scholarly journals Percutaneous, Ultrasound-guided Laser Ablation of Benign Thyroid Nodules: Results of 10-year Follow-up in 171 Patients

2021 ◽  
Author(s):  
Giovanni Gambelunghe ◽  
Elisa Stefanetti ◽  
Nicola Avenia ◽  
Pierpaolo De Feo
Keyword(s):  
Laser Ablation ◽  
Thyroid Nodules ◽  
Single Session ◽  
Ultrasound Guided ◽  
Prolonged Effect ◽  
Nodule Volume ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Abstract Background Percutaneous, ultrasound-guided laser ablation is effective in nodular thyroid disease. The aim of this study was to evaluate the long-term (10-year) efficacy and safety of laser ablation in the treatment of benign thyroid nodules. Methods Between 2009 and 2010, 171 patients received a single session of laser ablation. Evaluation of nodule volume was performed before treatment, at 6 months, and every year. Results Technique efficacy was achieved in 92% of patients at 1 year. Median nodule volume significantly decreased from 16.7 mL (range: 11.0−97.0 mL) at baseline to 5.0 mL (range: 4.1−32.0 mL) at 1 year, a volume reduction ratio (VRR) of 68%. The benefit of the treatment was durable (p < 0.001 vs baseline at all timepoints), with a VRR of 59% after 10 years. No cases of nodule regrowth >50% were observed at 1 year, although such cases did occur after 4 years (n = 3; 1.7% of the overall cohort) and 7 years (n = 8; 4.7%). There were no further cases of regrowth beyond 7 years. When patients were stratified according to baseline nodule volume (<15 mL, 15−25 mL, or >25 mL), durable results were observed across all 3 categories, with the largest, most prolonged effect observed in patients with nodules <15 mL. Treatment was well tolerated, with only minor, transient complications of fever and local pain, and 98% of patients willing to recommend the treatment. Conclusions Percutaneous, ultrasound-guided laser ablation of benign thyroid nodules provides long-term benefits and the treatment is well tolerated.

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.

scholarly journals Detection of the Single-Session Complete Ablation Rate by Contrast-Enhanced Ultrasound during Ultrasound-Guided Laser Ablation for Benign Thyroid Nodules: A Prospective Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Shuhua Ma ◽  
Ping Zhou ◽  
Xiaomin Wu ◽  
Shuangming Tian ◽  
Yongfeng Zhao
Keyword(s):  
Laser Ablation ◽  
Thyroid Nodules ◽  
Ablation Rate ◽  
Contrast Enhanced Ultrasound ◽  
Single Session ◽  
Ultrasound Guided ◽  
Complete Ablation ◽  
Contrast Enhanced ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

This study aimed to investigate the single-session complete ablation rate of ultrasound-guided percutaneous laser ablation (LA) for benign thyroid nodules. LA was performed in 90 patients with 118 benign thyroid nodules. Contrast-enhanced ultrasound (CEUS) was used to evaluate complete nodule ablation one day after ablation. Thyroid nodule volumes, thyroid functions, clinical symptoms and complications were evaluated 1, 3, 6, 12, and 18 months after ablation. Results showed that all benign thyroid nodules successfully underwent LA. The single-session complete ablation rates for nodules with maximum diameters ≤2 cm, 2-3 cm and ≥3 cm were 93.4%, 70.3% and 61.1%, respectively. All nodule volumes significantly decreased than that one day after ablation (P<0.05); at the final evaluation, the volume decreased from6.16±5.21 mL to0.05±0.01 mL. Thyroid functions did not show significant differences at one month after ablation compared with that before (P>0.05). Three patients had obvious pain during ablation; one (1.1%) had recurrent laryngeal nerve injury, but the voice returned to normal within 6 months after treatment. Thus, ultrasound-guided LA can effectively inactivate benign thyroid nodules. LA is a potentially viable minimally invasive treatment that offers good cosmetic effects.

scholarly journals Long-Term Efficacy of a Single Session of RFA for Benign Thyroid Nodules: A Longitudinal 5-Year Observational Study

2019 ◽  
Vol 104 (9) ◽  
pp. 3751-3756 ◽  
Author(s):  
Maurilio Deandrea ◽  
Pierpaolo Trimboli ◽  
Francesca Garino ◽  
Alberto Mormile ◽  
Gabriella Magliona ◽  
...  
Keyword(s):  
Observational Study ◽  
Thyroid Nodules ◽  
Long Term Results ◽  
Categorical Variables ◽  
Single Session ◽  
Term Efficacy ◽  
Nodule Volume ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Abstract Context Radiofrequency ablation (RFA) of benign thyroid nodules has been gaining consensus. However, no solid information on its long-term efficacy is available. Objective To analyze the long-term results of single-session RFA. Design Retrospective longitudinal observational study. Setting Primary care center. Patients or Other Participants Adult outpatients who underwent a single-session RFA and posttreatment follow-up of least 3 years. Intervention Ultrasound-guided RFA was performed after local anesthesia by “moving-shot” technique. RFA was performed with a median power of 55W and a median time of 14 minutes with an internally cooled 18-gauge electrode with an active 10-mm tip. Main Outcome Measures Objective (trend of nodule volume) and subjective (compressive and cosmetic concerns) response to RFA were evaluated. Continuous variables were analyzed by the Wilcoxon and ANOVA test and their correlations by using the Spearman test. Categorical variables were compared by Pearson χ2 test. Results Two hundred and fifteen patients were included. An early significant reduction of nodule volume was found at 1 year, lasting up to 5 years. A 67% nodule shrinkage was observed at the end of the observation period. The best response was recorded in nodules below 10 mL (79% reduction early and 81% at 5 years). Patients’ symptoms were significantly reduced. Conclusions This study, by demonstrating a durable shrinkage of benign thyroid nodules treated by RFA with an improvement of subjective symptoms, establishes the reliability of RFA as alternative to surgery in the management of thyroid nodules, thus representing a remarkable novelty for clinical practice.

scholarly journals Percutaneous laser ablation of benign thyroid nodules: a one year follow-up study

2018 ◽  
Vol 16 (4) ◽  
Author(s):  
Antonio Rahal ◽  
Priscila Mina Falsarella ◽  
Guilherme Falleiros Mendes ◽  
Jairo Tabacow Hidal ◽  
Danielle Macellaro Andreoni ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Thyroid Nodules ◽  
Follow Up Study ◽  
One Year ◽  
Percutaneous Laser Ablation ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

scholarly journals Long-Term Results of Ultrasound-Guided Radiofrequency Ablation of Benign Thyroid Nodules: State of the Art and Future Perspectives—A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Hervé Monpeyssen ◽  
Ahmad Alamri ◽  
Adrien Ben Hamou
Keyword(s):  
Systematic Review ◽  
Radiofrequency Ablation ◽  
Thyroid Nodules ◽  
Long Term Results ◽  
Future Perspectives ◽  
Time Duration ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

BackgroundNearly 20 years after the first feasibility study, minimally invasive ultrasound (US)-guided therapeutic techniques are now considered as a safe and effective alternative to surgery for symptomatic benign thyroid nodules. Radiofrequency ablation (RFA) is one of the most widely used treatment in specialized thyroid centers but, due to the relatively recent introduction into clinical practice, there are limited long-term follow-up studies. Aim of our work was to review the outcomes of RFA on solid nonfunctioning and on autonomous thyroid nodules (AFTN) on a long-time period for assessing the results in term of efficacy, complications, and costs and to compare them to the current indications of RFA.MethodsA systematic review was performed using EMBASE and Medline library data between 2008 and 2021. Seventeen studies evaluated RFA for the treatment of benign solid (nonfunctioning or autonomous) thyroid nodules, with an at least 18 months of follow-up. Data extraction and quality assessment were performed by two endocrinologist according to PRISMA guidelines. Anthropometric data, safety and efficacy parameters were collected.ResultsThe majority of the studies was retrospective study and reported 933 nodules, mostly solid. Baseline volume ranged between 6.1 ± 9.6 and 36.3 ± 59.8 ml. Local analgesia was used and the time duration of the treatment was between 5 ± 2 and 22.1 ± 10.9 min. The volume reduction rate at 12 months ranged from 67% to 75% for the nodule treated with a single procedure and reached to 93.6 ± 9.7% for nodules treated with repeat ablations. The regrowth rate at 12 months ranged from 0% to 34%.ConclusionAll the studies under examination consistently validated the long-term clinical efficacy and the substantial safety of RFA for the treatment of benign thyroid nodules. Thermal ablation, however, is an operator-dependent technique and should be performed in centers with specific expertise. The selection of the patients should be rigorous because the nodule size and the structural and functional characteristics influence the appropriateness and the outcomes of the treatment. Future perspectives as the treatment of micro-papillary thyroid cancer or cervical recurrence need further investigations.

scholarly journals Unfavorable Outcomes in Solid and Spongiform Thyroid Nodules Treated with Laser Ablation. A 5-Year Follow-up Retrospective Study

2019 ◽  
Vol 19 (7) ◽  
pp. 1041-1045 ◽  
Author(s):  
Roberto Negro ◽  
Gabriele Greco
Keyword(s):  
Retrospective Study ◽  
Laser Ablation ◽  
Thyroid Nodules ◽  
False Negative ◽  
Thyroid Function Test ◽  
Final Diagnosis ◽  
Therapeutic Modality ◽  
Nodule Volume

Objective: Laser Ablation (LA) is a therapeutic modality for reducing the volume of large benign thyroid nodules. This retrospective study was aimed at assessing the outcome of LA in patients with benign nonfunctioning thyroid nodules in a 5-years follow-up. Methods: Sixty-two patients (47 females; mean age 54.7±12 yr) with benign cold thyroid nodules underwent LA from July 2009 to March 2012. Nodule volume, thyroid function test, and ultrasound were monitored at baseline, and at 3, 6 and 12 months after the procedure, then annually. After dividing nodules in solid and spongiform, we evaluated unfavourable outcomes: 1) nodule’s volume reduction <50%; 2) need for surgery; 3) need for additive LA session (due to nodule re-growth with persistence of cosmetic concern or compressive symptoms). Results: Baseline volume did not differ between solid and spongiform nodules as well as energy delivered and the number of needles used. Unfavourable outcomes occurred in 24 patients (38.7%). Nineteen/ 24 (79.2%) patients who experienced unfavourable outcomes belonged to the solid nodules group (P<0.01). When considering only those who benefited from LA, the 5-years reduction was 59.7% for solid and 78.6% for spongiform nodules (P<0.05). One/6 patients who underwent surgery (solid nodules group) had a final diagnosis of Follicular Variant of Papillary Thyroid Cancer (FVPTC). Conclusion: Large solid nodules, unlike spongiform, submitted to LA are characterized by a long-term unfavourable outcome and entail a potential risk of false negative cytologic results.

Effectiveness of High-intensity Focused Ultrasound (HIFU) Therapy of Solid and Complex Benign Thyroid Nodules – A Long-term Follow up Two-center Study

2022 ◽  
Author(s):  
Anne Fischer ◽  
Christian Vorländer ◽  
Hüdayi Korkusuz
Keyword(s):  
Thyroid Nodules ◽  
High Intensity Focused Ultrasound ◽  
Rank Test ◽  
Signed Rank ◽  
Wilcoxon Signed Rank Test ◽  
Signed Rank Test ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Abstract Purpose To investigate the effectiveness of high-intensity focused ultrasound (HIFU) of solid and complex benign thyroid nodules. Methods Fifty-eight patients with benign thyroid nodules were treated with HIFU at two centers from 2014–2019. The device, EchoPulse (Teraclion, Malakoff, France), heats the nodes to 80–90 °C. Nodal volumes were measured by ultrasound at regular intervals before and up to 12 months after therapy. In a retrospective long-term two-center study, average volume reductions in relation to baseline volume were statistically analyzed by the Wilcoxon signed-rank test. Side effects were documented. Results In solid nodules, the average percent volume reductions at the 3, 6, 9, and 12-months follow-up were 49.98%, 46.40%, 65.77%, and 63.88%, respectively. The results were significant with p<0.05 in the Wilcoxon signed-rank test at the 3, 6, and 9-months follow-up. In complex nodules, the average percent volume reduction was 35.2% at 3 months, 36.89% at 6 months, and 63.64% at twelve months follow up. The results were significant with p<0.05 in the Wilcoxon signed-rank test at the 3- and 6-months follow-up. The complication rate was 5.2%. All complications occurred in patients with solid nodules. Conclusion The study showed that HIFU is an effective treatment method for both solid and complex nodules. The complication rate is relatively high at 5.2%. No long-term complications occurred. The solid nodules responded better to HIFU than complex nodules.

Ultrasound-guided percutaneous laser ablation in treating symptomatic solid benign thyroid nodules: Our experience in 45 patients

Head & Neck ◽  
2015 ◽  
Vol 38 (5) ◽  
pp. 677-682 ◽  
Author(s):  
Gaetano Achille ◽  
Stefania Zizzi ◽  
Enrico Di Stasio ◽  
Alberto Grammatica ◽  
Luciano Grammatica
Keyword(s):  
Laser Ablation ◽  
Thyroid Nodules ◽  
Ultrasound Guided ◽  
Percutaneous Laser Ablation ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

scholarly journals Ultrasound-guided percutaneous microwave ablation of benign thyroid nodules: experimental and clinical studies

2012 ◽  
Vol 166 (6) ◽  
pp. 1031-1037 ◽  
Author(s):  
Bing Feng ◽  
Ping Liang ◽  
Zhigang Cheng ◽  
Xiaoling Yu ◽  
Jie Yu ◽  
...  
Keyword(s):  
Microwave Ablation ◽  
Thyroid Nodules ◽  
Ex Vivo ◽  
Microwave Antenna ◽  
Ultrasound Guided ◽  
Internally Cooled ◽  
Percutaneous Microwave Ablation ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

PurposeTo obtain the treatment parameters of internally cooled microwave antenna and to evaluate the feasibility of ultrasound-guided percutaneous microwave ablation (MWA) for benign thyroid nodules.Materials and methodsMWAs were performed by microwave antenna (16G) in ex vivo porcine liver. The lesion diameters achieved in different groups (20, 25, and 30 W for 3, 5, 7, 10, and 12 min) were compared. The clinical study was approved by the ethics committee. Written informed consent was obtained from all patients. MWA was performed in 11 patients (male to female ratio=1:10; mean age, 50±7 years) with 11 benign thyroid nodules. Ultrasound scan, laboratory data, and clinical symptoms were evaluated before and 1 day and 1, 3, 6, 9, and 12 months after the procedure.ResultsIn ex vivo study, the ablation lesion at 30 W 12 min tended to have appropriate scope and spherical shape. In clinical study, the follow-up periods ranged from 1 to 9 months. At the last follow-up, the largest diameter decreased from 2.9±1.0 (range, 1.6–4.1) to 1.9±0.7 (range, 0.4–3.0) cm (P<0.01), and the volume decreased from 5.30±4.88 (range, 0.89–14.81) to 2.40±2.06 (range, 0.02–6.35) ml (P<0.01). The volume reduction ratio was 45.99±29.90 (range, 10.56–98.15) %. The cosmetic grading score was reduced from 3.20±0.79 to 2.30±0.95 (P<0.05). One patient experienced temporary nerve palsy and was recovered within 2 months after treatment.ConclusionThe internally cooled microwave antenna can yield ideal ablation lesions, and ultrasound-guided percutaneous MWA is a feasible technique for benign thyroid nodules.

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