Radiofrequency Ablation for Benign Thyroid Nodules: 1‐Year Follow‐Up in 184 Patients

Vuong, Nguyen Lam; Dinh, Le Quang; Bang, Ho Tat; Thuy, Tran Thi Mai; Bac, Nguyen Hoang

doi:10.1007/s00268-019-05044-5

Cited by 28 publications

(24 citation statements)

References 53 publications

(57 reference statements)

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“…The long-term efficacy of the treatment is assessed by observing the absence of nodular vital tissue regrowth, which can be demonstrated during ultrasound examinations carried out in the period following the treatment. Nodular regrowth, in the other hand, has been associated with the presence of inadequately treated nodular margins ( 21 , 26 – 28 ).…”

Section: Discussionmentioning

confidence: 99%

The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data

Offi¹,

Garberoglio²,

Antonelli³

et al. 2021

Front. Endocrinol.

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Induced radiofrequency thermal ablation is the cytoreductive treatment of symptomatic benign thyroid nodules, metastatic and recurrent thyroid tumors and papillary thyroid microcarcinomas. It is a safe and effective alternative to surgery and it allows to obtain satisfactory results in terms of volumetric reduction of the nodule with significant improvement in the quality of life. The trans-isthmic approach and the moving shot technique are the two basic techniques; however, an advanced technique, artery-first feeding radiofrequency ablation, has been developed and validated. We have prospectively included 29 consecutive patients who have undergone radiofrequency ablation (Group A) or artery- first vRFA (Group B). All included patients had a diagnosis of benign nodular goiter and they underwent a single session of radiofrequency ablation. All patients followed a follow-up program at 1 month, 3 months, and 6 months. Continuous variables (age, TSH value, basal volume of nodule, used Joule, time in second of the procedure, nodules’ volume at 1-, 3-, and 6- months of follow-up and percentage of volume reduction at 1-, 3-, and 6- months of follow-up) were described as mean, standard deviation and range, while categorical variables (gender, nodule structure and nodule vascularization) were described as number of cases and percentage. Independent samples t-test were performed to compare the continuous variables. A Test of Proportions was applied to the categorical variables. The Fisher’s exact test was used to analyze the gender. Statistical significance was considered in case of p-value <0.05. Solid structure and spongiform structure showed statistic differences with p-values of 0.022 and 0.023 respectively between two groups. The percentage of reduction at 1 month did not show a significant difference between two groups; instead, the percentage of volume reduction was decreased mostly in the Group B at 3 months and 6 months of follow-up with a p-value of 0.003 and 0.013, respectively. The Joules/energy used showed a statistically significant difference (p-value=0.05), more energy must be used in vascular radiofrequency ablation. These data allow us to hypothesize that vRFA may improve the effectiveness of the procedure, allowing for a reduction in volume more quickly. They were preliminary but promising results, clearly a larger series of cases and prolonged follow-up are needed to clarify and confirm our observations.

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Section: Discussionmentioning

confidence: 99%

The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data

Offi¹,

Garberoglio²,

Antonelli³

et al. 2021

Front. Endocrinol.

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“…PEI compared with cyst aspiration only was associated with a thyroid nodule volume reduction of at least 50% in 83% versus 44% of participants; improvement in compression symptoms occurred in 78% versus 38%, after six to 12 months. A retrospective study of radiofrequency ablation in 251 benign thyroid nodules showed a volume reduction ratio of 81% after 12 months 205. A multicenter study of 601 thyroid nodules treated with laser therapy or radiofrequency ablation showed that for larger thyroid nodules (volume >30 mL), a higher percentage of thyroid nodule volume reduction was achieved in the laser therapy group (−73) than the radiofrequency ablation group (–54) at 12 months 206.…”

Section: Emerging Treatmentsmentioning

confidence: 99%

Thyroid nodules: diagnostic evaluation based on thyroid cancer risk assessment

Ospina

Iñiguez-Ariza

Castro

2020

BMJ

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Thyroid nodules are extremely common and can be detected by sensitive imaging in more than 60% of the general population. They are often identified in patients without symptoms who are undergoing evaluation for other medical complaints. Indiscriminate evaluation of thyroid nodules with thyroid biopsy could cause a harmful epidemic of diagnoses of thyroid cancer, but inadequate selection of thyroid nodules for biopsy can lead to missed diagnoses of clinically relevant thyroid cancer. Recent clinical guidelines advocate a more conservative approach in the evaluation of thyroid nodules based on risk assessment for thyroid cancer, as determined by clinical and ultrasound features to guide the need for biopsy. Moreover, newer evidence suggests that for patients with indeterminate thyroid biopsy results, a combined assessment including the initial ultrasound risk stratification or other ancillary testing (molecular markers, second opinion on thyroid cytology) can further clarify the risk of thyroid cancer and the management strategies. This review summarizes the clinical importance of adequate evaluation of thyroid nodules, focuses on the clinical evidence for diagnostic tests that can clarify the risk of thyroid cancer, and highlights the importance of considering the patient’s values and preferences when deciding on management strategies in the setting of uncertainty about the risk of thyroid cancer.

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“… 19 Reduction rates for benign thyroid nodules of 33% to 58% after 1 month of ablation and 51% to 92% after 6 months of ablation have been reported. 20 In this study, ultrasound performed immediately after ablation of 96 lesions showed no perfusion of contrast agents in 88.5% lesions, and enhancement to varying degrees at the edge or inside the lesion in 11.4% of lesions. Although there were no significant changes in lesion volume at 1 month after the operation, the lesion volumes were reduced by 40% to 80% at 3 months after surgery.…”

Section: Discussionmentioning

confidence: 46%

Clinical value of matrix metalloproteinase-2 and -9 in ultrasound-guided radiofrequency ablation treatment for papillary thyroid carcinoma

2020

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Objective This study aimed to investigate serum matrix metalloproteinase (MMP)-2 and MMP-9 levels in patients with papillary thyroid carcinoma (PTC). Methods Forty-one patients with PTC undergoing ultrasound-guided radiofrequency ablation (RFA) and 56 controls were included. Serum MMP-2 and MMP-9 levels were determined by enzyme-linked immunosorbent assay before and after surgery. Potential affecting factors were evaluated by logistic regression analysis. Results Serum MMP-2 and MMP-9 levels were significantly higher in PTC patients compared with controls, and decreased significantly after surgery. According to receiver operating characteristic curve analysis, diagnostic values for preoperative serum MMP-2 and MMP-9 levels were 82.4% and 86.6%. There was no contrast-agent perfusion in the ablation zone in 88.5% of lesions, and enhancement within or at the lesion edge in 11.4%. The volume reduction at 3 months’ follow-up was >40%. Age, microcalcification, irregular shape, and lesion diameter and number were influencing factors for PTC. Age, and lesion diameter and number were independent risk factors, while calcification and morphology were protective factors. Conclusion Serum MMP-2 and MMP-9 levels have important clinical values for the diagnosis and treatment of PTC by RFA. Preoperative serum MMP-2 and MMP-9 levels, combined with other affecting factors, contribute to disease prognosis.

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Radiofrequency Ablation for Benign Thyroid Nodules: 1‐Year Follow‐Up in 184 Patients

Cited by 28 publications

References 53 publications

The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data

The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data

Thyroid nodules: diagnostic evaluation based on thyroid cancer risk assessment

Clinical value of matrix metalloproteinase-2 and -9 in ultrasound-guided radiofrequency ablation treatment for papillary thyroid carcinoma

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