Radiofrequency Ablation of Benign Cold Thyroid Nodules: Initial Clinical Experience

Kim, Young-Sun; Rhim, Hyunchul; Tae, Kyung; Park, Dong Woo; Kim, Sung Tae

doi:10.1089/thy.2006.16.361

Cited by 240 publications

(253 citation statements)

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“…Three orthogonal nodule diameters, including the largest diameter, are measured by US to assess nodule volume using the following equation: V = pabc/6, where V is the volume, a is the maximum diameter, and b and c are the other two perpendicular diameters [33,34,37,41,43,[45][46][47][48][49]. Laboratory tests usually include a complete blood count, a blood coagulation battery, measurements of thyrotrophin, thyroid hormones, thyroid auto-antibodies, and calcitonin concentrations.…”

Section: Clinical Resultsmentioning

confidence: 99%

“…There was only one case of thyrotoxicosis, which spontaneously resolved within 30 days [46]. Major complications were, in the order of frequency, permanent voice change [33,34,44,46,47,52], rupture of the nodule [44,52], permanent hypothyroidism [41,52], and brachial plexus injury [47,52]. None of the patients experienced any lifethreatening complications related to RFA.…”

Section: Complicationsmentioning

confidence: 98%

“…The first RFA studies on thyroid nodules were performed with a 17-G straight internally cooled electrode needle with a 1-cm active tip [33][34][35][36][37] or with 14-gauge multi-tined expandable electrodes to obtain a more extended ablation area [38][39][40]. Thinner (18-G or 19-G) internally cooled multi-tined (0.5-1-1.5 cm) electrode needles were later developed specifically for thyroid lesions, to make control of the needle easier, minimizing normal tissue injury [41][42][43][44][45][46][47][48][49].…”

Section: Rfa Devices and Proceduresmentioning

confidence: 99%

“…Most procedures are performed with local anesthesia [33][34][35][36][37][38][40][41][42][43][44][45][46][47][48][49].…”

Section: Rfa Devices and Proceduresmentioning

confidence: 99%

“…The most common complication in all studies was pain [33,34,38,[45][46][47][48][49][50][51][52] (Table 1). In the order of frequency, authors also reported hematomas [33,47,52], vomiting [47,52], skin burn [33,52], fever [38], and thyrotoxicosis [46]. Hematomas can be controlled by neck compression and usually disappear within 2 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: Clinical Resultsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 98%

Section: Rfa Devices and Proceduresmentioning

confidence: 99%

“…Most procedures are performed with local anesthesia [33][34][35][36][37][38][40][41][42][43][44][45][46][47][48][49].…”

Section: Rfa 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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Levothyroxine or minimally invasive therapies for benign thyroid nodules

Bandeira‐Echtler

Bergerhoff

Richter

2014

Cochrane Database of Systematic Reviews

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No study evaluated all-cause mortality, health-related quality of life or provided systematic data on the development of thyroid cancer. Longest follow-up was five years and median follow-up was 12 months. Nodule volume reductions were achieved by PEI, LP and RF, and to a lesser extent, by LT4. However, the clinical relevance of this outcome measure is doubtful. PEI, LP and RF led to improvements in pressure symptoms and cosmetic complaints. Adverse events such as light-to-moderate periprocedural pain were seen after PEI, LP and RF. Future studies should focus on patient-important outcome measures, especially health-related quality of life, and compare minimally invasive procedures with surgery. RCTs with follow-up periods of several years and good-quality observational studies are needed to provide evidence on the development of thyroid cancer, all-cause mortality and long-term adverse events.

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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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Radiofrequency Ablation of Benign Cold Thyroid Nodules: Initial Clinical Experience

Abstract: RF ablation may be an effective and safe nonsurgical technique to treat benign cold thyroid nodules.

Cited by 240 publications

References 22 publications

Image-guided thermal ablation of benign thyroid nodules

Image-guided thermal ablation of benign thyroid nodules

Levothyroxine or minimally invasive therapies for benign thyroid nodules

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

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