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Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients

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Abstract

This study evaluated the safety and volume reduction of ultrasonography (US)-guided radiofrequency ablation (RFA) for benign thyroid nodules, and the factors affecting the results obtained. A total of 302 benign thyroid nodules in 236 euthyroid patients underwent RFA between June 2002 and January 2005. RFA was carried out using an internally cooled electrode under local anesthesia. The volume-reduction ratio (VRR) was assessed by US and safety was determined by observing the complications during the follow-up period (1–41 months). The correlation between the VRR and several factors (patient age, volume and composition of the index nodule) was evaluated. The volume of index nodules was 0.11–95.61 ml (mean, 6.13 ± 9.59 ml). After ablation, the volume of index nodules decreased to 0.00–26.07 ml (mean, 1.12 ± 2.92 ml) and the VRR was 12.52–100% (mean, 84.11 ± 14.93%) at the last follow-up. A VRR greater than 50% was observed in 91.06% of nodules, and 27.81% of index nodules disappeared. The complications encountered were pain, hematoma and transient voice changes. In conclusion, RFA is a safe modality effective at reducing volume in benign thyroid nodules.

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References

  1. Weiss RE, Lado-Abeal J (2002) Thyroid nodules: diagnosis and therapy. Curr Opin Oncol 14:46–52

    Article  PubMed  Google Scholar 

  2. Tan GH, Gharib H (1997) Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med 126:226–231

    PubMed  CAS  Google Scholar 

  3. Lima N, Knobel M, Cavaliere H, Sztejnsznajd C, Tomimori E, Medeiros-Neto G (1997) Levothyroxine suppressive therapy is partially effective in treating patients with benign, solid thyroid nodules and multinodular goiters. Thyroid 7:691–697

    PubMed  CAS  Google Scholar 

  4. Tsai CC, Pei D, Hung YJ et al (2006) The effect of thyroxine-suppressive therapy in patients with solitary non-toxic thyroid nodules—a randomised, double-blind, placebo-controlled study. Int J Clin Pract 60:23–26

    Article  PubMed  CAS  Google Scholar 

  5. Blum M (1995) Why do clinicians continue to debate the use of levothyroxine in the diagnosis and management of thyroid nodules? Ann Inter Med 122:63–64

    CAS  Google Scholar 

  6. Livraghi T, Paracchi A, Ferrari C, Reschini E, Macchi RM, Bonifacino A (1994) Treatment of autonomous thyroid nodules with percutaneous ethanol injection: 4-year experience. Radiology 190:529–533

    PubMed  CAS  Google Scholar 

  7. Papini E, Pacella CM, Verde G (1995) Percutaneous ethanol injection: what is its role in the treatment of benign thyroid nodules? Thyroid 5:147–150

    PubMed  CAS  Google Scholar 

  8. Kim JH, Lee HK, Lee JH, Ahn IM, Choi CG (2003) Efficacy of sonographically guided percutaneous ethanol injection for treatment of thyroid cysts versus solid thyroid nodules. AJR Am J Roentgenol 180:1723–1726

    PubMed  Google Scholar 

  9. Døssing H, Bennedbæk FN, Karstrup S, Hegedüs L (2002) Benign solitary solid cold thyroid nodules; US-guided interstitial laser photocoagulation-initial experience. Radiology 225:53–57

    Article  PubMed  Google Scholar 

  10. Pacella CM, Bizzarri G, Spiezia S et al (2004) Thyroid tissue: US-guided percutaneous laser thermal ablation. Radiology 232:272–280

    Article  PubMed  Google Scholar 

  11. Spiezia S, Vitale G, Di Somma C et al (2003) Ultrasound-guided laser thermal ablation in the treatment of autonomous hyperfunctioning thyroid nodules and compressive nontoxic nodular goiter. Thyroid 13:941–947

    Article  PubMed  Google Scholar 

  12. Lee SJ, Ahn IM (2005) Effectiveness of percutaneous ethanol injection therapy in benign nodular and cystic thyroid diseases: long-term follow-up experience. Endocr J 52:455–462

    Article  PubMed  CAS  Google Scholar 

  13. Guglielmi R, Pacella CM, Bianchini A et al (2004) Percutaneous ethanol injection treatment in benign thyroid lesions: role and efficacy. Thyroid 14:125–131

    Article  PubMed  CAS  Google Scholar 

  14. Papini E, Guglielmi R, Bizzarri G et al (2007) Treatment of benign cold thyroid nodule: a randomized clinical trial of percutaneous laser ablation versus levothyroxine therapy or follow-up. Thyroid 17:229–235

    Article  PubMed  CAS  Google Scholar 

  15. Gambelunghe G, Fatone C, Ranchelli A et al (2006) A randomized controlled trial to evaluate the efficacy of ultrasound-guided laser photocoagulation for treatment of benign thyroid nodules. J Endocrinol Invest 29:RC23–RC26

    PubMed  CAS  Google Scholar 

  16. Døssing H, Bennedbæk FN, Hegedüs L (2006) Effect of ultrasound-guided interstitial laser photocoagulation on benign solitary solid cold thyroid nodules: one versus three treatments. Thyroid 16:763–768

    Article  PubMed  Google Scholar 

  17. Tarantino L, Giorgio A, Mariniello N et al (2000) Percutaneous ethanol injection of large autonomous hyperfunctioning thyroid nodules. Radiology 214:143–148

    PubMed  CAS  Google Scholar 

  18. Del Prete S, Russo D, Caraglia M et al (2001) Percutaneous ethanol injection of autonomous thyroid nodules with a volume larger than 40 ml: three years of follow-up. Clin Radiol 56:895–901

    Article  PubMed  Google Scholar 

  19. Døssing H, Bennedbæk FN, Hegedüs L (2003) Ultrasound-guided interstitial laser photocoagulation of an autonomous thyroid nodule: the introduction of a novel alternative. Thyroid 13:885–888

    Article  PubMed  Google Scholar 

  20. Amabile G, Rotondi M, Chiara GD et al (2006) Low-energy interstitial laser photocoagulation for treatment of nonfunctioning thyroid nodules: therapeutic outcome in relation to pretreatment and treatment parameters. Thyroid 16:749–755

    Article  PubMed  Google Scholar 

  21. Gazelle G, Goldberg S, Solbiati L, Livraghi T (2000) Tumor ablation with radio-frequency energy. Radiology 217:633–646

    PubMed  CAS  Google Scholar 

  22. Dupuy DE, Goldberg SN (2001) Image-guided radiofrequency tumor ablation: challenges and opportunities-part II. J Vasc Interv Radiol 12:1135–1148

    Article  PubMed  CAS  Google Scholar 

  23. Dupuy DE, Monchik JM, Decrea C, Pisharodi L (2001) Radiofrequency ablation of regional recurrence from well-differentiated thyroid malignancy. Surgery 130:971–977

    Article  PubMed  CAS  Google Scholar 

  24. Hansler J, Harsch IA, Strobel D, Hahn EG, Becker D (2005) Treatment of a solitary adenoma of the parathyroid gland with ultrasound-guided percutaneous Radiofrequency tissue ablation (RFTA). Ultraschall Med 23:202–206

    Article  Google Scholar 

  25. Kim YS, Rhim H, Tae K, Park DW, Kim ST (2006) Radiofrequency ablation of benign cold thyroid nodules: initial clinical experience. Thyroid 16:361–367

    Article  PubMed  Google Scholar 

  26. Rozman B, Bence-Zigman Z, Tomic-Brzac H, Skreb F, Pavlinovic Z, Simonovic I (1989) Sclerosation of thyroid cysts by ethanol. Period Biol 91:453

    Google Scholar 

  27. Caraccio N, Goletti O, Lippolis PV et al (1997) Is percutaneous ethanol injection a useful alternative for the treatment of the cold benign thyroid nodule? Five years’ experience. Thyroid 7:699–704

    PubMed  CAS  Google Scholar 

  28. Zingrillo M, Torlontano M, Chiarella R et al (1999) Percutaneous ethanol injection may be a definitive treatment for symptomatic thyroid cystic nodules not treatable by surgery: five-year follow-up study. Thyroid 9:763–767

    PubMed  CAS  Google Scholar 

  29. Del Prete S, Caraglia M, Russo D et al (2002) Percutaneous ethanol injection efficacy in the treatment of large symptomatic thyroid cystic nodules: ten-year follow-up of a large series. Thyroid 12:815–821

    Article  PubMed  Google Scholar 

  30. Bennedbæk FN, Hegedüs L (2003) Treatment of recurrent thyroid cysts with ethanol: a randomized double-blinded controlled trial. J Clin Endocrinol Metab 88:5773–5777

    Article  PubMed  CAS  Google Scholar 

  31. Song HT, Rhim H, Choi JB et al (2001) Radiofrequency thermal ablation of benign cystic lesions: an experimental pilot study in a porcine gallbladder model. J Korean Radiol Soc 11:571–576

    Google Scholar 

  32. Sturniolo G, D’Alia C, Tonante A, Gagliano E, Taranto F, Lo Schiavo MG (1999) The recurrent laryngeal nerve related to thyroid surgery. Am J Surg 177:485–488

    Article  PubMed  CAS  Google Scholar 

  33. Hisham AN, Lukman MR (2002) Recurrent laryngeal nerve in thyroid surgery: a critical appraisal. ANZ J Surg 72:887–889

    Article  PubMed  Google Scholar 

  34. Bron LP, O’Brien CJ (2004) Total thyroidectomy for clinically benign disease of the thyroid gland. Br J Surg 91:569–574

    Article  PubMed  CAS  Google Scholar 

  35. Crile G Jr (1996) Treatment of thyroid cysts by aspiration. Surgery 59:210–212

    Google Scholar 

  36. Ozdemir H, Ilgit ET, Yucel C et al (1994) Treatment of autonomous thyroid nodules: safety and efficacy of sonographically guided percutaneous injection of ethanol. AJR Am J Roentgenol 163:929–932

    PubMed  CAS  Google Scholar 

  37. Bennedbæk FN, Hegedüs L (1999) Percutaneous ethanol injection therapy in benign solitary solid cold thyroid nodules: a randomized trial comparing one injection with three injections. Thyroid 9:225–233

    Article  PubMed  Google Scholar 

  38. Hegedüs L, Bonnema SJ, Bennedbæk FN (2003) Management of simple nodular goiter: current status and future perspectives. Endocrine Rev 24:102–132

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea

    Woo Kyoung Jeong

  2. Department of Radiology, Thyroid center, Daerim St. Mary’s Hospital, #978-13 Daerim-dong, Youngdeunpo-gu, Seoul, 150-070, South Korea

    Jung Hwan Baek, Yoon Suk Kim, Min Sook Kwak & Hyun Jo Jeong

  3. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Hyunchul Rhim

  4. Department of Internal Medicine, Thyroid center, Daerim St. Mary’s Hospital, Seoul, South Korea

    Ducky Lee

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  1. Woo Kyoung Jeong
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  2. Jung Hwan Baek
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  3. Hyunchul Rhim
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  4. Yoon Suk Kim
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  5. Min Sook Kwak
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  6. Hyun Jo Jeong
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  7. Ducky Lee
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Correspondence to Jung Hwan Baek.

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Jeong, W.K., Baek, J.H., Rhim, H. et al. Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol 18, 1244–1250 (2008). https://doi.org/10.1007/s00330-008-0880-6

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  • DOI: https://doi.org/10.1007/s00330-008-0880-6

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