scholarly journals Machine Learning Prediction of Radiofrequency Thermal Ablation Efficacy: A New Option to Optimize Thyroid Nodule Selection

2019 ◽  
Vol 9 (4) ◽  
pp. 205-212 ◽  
Author(s):  
Roberto Negro ◽  
Matteo Rucco ◽  
Annalisa Creanza ◽  
Alberto Mormile ◽  
Paolo Piero Limone ◽  
...  
Keyword(s):  
Machine Learning ◽  
Predictive Value ◽  
Thermal Ablation ◽  
Thyroid Nodules ◽  
Reduction Rate ◽  
Learning Model ◽  
Volume Reduction ◽  
Machine Learning Model ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Background: Radiofrequency (RF) is a therapeutic modality for reducing the volume of large benign thyroid nodules. If thermal therapies are interpreted as an alternative strategy to surgery, critical issues in their use are represented by the extent of nodule reduction and by the durability of nodule reduction over a long period of time. Objective: To assess the ability of machine learning to discriminate nodules with volume reduction rate (VRR) < or ≥50% at 12 months following RF treatment. Methods: A machine learning model was trained with a dataset of 402 cytologically benign thyroid nodules subjected to RF at six Italian Institutions. The model was trained with the following variables: baseline nodule volume, echostructure, macrocalcalcifications, vascularity, and 12-month VRR. Results: After training, the model could distinguish between nodules having VRR <50% from those having VRR ≥50% in 85% of cases (accuracy: 0.85; 95% confidence interval [CI]: 0.80–0.90; sensitivity: 0.70; 95% CI: 0.62–0.75; specificity: 0.99; 95% CI: 0.98–1.0; positive predictive value: 0.95; 95% CI: 0.92–0.98; negative predictive value: 0.95; 95% CI: 0.92–0.98). Conclusions: This study demonstrates that a machine learning model can reliably identify those nodules that will have VRR < or ≥50% at 12 months after one RF treatment session. Predicting which nodules will be poor or good responders represents valuable data that may help physicians and patients decide on the best treatment option between thermal ablation and surgery or in predicting if more than one session might be necessary to obtain a significant volume reduction.

scholarly journals Ultrasound-guided microwave ablation in the treatment of benign thyroid nodules in 435 patients

2017 ◽  
Vol 242 (15) ◽  
pp. 1515-1523 ◽  
Author(s):  
Yu-Jiang Liu ◽  
Lin-Xue Qian ◽  
Dong Liu ◽  
Jun-Feng Zhao
Keyword(s):  
Microwave Ablation ◽  
Thyroid Nodules ◽  
Reduction Rate ◽  
Volume Reduction ◽  
Ultrasound Guided ◽  
Nodule Volume ◽  
Safe Technique ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

The objective of the present study was to investigate the effectiveness and safety of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules. A total of 474 benign thyroid nodules in 435 patients who underwent ultrasound-guided microwave ablation from September 2012 to August 2015 were included. Nodule volume and thyroid function were measured before treatment and at 1, 3, 6, and 12 months and subsequently after every 6 months. The nodule volume reduction rate and changes of thyroid function were evaluated. The volume of all thyroid nodules significantly decreased after ultrasound-guided microwave ablation. The average volume was 13.07 ± 0.95 ml before treatment, and 1.14 ± 0.26 ml at 12-months follow-up. The mean volume reduction rate was 90% and the final volume reduction rate was 94%. The volume reduction rate of mainly cystic nodules was significantly higher than that of simple solid and mainly solid nodules (all P < 0.05). The pretreatment volume of nodules was positively correlated with the final volume reduction rate at final follow-up ( P = 0.004). No serious complications were observed after treatment. In conclusion, ultrasound-guided microwave ablation is an effective and safe technique for treatment of benign thyroid nodules, and has the potential for clinical applications. Impact statement Ultrasound-guided MWA is an effective and safe technique for the treatment of benign thyroid nodules. It can significantly reduce the nodule volume, improve the patients’ clinical symptoms, has less complication, guarantees quick recovery, meets patients' aesthetic needs, and shows less interference on the physiological and psychological aspects of the body. MWA should be a good complement to traditional open surgery and has potentials in clinical applications.

Radiofrequency Thermal Ablation of Benign Thyroid Nodules: The Correlation Between Ultrasound Nodule Characteristics and Results

2020 ◽  
pp. 155335062091313
Author(s):  
Francesco Feroci ◽  
Tommaso Guagni ◽  
Angela Coppola ◽  
Davina Perini ◽  
Barbara Conforti ◽  
...  
Keyword(s):  
Thermal Ablation ◽  
Thyroid Nodules ◽  
Reduction Rate ◽  
Response To Treatment ◽  
Initial Size ◽  
Benign Nodules ◽  
Benign Thyroid Nodules ◽  
Radiofrequency Thermoablation ◽  
Benign Thyroid

Background. The aim of this observational study was to investigate for which nodules a better response to radiofrequency thermoablation (RFA) for nonfunctioning benign thyroid nodules is likely. Methods. Aesthetic score, compressive score, and volume of 32 benign nodules from 32 patients were registered during follow-up at baseline, 1, 3, 6, and 12 months. Results. A volume reduction rate (VRR) of 72.56% at 12 months after the procedure ( P = .009) was registered. A significant ( P < .001) improvement in the compressive and aesthetic scores was observed. Nodules with a baseline volume <20 mL had VRRs at 3 and 6 months that were significantly greater than those with volume >20 mL ( P = .037). Conclusions. RFA was shown to be a safe and effective procedure for the management of benign thyroid nodules and that there is a correlation between the initial size of the nodule and the response to treatment.

scholarly journals Superb Microvascular Imaging Compared with Contrast-Enhanced Ultrasound for Assessing Laser Ablation Treatment of Benign Thyroid Nodules

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Wengang Liu ◽  
Ping Zhou ◽  
Yongfeng Zhao ◽  
Shuangming Tian ◽  
Xiaomin Wu
Keyword(s):  
Laser Ablation ◽  
Thyroid Nodules ◽  
Reduction Rate ◽  
Microvascular Perfusion ◽  
Volume Reduction ◽  
Contrast Enhanced ◽  
Superb Microvascular Imaging ◽  
Microvascular Imaging ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Purpose. To compare superb microvascular imaging (SMI) with contrast-enhanced ultrasonography (CEUS) for evaluating the ablation of benign thyroid nodules. Methods. 225 Patients with 256 benign thyroid nodules underwent conventional ultrasound, color Doppler flow imaging (CDFI), CEUS, and SMI before and after laser ablation. They were routinely followed up at 1, 3, 6, and 12 months. The volume and volume reduction rate of the ablated nodules was calculated. Results. On SMI, the complete ablated nodules had no microvascular perfusion, while the incompletely ablated nodules had microvascular perfusion at the edge of the nodule. The percentages of the detected incompletely ablated nodules of SMI (37/256, 14.45%) and CEUS (41/256, 16.02%) were comparable, and both were significantly higher than CDFI (P< 0.001). CEUS was used as the criterion to determine whether the nodules were completely ablated. The sensitivity, specificity, and accuracy of SMI for detecting incompletely ablated nodules were 90.2, 98.2, and 100%, respectively. The volume of ablated nodules, as measured on ultrasound, was greater than that on CEUS or SMI (both P< 0.001), while CEUS and SMI were similar. The average volume reduction rate of nodules at 1, 3, 6, and 12 months was 40.25, 54.98, 76.83, and 95.43%, respectively. Conclusion. SMI sensitively detected the capillaries within residual thyroid nodules after laser ablation. The lesion size and detection rate of incompletely ablated nodules via SMI was consistent with that of CEUS. SMI may replace CEUS in certain cases for monitoring the curative effect of laser ablation for benign thyroid nodules.

scholarly journals Initial Ablation Ratio Predicts Volume Reduction and Retreatment After 5 Years From Radiofrequency Ablation of Benign Thyroid Nodules

2021 ◽  
Vol 11 ◽  
Author(s):  
Stella Bernardi ◽  
Marco Cavallaro ◽  
Giacomo Colombin ◽  
Fabiola Giudici ◽  
Giulia Zuolo ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Correlation Coefficients ◽  
Volume Reduction ◽  
Interobserver Reproducibility ◽  
Cox Models ◽  
Logistic Regression Models ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

BackgroundRadiofrequency ablation (RFA) has gained ground as an effective and well-tolerated technique to treat benign thyroid nodules. Most of the available studies have described the short-term outcomes of RFA, whereas there is a limited number of studies evaluating long-term issues, such as regrowth and the likelihood of retreatments. In addition, risk markers of regrowth and retreatment remain to be defined. The initial ablation ratio (IAR) is an index that measures the amount of ablation after RFA, which has been associated with technique efficacy (i.e. volume reduction &gt;50% after 1 year from the procedure). This study aimed at evaluating i) IAR reproducibility and ii) IAR predictive value for RFA 5-year outcomes.Materials and MethodsThis is a retrospective single center study on patients with benign thyroid nodules treated with RFA and followed for 5 years after initial treatment. IAR interobserver reproducibility was evaluated with Bland-Altman method and Lin’s concordance correlation coefficient (ρc). IAR predictive value for RFA 5-year outcomes was evaluated with linear and logistic regression models, as well as with Cox models, while receiver operating characteristic (ROC) analyses were used for cut-offs.ResultsWe selected 78 patients with 82 benign thyroid nodules. The procedure significantly reduced nodule volume and this reduction was generally maintained over time. Technique efficacy was achieved in 92% of patients, while 23% of nodules regrew and 12% of nodules were retreated. Median IAR was 83%. Lin’s concordance and Pearson’s correlation coefficients suggested a good interobserver reproducibility of this index, consistent with the limits of agreement of the Bland-Altman plot. IAR was significantly associated with technique efficacy, 1- and 5-year volume reduction ratio, and with the likelihood of a retreatment, but not with nodule regrowth. ROC analyses showed that IAR cut-off was 49% for technique efficacy and 73% for retreatment.ConclusionsOur results show for the first time that IAR is reproducible and that it predicts the volume reduction and the likelihood of a retreatment after 5 years from RFA.

Conventional thyroidectomy vs thyroid thermal ablation on postoperative quality of life and satisfaction for patients with benign thyroid nodules

2021 ◽  
Vol 184 (1) ◽  
pp. 131-141
Author(s):  
Hao Jin ◽  
Weidong Lin ◽  
Ligong Lu ◽  
Min Cui
Keyword(s):  
Quality Of Life ◽  
Thermal Ablation ◽  
Treatment Effects ◽  
Thyroid Nodules ◽  
Volume Reduction ◽  
Patients Satisfaction ◽  
Conventional Thyroidectomy ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Objective The complications and treatment effects of conventional thyroidectomy and thyroid thermal ablation should be compared in order to identify the best intervention for patients with benign thyroid nodules. Methods Patients (18–50 years old) who had benign thyroid nodules and were eligible for both thyroidectomy and thyroid thermal ablation were randomly allocated (1:1) to either conventional thyroidectomy group or thyroid thermal ablation group. Patients’ satisfaction and condition-specific quality of life were measured with the Thyroid-Specific Quality-of-Life Questionnaire Scale (QoL) at the 15th post-randomization month and were set as the co-primary outcome. Results A total of 450 patients were enrolled and randomized (225 patients in each group). At the 15th month after randomization, more patients in the thyroid thermal ablation group were satisfied with the treatment effects compared to those in the conventional thyroidectomy group. More patients in the thyroid thermal ablation group have a QoL score of 410 (QOL scores ranges from 0 to 410) than patients in conventional thyroidectomy. Eight (4%) of the 209 patients in conventional thyroidectomy group and 6 (3%) of the 208 patients in thyroid thermal ablation group had at least one severe postoperative complication. The time to achieve volume reduction was longer in the thermal ablation group. Conclusion Thyroid thermal ablation is superior to conventional thyroidectomy in terms of patients satisfaction, post-operative quality of life, and shorter hospital stay but takes longer to achieve BTNs volume reduction. The complication rates between the two groups were similar.

Effect of thermal ablation on HSP70 expression in benign thyroid nodules

2014 ◽  
Vol 35 (11) ◽  
pp. 1215
Author(s):  
Lei YAN ◽  
Jian-quan ZHANG ◽  
Qian PAN ◽  
Jian-ming ZHENG ◽  
Yan-hong Lv
Keyword(s):  
Thermal Ablation ◽  
Thyroid Nodules ◽  
Hsp70 Expression ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Ultrasound predictive criteria for short term benign thyroid nodular volume reduction after ultrasound guided radiofrequency ablation

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Fikry Tawfik Shehab ◽  
Ahmed Mohamed Hussein ◽  
Rasha Tolba Khattab
Keyword(s):  
Thyroid Nodules ◽  
Reduction Ratio ◽  
Volume Reduction ◽  
Body Sensation ◽  
Significant Difference ◽  
Noticeable Improvement ◽  
Us Findings ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid ◽  
Ultrasound Features

Abstract Purpose This study evaluates the outcome of patients complaining of compressive& cosmetic problems due to benign thyroid nodules after recieving RF ablation with correlation between some ultrasound features of the nodules and their shrinkage and volume reduction. Methods and material fifteen patients with benign thyroid nodules causing compressive symptoms (foreign body sensation,neck discomfort or pain) and cosmetic problems. Results A total of 15 patients were included with the age rangmg from 22-82 years old the mean was 52.73 years old (SD + 14.37).Among them 12 patients (800 0)were females and 3 patients(20%) were males. There was statistically significant difference between volume of nodules before the procedure with mean volume was 21.13±5.13 and I month after with mean volume I I .96±3.08 and 3 months after the procedure with mean volume 7.70±2.82 with noticeable improvement in nodules with peri and intranodular vascularity showing mean reduction ratio 69.88% after 3 months vs 59.93% and 64 12% of weak peripheral vascularity and intense intra-nodular vasculanty respectively as well as US structure with spongiform nodules showing mean reduction ratio 68.48% at 3 months vs 59.87% and 62.14% for solid &mixed nodules respectively.Mean symptoms and cosmetic score were significantly reduced. Conclusion: This study validated the efficacy and safety of RFA for treatment of benign thyroid nodules and showed correlation between shrinkage and some common US findings.

scholarly journals Predictor Analysis in Radiofrequency Ablation of Benign Thyroid Nodules: A Single Center Experience

2021 ◽  
Vol 12 ◽  
Author(s):  
Alessandro Bisceglia ◽  
Ruth Rossetto ◽  
Sara Garberoglio ◽  
Angelica Franzin ◽  
Alice Cerato ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Thyroid Nodules ◽  
Neck Circumference ◽  
Volume Reduction ◽  
Single Center ◽  
Treatment Volume ◽  
Pre Treatment ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

PurposeTo confirm the efficacy of ultrasound (US) guided radiofrequency ablation (RFA) in the treatment of benign thyroid nodules, we evaluated as primary outcome the technical efficacy and clinical success in a single center dataset. The secondary outcome was to find a correlation between nodules’ pre-treatment features and volume reduction rate (VRR) ≥75% at 12 months after RFA and during follow-up period.MethodsThis retrospective study included 119 consecutive patients (99 females, 20 males, 51.5 ± 14.4 years) with benign thyroid nodules treated in our hospital between October 2014 and December 2018 with a mean follow-up of 26.8 months (range 3–48). Clinical and US features before and after RFA were evaluated by a US examination at 1, 3, 6, 12 months and annually thereafter up to 48 months.ResultsThe median pre-treatment volume was 22.4 ml; after RFA we observed a statistically significant volume reduction from the first month (11.7 ml) to the last follow-up (p &lt; 0.001 for all follow-up times). The median VRR was 47.1, 55.3, 61.2, 67.6, 72.8, 71.3, and 62.9% at 1, 3, 6, 12, 24, 36, and 48 months of follow-up respectively, showing a progressive significant improvement up to 24 months (VRRs 1 vs 3 months, 3 vs 6 months and 6 vs 12 months p &lt; 0.001, 12 vs 24 months p = 0.05) while no differences at 24 vs 36 and 36 vs 48 months were observed. Symptoms improved significantly (complete resolution 64.35%, partial resolution 35.65%), and neck circumference was reduced as compared to pre-treatment (p &lt; 0.001). Lower pre-treatment neck circumference (37.5 vs 36.0 cm, p = 0.01) was a positive predictor of VRR ≥75% at 12 months. Macrocystic echostructure (HR 2.48, p 0.046) and pre-treatment volume &gt;22.4 ml (HR 0.54, p 0.036) were found to be independent positive and negative predictors of VRR ≥75% respectively. One-month post RFA VRR ≥50% represented the best positive predictor of technical success.ConclusionsThis study confirmed the efficacy of RFA in the treatment of benign thyroid nodules. In particular we show that by selecting macrocystic nodules smaller than 22.4 ml better long-term response can be achieved, which is predicted by an early shrinkage of the nodule.

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