Percutaneous Radiofrequency Ablation of Benign Thyroid Nodules Assisted by a Virtual Needle Tracking System

Turtulici, Giovanni; Orlandi, Davide; Corazza, Angelo; Sartoris, Riccardo; Derchi, Lorenzo E.; Silvestri, Enzo; Baek, Jung Hwan

doi:10.1016/j.ultrasmedbio.2014.02.017

Cited by 53 publications

(57 citation statements)

References 21 publications

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“…With the fusion of different imaging modalities and the possibility of virtually navigating into a pre = acquired volume, the operator might be more confident during the ablation procedure, particularly when gas develops from the ablation, limiting the real-time US visualization [105,106]. Virtual navigation and fusion imaging may be particularly important in complex and delicate anatomical regions, such as the neck, allowing a better identification of the target tumor or nodule and a clearer visualization of surrounding anatomical structures [105].…”

Section: Clinical Resultsmentioning

confidence: 99%

“…Turtulici et al applied virtual navigation and fusion imaging to ultrasound-guided percutaneous RFA of benign thyroid nodules, using a real-time virtual needle tracking system to track the RF electrode tip when the tip is obscured by the bubbles produced by RFA [106]. This technique, which is already described during use in the abdomen [107][108][109][110], is still under investigation in neck applications, but appears possibly one of the most relevant recent technical advancements for increasing the success rate and reducing the complications of image-guided ablations in the neck.…”

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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“…The fusion system allows the use of so-called virtual tracking, a system based on a position and direction sensor mounted over the needle base that generates on the ultrasound screen a track of the current position of the tip, the direction and the position that the tip will have when it reaches the ultrasound scan plane [33].…”

Section: Discussionmentioning

confidence: 99%

In vivo feasibility of real-time MR–US fusion imaging lumbar facet joint injections

Sartoris

Orlandi²,

Corazza

et al. 2017

J Ultrasound

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Objectives Traditionally, facet joint injections (FJI) are performed under fluoroscopic or computed tomography (CT) guidance, mainly due to the deep anatomical location and the presence of bony landmarks. Fusion imaging technology, which couples the ultrasound scan with the corresponding CT or magnetic resonance (MR) image obtained from the diagnostic examination and reformatted in real time according to the ultrasound scanning plane, allows to combine the panoramic view and the elevated anatomical detail of MR or CT with the ease of use of ultrasound without patient exposure to ionizing radiation. Methods Thirty eight patients (24 females; mean age ± SD: 64 ± 9 years) received MR fusion-assisted ultrasound-guided FJI of 1 ml of a mixture of local anaesthetic and corticosteroid using a ultrasound machine (Logiq E9, GE Healthcare) equipped with a GPS-enhanced fusion imaging technology which couples real-time B-mode images with those of the previous recent diagnostic MR examination. Low-dose CT needle positioning confirmation was performed in the first 28 patients. Patients' pain was recorded using a visual analogue scale (VAS), at baseline and at 2, 4 and 8 weeks.Results All fusion imaging-guided injections were performed successfully. Out of 112, 96 FJI had optimal intraarticular needle positioning (accuracy: 85.7%). Patients VAS significantly decreases after the procedure with no differences among who received CT needle positioning control and who did not receive it. No major complications were observed. Conclusions Ultrasound needle guidance with MR fusion assistance allows for safe and effective injection of degenerative facet joint disease.Keywords Facet joint Á Injection Á Fusion imaging Á Ultrasound Á Magnetic resonance Sommario Obiettivi Tradizionalmente, le iniezioni delle faccette articolari (FJI) sono state eseguite sotto guida fluoroscopica o tomografia computerizzata (TC), principalmente a causa della posizione anatomica profonda e la presenza di reperi ossei. L'imaging di fusione permette di accoppiare le immagine ecografiche con quelle TC o di risonanza magnetica (RM) corrispondenti, ottenute da un precedente esame diagnostico e riformattate in tempo reale in base al piano di scansione ecografico. Questa tecnica permette di coniugare la visione panoramica e l'elevato dettaglio anatomico della RM o TC con la praticità della guida ecografica senza ulteriore esposizione del paziente a radiazioni ionizzanti. Metodi Trentotto pazienti (24 femmine, età media ± DS: 64 ± 9 anni) hanno ricevuto FJI guidata da fusione ecografia-RM di 1 ml di una miscela di anestetico locale e corticosteroide utilizzando una apparecchiatura ecografica (Logiq E9, GE Healthcare) dotata di tecnologia fusion. Nei (2017( ) 20:23-31 DOI 10.1007 primi 28 pazienti il posizionamento dell'ago è stato confermato mediante esame TC a bassa dose. Il dolore dei pazienti è stato registrato utilizzando una scala analogica visiva (VAS), al tempo 0 e dopo 2, 4 e 8 settimane.Risultati Tutte le iniezioni fusion guidate sono state esegui...

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“…Using both approaches, the fixed-electrode procedure and the moving shot technique, a significant nodule shrinkage is obtained in nonfunctioning thyroid nodules, coupled with a marked clinical improvement in nodule-related symptoms. In all series [19,20,[22][23][24][26][27][28][29][30][31][32], volume shrinkage gradually occurs during the first months after treatment, when necrotic tissue within nodule is reabsorbed. Following one or more RF sessions, a significant, sometimes impressive, nodule size reduction (46-93 % in different studies) is reached after 6 months and seems to be stable during a four-year follow-up [29].…”

Section: Radiofrequency Ablation In Thyroid Pathologymentioning

confidence: 99%

Radiofrequency ablation for thyroid nodules: which indications? The first Italian opinion statement

Garberoglio

Aliberti

Appetecchia³

et al. 2015

J Ultrasound

114

140

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Nodular thyroid disease is a very common finding in\ud clinical practice, discovered by ultrasound (US) in about\ud 50 % of the general population, with higher prevalence in\ud women and in the elderly [1–4].\ud Whereas therapeutic flowchart is quite established and\ud shared for malignant lesions, multiple options are now\ud available for patients presenting with benign thyroid nod-\ud ules, ranging from simple clinical and US follow-up to\ud thyroid surgery. The majority of thyroid nodules, benign by\ud fine-needle aspiration, are asymptomatic, stable, or slow-\ud growing over time and require no treatmen

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Percutaneous Radiofrequency Ablation of Benign Thyroid Nodules Assisted by a Virtual Needle Tracking System

Cited by 53 publications

References 21 publications

Image-guided thermal ablation of benign thyroid nodules

Image-guided thermal ablation of benign thyroid nodules

In vivo feasibility of real-time MR–US fusion imaging lumbar facet joint injections

Radiofrequency ablation for thyroid nodules: which indications? The first Italian opinion statement

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