Risk Assessment and Hydrodissection Technique for Radiofrequency Ablation of Thyroid Benign Nodules

Tang, Xianhui; Li, Ping; Cui, Dan; Ding, Min; Chi, Jiachang; Wang, Tao; Shi, Yaoping; Wang, Zhi; Zhai, Bo

doi:10.7150/jca.26060

Cited by 35 publications

(32 citation statements)

References 26 publications

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“…Especially for nodules located close to the thyroid capsule, trachea and/or carotid artery, attention should be paid to preventing damage to the vital neck structures. In selected cases, local infusion of saline, or 5% glucose, solution forming a liquid barrier of at least 5 mm is required to isolate the target area from nearby critical structures [34]. Patients should be asked to communicate the onset of neck pain, which usually indicates heating of the thyroid capsule and requires discontinuation of treatment followed by repositioning of the TA applicator.…”

Section: Methodsmentioning

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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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: Methodsmentioning

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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“…Hydrodissection can preserve a safety margin around adjacent critical structures during RFA. In this technique, 5% DW is injected to separate the thyroid nodules from many critical structures; the nodule margin can then be treated safely using the 5% DW as a thermal barrier [ 2 , 35 , 36 ].…”

Section: Methodsmentioning

confidence: 99%

Radiofrequency ablation of benign thyroid nodules: recommendations from the Asian Conference on Tumor Ablation Task Force

Baek

Che

et al. 2021

Ultrasonography

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Epub ahead of print Radiofrequency ablation (RFA) is a thermal ablation technique widely used for the management of benign thyroid nodules. To date, five academic societies in various countries have reported clinical practice guidelines, opinion statements, or recommendations regarding the use of thyroid RFA. However, despite some similarities, there are also differences among the guidelines, and a consensus is required regarding safe and effective treatment in Asian countries. Therefore, a task force was organized by the guideline committee of the Asian Conference on Tumor Ablation with the goal of devising recommendations for the clinical use of thyroid RFA. The recommendations in this article are based on a comprehensive analysis of the current literature and the consensus opinion of the task force members.

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“…https://doi.org/10.3348/kjr.2020.0037 kjronline.org (32)(33)(34). Therefore, a hydrodissection technique (injection of a 5% dextrose solution between the nerve and the tumor) is essential for the prevention of thermal injury.…”

Section: A B Cmentioning

confidence: 99%

Minimally Invasive Treatment for Benign Parathyroid Lesions: Treatment Efficacy and Safety Based on Nodule Characteristics

Baek

2020

Korean J Radiol

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This study aimed to evaluate the efficacy and safety of ultrasound (US)-guided minimally invasive treatment in patients with parathyroid lesions. Materials and Methods: This study included 27 patients who had undergone US-guided radiofrequency ablation (RFA) or ethanol ablation (EA) for parathyroid lesions between January 2010 and 2018. RFA was performed in 19 patients with primary hyperparathyroidism (PHPT, n = 11) or secondary hyperparathyroidism (SHPT, n = 8), and EA was performed in eight patients with symptomatic nonfunctioning parathyroid cysts (SNPCs). Nodule size, volume, serum parathyroid hormone (PTH) and calcium levels were recorded before and after treatment. Complications were evaluated during and after treatment. Results: In patients with PHPT, significant reductions in size and volume were noted after RFA at 6-and 12-month follow-up (all, p < 0.05). Seven nodules nearly completely disappeared (residual volume < 0.1 mL); serum PTH and calcium levels were reduced to normal ranges (7/11, 63.6%). Four patients experienced partial reductions of serum PTH and calcium levels (4/11, 36.4%). In patients with SHPT, three experienced therapeutic response of serum PTH (3/8, 37.5%), while five showed persistent hyperparathyroidism (5/8, 62.5%) within 6 months after RFA. In patients with SNPCs, EA resulted in significant reductions in cyst size and volume (all, p < 0.05) at the last follow-up. A total of four complications (two transient hypocalcemia [RFA], one permanent [RFA], and one transient [EA] hoarseness) were observed. Conclusion: Minimally invasive treatments, such as RFA and EA, may serve as therapeutic alternatives for patients with PHPT or SNPCs; they may have limited usefulness in patients with SHPT.

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Risk Assessment and Hydrodissection Technique for Radiofrequency Ablation of Thyroid Benign Nodules

Cited by 35 publications

References 26 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 of benign thyroid nodules: recommendations from the Asian Conference on Tumor Ablation Task Force

Minimally Invasive Treatment for Benign Parathyroid Lesions: Treatment Efficacy and Safety Based on Nodule Characteristics

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