][113][114][115]. Such techniques, if further validated, may offer patients with difficult surgical approaches novel, minimally invasive therapeutic options.…”

Section: Clinical Resultsmentioning

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: Clinical Resultsmentioning

confidence: 99%

Section: Clinical Resultsmentioning

confidence: 99%

Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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“…Thermal ablations for benign thyroid nodules have been reported to be an effective and safe treatment [1][2][3][4]. Particularly for radiofrequency ablation (RFA), the recommendations of the Korean Society of Thyroid Radiology suggested a trans-isthmic approach and a moving-shot technique [5].…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency ablation of benign thyroid nodules: depicting early sign of regrowth by calculating vital volume

Sim¹,

Baek

Lee

et al. 2017

International Journal of Hyperthermia

149

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Objective: We evaluated long-term follow-up results of radiofrequency ablation of benign thyroid nodules to analyse the role of marginal vital tissue on nodule regrowth. Materials and methods: We reviewed the medical records of 54 patients who underwent radiofrequency ablation between June 2008 and November 2013 with pressure symptoms, and/or cosmetic problems. All patients were followed up at least 12 months on three occasions. To evaluate an early sign of regrowth, three types of nodule volumes (total volume, ablated volume and vital volume) were measured and calculated using ultrasonography. Regrowth was defined as a more than a 50% increase in the total volume and vital volume increase was defined as a more than 50% increase compared to the previously reported smallest volume on ultrasonography. Results: The mean follow-up period was 39.4 ± 21.7 (range, 13-87) months. Vital volume increases occurred in 31 nodules (57.4%) and there was regrowth in 13 nodules (24.1%). The mean timing of the vital volume increase was 27.5 ± 18.5 months, and for regrowth it was 39.9 ± 17.5 months. Vital volume increase tended to precede regrowth. Conclusion: Vital volume increase tended to occur earlier than regrowth and might be an early sign of regrowth in following-up after the radiofrequency ablation of benign thyroid nodules. ARTICLE HISTORY

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“…In contrast, CEUS is not reliable for monitoring during thermal ablation, because MWA creates so-called microbubbles [14], which interfere with CEUS imaging. After ablation, CEUS is reported to predict successful treatment of soft tissue and is used to identify local recurrences of malignant neoplasia [21,26]. In particular, the imaging of malignant lesions benefits from CEUS as success depends on exact ablation.…”

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confidence: 99%

Microwave Ablation of Symptomatic Benign Thyroid Nodules: Energy Requirement per ml Volume Reduction

Korkusuz

Kohlhase

Gröner

et al. 2016

Fortschr Röntgenstr

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Zusammenfassung ▼Hintergrund: Mikrowellenablationen (MWA) stellen eine neuartige thermoablative Behandlung für benigne Schilddrüsenknoten dar. Ziel war es, die benötigte Energie pro ml Volumenreduktion zu benutzen, um die benötigte Energie für ein volume-of-interest (VOI) abschätzen zu können. Methode: 25 Patienten mit 25 Knoten (6 solide, 13 komplex und 6 zystisch) wurden durch MWA behandelt. Die übertragene Energie (E) wurde mit der Volumenveränderung (Δ V) nach 3 Monaten korreliert. Der Energiebedarf pro ml Volumenreduktion wurde durch E/Δ V bestimmt. Ergebnisse: MWA zeigte eine signifikante (p < 0,0001) Volumenreduktion (Δ V) im Mittel von 12,4 ± 13,0 ml (range: 1,5 -63,2 ml) und eine relative Reduktion von 52 ± 16 % (range: 22 -77 %). Es zeigte sich eine positive Korrelation zwischen E und Δ V (r = 0,82; p < 0,05). Die mittlere E/Δ V war 1,52 ± 1,08 (range: 0,4 -4,6) kJ/ml für alle Knoten und 2,30 ± 1,5 (0,9 -4,6); 1,5 ± 0,9 (0,4 -3,6); 0,75 ± 0,25 (0,4 -1,2) kJ/ml für solide, komplexe und zystische Knoten mit einer signifikanten Differenz der in E/Δ V zwischen soliden und zystischen Knoten (p < 0,03 Abstract ▼Purpose: Microwave ablation (MWA) represents a novel thermal ablative treatment of benign thyroid nodules. The aim was to determine the energy required per ml volume reduction in order to match the required energy to the volume-of-interest (VOI). Materials and Methods: 25 patients with 25 nodules (6 solid, 13 complex and 6 cystic) were treated by microwave ablation (MWA). The transmitted energy (E) was correlated with the volume change (Δ V) after 3 months. The energy required per ml volume reduction after 3 months was calculated by E/Δ V. Results: MWA resulted in a significant (p < 0.0001) volume reduction (Δ V) with a mean of 12.4 ± 13.0 ml (range: 1.5 -63.2 ml) and relative reduction of 52 ± 16 % (range: 22 -77 %). There was a positive correlation between E and Δ V (r = 0.82; p < 0.05). The mean E/Δ V was 1.52 ± 1.08 (range: 0.4 -4.6) kJ/ml for all nodules and 2.30 ± 1.5 (0.9 -4.6), 1.5 ± 0.9 (0.4 -3.6), 0.75 ± 0.25 (0.4 -1.2) kJ/ ml, respectively, for solid, complex and cystic nodules with a significant difference in E/Δ V for solid and cystic (p < 0.03). Conclusion: The energy required per volume depends on the nodule consistency. Solid nodules require more energy than cystic ones. The estimation of the energy needed per volume-of-interest as an additional parameter should help to avoid under-or overtreatment. Key Points:▶ The estimated required energy for a volumeof-interest depends on the nodule consistency ▶ In solid nodules a higher energy transmission than in cystic nodules is recommended ▶ The energy transmission as an additional marker to ultrasound is helpful for improving periprocedural monitoring This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

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Percutaneous Laser Ablation of Metastatic Lymph Nodes in the Neck From Papillary Thyroid Carcinoma: Preliminary Results

Abstract: PLA is potentially feasible, safe, and effective for the treatment of metachronous cervical nodal metastases from papillary thyroid carcinoma. This procedure may reduce or delay a large number of highly invasive repeat neck dissections.

Cited by 81 publications

References 18 publications

Image-guided thermal ablation of benign thyroid nodules

Image-guided thermal ablation of benign thyroid nodules

Radiofrequency ablation of benign thyroid nodules: depicting early sign of regrowth by calculating vital volume

Microwave Ablation of Symptomatic Benign Thyroid Nodules: Energy Requirement per ml Volume Reduction

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