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

Sim, Jung Suk; Baek, Jung Hwan; Lee, Joongyub; Cho, Woojin; Jung, Sung Il

doi:10.1080/02656736.2017.1309083

Cited by 73 publications

(154 citation statements)

References 43 publications

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“…Color-Doppler mapping improves defining the treated area, which appears as devoid of vascular signals. Contrast-enhanced US provides a more accurate assessment of the loss of small vessel signals and better depicts the incompletely treated peripheral areas [14,[35][36][37][38][39][40]. Notably, in a few European countries, thyroid nodular disease is not among the licensed indications for the use of US contrast agents.…”

Section: Post-procedural Management and Follow-upmentioning

confidence: 99%

“…Currently, regrowth after treatment should be defined as a nodule volume increase > 50% over the smallest recorded volume [11,12,14]. Main predictive factors for recurrence appear to be large initial size, functional autonomy, low applied energy, and incomplete ablation of the marginal areas of the nodules [36][37][38]. Therefore, during follow-up, demonstration of initial regrowth in untreated peripheral areas should prompt a second targeted TA to prevent further volume increase and recurrence of symptoms over time [39].…”

Section: Post-procedural Management and Follow-upmentioning

confidence: 99%

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2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules

et al. 2020

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Standard therapeutic approaches for benign thyroid lesions that warrant intervention are surgery for cold and either surgery or radioiodine for autonomously functioning thyroid nodules (AFTN). Image-guided thermal ablation (TA) procedures are increasingly proposed as therapy options for selected clinical conditions. Due to mounting scientific evidence and widening availability, ETA considered it appropriate to develop guidelines for the use of TA in adult patients. TA procedures are well tolerated, but a dedicated training of the operators is required and information on possible complications needs to be shared with the patients. The following factors should be considered when weighing between observation, surgery, and TA for benign thyroid nodules. In solid non-hyperfunctioning nodules, TA induces a decrease in thyroid nodule volume, paralleled by improvement in symptoms. Nodule re-growth is possible over time and may necessitate repeat treatment, or surgery, in a dialogue with the patient. In AFTN, radioactive iodine is the first-line treatment, but TA may be considered in young patients with small AFTN due to higher probability of restoring normal thyroid function and avoidance of irradiation. In cystic nodules, ethanol ablation (EA) is the most effective and least expensive treatment. TA may be considered for cystic lesions that relapse after EA or have a significant residual solid component following drainage and EA. TA should be restricted to benign lesions that cause symptoms or cosmetic concern. Presently, laser and radiofrequency ablation are the most thoroughly assessed techniques, with similar satisfactory clinical results. Microwaves and high-intensity focused ultrasound therapy options remain to be fully evaluated.© 2020 European Thyroid Association Published by S. Karger AG, Basel Recommendation 1. In adult patients with benign thyroid nodules that cause pressure symptoms and/or cosmetic concerns and decline surgery, image-guided TA should be considered as a costand risk-effective alternative option to surgical treatment or observation alone (1, ØØOO).Recommendation 2. We recommend against the use of TA for asymptomatic lesions (1, ØØØO).

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Section: Post-procedural Management and Follow-upmentioning

confidence: 99%

Section: Post-procedural Management and Follow-upmentioning

confidence: 99%

2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules

et al. 2020

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“…At the moment, a common consensus regarding the definition of small, medium and large nodule has not been established. Some authors categorize thyroid nodules with volumes of <10 mL as small and >20 mL as large . Others consider nodules with initial volumes between 12.0 and 30.0 mL as medium, and those >30.0 mL as large .…”

Section: Clinical Outcomesmentioning

confidence: 99%

Radiofrequency ablation for the management of thyroid nodules: A critical appraisal of the literature

Cesáreo

Palermo

Pasqualini

et al. 2017

Clinical Endocrinology

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The majority of benign thyroid nodules are asymptomatic, remain stable in size and do not require treatment. However, a minority of patients with growing nodules may have local symptoms or cosmetic concerns, and thus demand surgical therapy. The timely use of ultrasound-guided, minimally invasive thermal therapies has changed the natural history of benign, enlarging thyroid nodules (TNs). These procedures produce persistent shrinkage of TNs and an improvement of local symptoms. Among the various procedures, percutaneous ethanol injection represents the first-line treatment for thyroid cysts, while in solid cold nodules, laser and radiofrequency ablation (RFA) have proven to be very effective and safe techniques in producing significant volume reduction that remains stable over several years. In particular, RFA seems to be suited for the management of small and medium nodules, while larger nodules may require repeated RFA treatments, and could be difficult to treat if they extend into the chest. RFA is performed in outpatient clinics and has a lower risk of complications compared to surgery. However, to date, there is still no unanimous consensus on the percutaneous treatment of benign nodules using such minimally invasive thermal techniques. In this review, we critically revise the literature to identify patients who are more likely to benefit from RFA treatment as an alternative to surgery.

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“…Since 2006, many studies have evaluated feasibility, safety and efficacy of RFA in benign thyroid nodules, reporting good results in reducing both the volume of the nodules and the associated compressive symptoms/ cosmetic concerns. More recent studies have demonstrated the absence of regrowth at the mid-term follow-up controls (39.4±21.7 months) in 76% of cases (12).…”

Section: Introductionmentioning

confidence: 92%

Cooled tip radiofrequency ablation of benign thyroid nodules: preliminary experience with two different devices

et al. 2018

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

Cited by 73 publications

References 43 publications

2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules

2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules

Radiofrequency ablation for the management of thyroid nodules: A critical appraisal of the literature

Cooled tip radiofrequency ablation of benign thyroid nodules: preliminary experience with two different devices

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