Thyroid Nodules Treated with Percutaneous Radiofrequency Thermal Ablation: A Comparative Study

Faggiano, Antongiulio; Ramundo, Valeria; Assanti, Angelo Pio; Fonderico, Francesco; Macchia, Paolo Emidio; Misso, Claudia; Marciello, Francesca; Marotta, Vincenzo; Prete, Michela Del; Papini, Enrico; Lombardi, Gaetano; Colao, Annamaria; Spiezia, Stefano

doi:10.1210/jc.2012-2251

Cited by 109 publications

(124 citation statements)

References 36 publications

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“…Most articles consider a 3-6-month and a 1-year follow-up. The mean volume reduction has been found to range from 47 to 84 % at 3-6 months, and from 62 to 93 % at 1 year [34,[37][38][39][40][41][42][43][44][45][46][47][48] (Table 2). Most of the volume reduction was observed within 3-6 months, and then, the volume size decreased more gradually up to 1 year.…”

Section: Clinical Resultsmentioning

confidence: 98%

“…The results of RFA are evaluated by change in nodule volume and improvement of clinical problems, including symptoms and cosmetic issues. Some studies consider the efficacy of RFA only in hyperfunctioning thyroid nodules [35,41,42], others only in cold nodules [33,37,47] and others in both hyperfunctioning and cold nodules [38][39][40][44][45][46]. Follow-up US examinations are usually performed at 1, 3, 6, and 12 months and every 6-12 months after that.…”

Section: Clinical Resultsmentioning

confidence: 99%

“…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%

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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: 98%

Section: Clinical Resultsmentioning

confidence: 99%

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%

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Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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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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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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Thyroid Nodules Treated with Percutaneous Radiofrequency Thermal Ablation: A Comparative Study

Abstract: RTA induced a marked TN volume shrinkage resulting in parallel improvement of pressure symptoms. In most patients with toxic TNs, hyperthyroidism significantly improved as well. RTA may represent a valid therapeutic approach in patients with TNs not receiving conventional treatments.

Cited by 109 publications

References 36 publications

Image-guided thermal ablation of benign thyroid nodules

Image-guided thermal ablation of benign thyroid nodules

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

Levothyroxine or minimally invasive therapies for benign thyroid nodules

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