Treatment of Metastatic Lymph Nodes in the Neck from Papillary Thyroid Carcinoma with Percutaneous Laser Ablation

Mauri, Giovanni; Cova, Luca; Ierace, Tiziana; Baroli, Alberto; Mauro, Enzo Di; Pacella, Claudio Maurizio; Goldberg, S. Nahum; Solbiati, Luigi

doi:10.1007/s00270-016-1313-6

Cited by 108 publications

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“…As ablations are widely applied to malignant tumors in other regions, such as the liver, the kidneys, or even the lungs, and good results have been reported in the treatment of benign thyroid disease, a few authors have started investigating the feasibility and effectiveness of imageguided thermal ablations in malignant diseases in the neck [111][112][113][114][115]. LA and RFA, in particular, seem to offer a possible curative treatment in the case of recurrent thyroid nodules and in metachronous lymph-node metastases from papillary thyroid carcinoma [111][112][113][114][115].…”

Section: Clinical Resultsmentioning

confidence: 99%

“…LA and RFA, in particular, seem to offer a possible curative treatment in the case of recurrent thyroid nodules and in metachronous lymph-node metastases from papillary thyroid carcinoma [111][112][113][114][115]. Such techniques, if further validated, may offer patients with difficult surgical approaches novel, minimally invasive therapeutic options.…”

Section: Clinical Resultsmentioning

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: Clinical Resultsmentioning

confidence: 99%

Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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“…These techniques have been reported to have a high efficacy with a low complication rate [1,6]. Recently, thermal ablation for recurrent thyroid cancers and primary thyroid cancers has been reported [4,[7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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

Sim¹,

Baek

Lee

et al. 2017

International Journal of Hyperthermia

149

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Objective: We evaluated long-term follow-up results of radiofrequency ablation of benign thyroid nodules to analyse the role of marginal vital tissue on nodule regrowth. Materials and methods: We reviewed the medical records of 54 patients who underwent radiofrequency ablation between June 2008 and November 2013 with pressure symptoms, and/or cosmetic problems. All patients were followed up at least 12 months on three occasions. To evaluate an early sign of regrowth, three types of nodule volumes (total volume, ablated volume and vital volume) were measured and calculated using ultrasonography. Regrowth was defined as a more than a 50% increase in the total volume and vital volume increase was defined as a more than 50% increase compared to the previously reported smallest volume on ultrasonography. Results: The mean follow-up period was 39.4 ± 21.7 (range, 13-87) months. Vital volume increases occurred in 31 nodules (57.4%) and there was regrowth in 13 nodules (24.1%). The mean timing of the vital volume increase was 27.5 ± 18.5 months, and for regrowth it was 39.9 ± 17.5 months. Vital volume increase tended to precede regrowth. Conclusion: Vital volume increase tended to occur earlier than regrowth and might be an early sign of regrowth in following-up after the radiofrequency ablation of benign thyroid nodules. ARTICLE HISTORY

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“…PLA and RFA have been widely used for performing image guided ablation of benign and malignant tumors [4,[15][16][17][18][19][20][21]. Even though technical differences have been quite largely studied, no clear evidence of clinical superiority of one technique over the other is present in the literature.…”

Section: Discussionmentioning

confidence: 97%

Benign thyroid nodules treatment using percutaneous laser ablation (PLA) and radiofrequency ablation (RFA)

Park

Baek

2017

International Journal of Hyperthermia

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PurposeTo evaluate the reduction over time of benign thyroid nodules treated using percutaneous laser ablation (PLA) and radiofrequency ablation (RFA) by the same equipe. Materials and MethodsNinety patients (age 55.6±14. 34,662.7±15,812.3 J in PLA vs. RFA group. Mean volume reduced from 20.3±16.4 ml to 13.17±10.74 ml (42%±17% reduction) at 1 month, 8.7±7.4 ml (60%±15% reduction) at 6 months and 7.1±7.7 ml (70%%±16% reduction) at 12 months In PLA group, and from 32.7±19.5 ml to 17.2±12.9 ml (51%±15% reduction) at 1 month, 12.8±9.6 ml (64±14% reduction) at 6 months and 9.9±9.2 ml (74%±14% reduction) at 12 months in RFA group. No difference in time course of the relative volume reduction between the two techniques was found. ConclusionsRFA and PLA are similarly feasible, safe and effective in treating benign thyroid nodules when performed by the same equipe. RFA is faster than PLA but require significantly higher energy.

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Treatment of Metastatic Lymph Nodes in the Neck from Papillary Thyroid Carcinoma with Percutaneous Laser Ablation

Abstract: Ultrasound-guided PLA is a feasible, safe, and effective therapy for the treatment of cervical lymph node metastases from papillary thyroid carcinoma.

Cited by 108 publications

References 41 publications

Image-guided thermal ablation of benign thyroid nodules

Image-guided thermal ablation of benign thyroid nodules

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

Benign thyroid nodules treatment using percutaneous laser ablation (PLA) and radiofrequency ablation (RFA)

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