Which needle in the treatment of thyroid nodules?

Pescatori, Lorenzo; Torcia, Pierluca; Nicosia, Luca; Mauri, Giovanni; Rossi, Umberto; Cariati, Maurizio

doi:10.21037/gs.2018.01.03

Cited by 14 publications

(13 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In principle, RFA generated high-frequency oscillating current, and the polarized molecules and ions in the surrounding tissue were vibrated and rubbed by the exposed electrode needle, which was then converted into heat energy. The heat was gradually transmitted to the periphery, causing irreversible thermal coagulation and necrosis of local tissue to kill tissue cells [ 53 , 54 ].…”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy of different ultrasound-guided ablation for the treatment of benign thyroid nodules: Systematic review and network meta-analysis of randomized controlled trials

Zhao

Xia

et al. 2021

PLoS ONE

View full text Add to dashboard Cite

Background Percutaneous ablation is currently deemed an additionally treatment option for benign thyroid nodules in the world, but possibly different effect among the ablation modalities is not clear. So we aim to evaluate the efficacy and complications of thermal/chemical ablation by network meta-analysis. Materials and methods In the network meta-analysis, PubMed, EMBASE and the Cochrane Library databases were searched from 1980 to 2020. Studies of adults with thyroid benign nodules under percutaneous ablation therapy were included. Percentage mean volume change, symptom score change, cosmetic score change and complications were evaluated by network meta-analysis. Results In the network meta-analysis, Radiofrequency Ablation(RFA) with 2 treatment sessions group was associated with the highest reduction for the mean volume change during 6-month follow-up (MD = 79.09 and 95% CrI:48.23–89.94). There is no significant difference in the incidence of complications. Subgroup analysis showed that 2 sessions of Radiofrequency Ablation (RFA) ranks the highest probability (surface under the cumulative ranking curve (SUCRA) values 77.9) of being the most efficacious treatment for solid or predominantly solid benign nodules. Ethanol ablation (EA) ranked first (SUCRA value 81.1) in the treatment for cyst or predominantly cyst benign nodules. Conclusion RFA appears to be superior to other US-guided percutaneous ablation in reducing benign thyroid nodule volume during short- and long-term follow-up. In the subgroup analysis, RFA with 2 treatment sessions showed the most significant effectiveness for solid benign thyroid nodules and EA showed more effectiveness to decrease the volume of cyst benign thyroid nodules.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparative efficacy of different ultrasound-guided ablation for the treatment of benign thyroid nodules: Systematic review and network meta-analysis of randomized controlled trials

Zhao

Xia

et al. 2021

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Then, a 300 mm diameter plane-cut quartz optical fiber is inserted and advanced up to the introducer needle tip. The introducer needles are then pulled back so as to expose the tip of each fiber at least 5 mm in direct contact with the target tissue [11]. Common protocols are based on a mean power of 3-5 W, for a total energy delivery of 1200-1800 J for every illumination.…”

Section: Laser Ablationmentioning

confidence: 99%

Laser and radiofrequency ablations for benign and malignant thyroid tumors

Mauri

Gennaro

Lee

et al. 2019

International Journal of Hyperthermia

Self Cite

View full text Add to dashboard Cite

A growing body of evidence is being published regarding the safety and efficacy of minimally invasive image-guided ablation techniques. While clinical applications of these techniques are increasing, international societies have started to publish treatment guidelines and to make efforts to standardize both terminology and reporting criteria for image-guided thyroid ablations. Laser ablation and radiofrequency ablation (RFA) are among the most common ablation techniques either for benign and malignant thyroid nodules. Unlike laser ablation and RFA in the treatment of benign thyroid nodules, where safety and efficacy have been widely demonstrated, evidence regarding local tumor control of thyroid malignancies is still limited. However, preliminary results are encouraging and image-guided thermal ablation techniques can be considered a valid alternative to surgery for the treatment of benign thyroid nodules and recurrent thyroid cancers. This review evaluates the basic concept of RFA and laser ablations, their techniques, clinical outcomes, and complications based on the suggestions of several society guidelines. Multidisciplinary collaboration remains critical to identify patients which may benefit from minimally invasive image-guided thermal ablations, especially if surgery or radioiodine therapy are not feasible options.

show abstract

“…A vast literature has been produced on radiofrequency and microwave, firstly used in liver ablation [43] and then to treat tumors of others locations, such as kidney, bone) and thyroid [44,45] among the others.…”

Section: Comparison According To the Ablation Modalitymentioning

confidence: 99%

Image-guided lung metastasis ablation: a literature review

Prud’homme

Deschamps

Moulin

et al. 2019

International Journal of Hyperthermia

View full text Add to dashboard Cite

Purpose: To review the available options of percutaneous ablation of lung metastasis. Methods: General indications, prognostic factors, and image guidance of percutaneous lung ablations were reviewed. Specificities, technical aspects, advantages and limitations of each technic were highlighted. Complications and follow up where also reviewed. Results: Image-guided, percutaneous ablation is of interest for patients with a limit number (<3-5) small metastases (<2-3 cm). Other predictive factors have been reported such as the disease-free interval, the primary tumor, or the proximity with large vessels or bronchus. Radiofrequency ablation (RFA) is the most reported technic, with local control rate >90% for small tumors, and a very low complication rate. Microwave (MWA) and cryoablation are alternative technics developed in the last 15 years to overcome RFA limitations, with encouraging results. Larger ablations zones and less heat sink effect have been described with MWA. On the other hand, cryoablation allows painless treatments under conscious sedation and/or local anesthesia, high accessibility of difficult locations and promising results on prospective multicenter series. Although irreversible electroporation (IRE) could be used for lesions close to main blood vessels as it is not limited by the heat sink effect and does not have significant effects on connective tissue, allowing to treat lesions near to vital organs, preliminary results for lung metastasis are disappointing. Conclusion: Percutaneous ablation of lung metastases, whatever technic is used, is feasible, with high local control rate, and acceptable complication rate. Although indications seem clear enough, validation through controlled trials is mandatory.

show abstract

Which needle in the treatment of thyroid nodules?

Cited by 14 publications

References 35 publications

Comparative efficacy of different ultrasound-guided ablation for the treatment of benign thyroid nodules: Systematic review and network meta-analysis of randomized controlled trials

Comparative efficacy of different ultrasound-guided ablation for the treatment of benign thyroid nodules: Systematic review and network meta-analysis of randomized controlled trials

Laser and radiofrequency ablations for benign and malignant thyroid tumors

Image-guided lung metastasis ablation: a literature review

Contact Info

Product

Resources

About