Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules

AimTo evaluate the long-term efficacy of interstitial laser photocoagulation (ILP) in solitary benign thyroid nodules.Design and methodsA total of 78 euthyroid outpatients (45 participating in randomized trials) with a benign solitary solid and scintigraphically cold thyroid nodule causing local discomfort were assigned to ILP. ILP (using one laser fiber) was performed under continuous ultrasound (US) guidance and with an output power of 1.5–3.5 W. Thyroid nodule volume was assessed by US and thyroid function determined by routine assays, before and during follow-up. Pressure symptoms and cosmetic complaints were evaluated on a visual analogue scale (0–10 cm). Of the total patients, six had thyroid surgery 6 months after ILP and three were lost to follow-up. The median follow-up for the remaining 69 patients was 67 months (range 12–114).ResultsThe overall median nodule volume decreased from 8.2 ml (range 2.0–25.9) to 4.1 ml (range 0.6–33.0; P<0.001) at the final evaluation, corresponding to a median reduction of 51% (range: −194 to 95%). This correlated with a significant decrease in pressure as well as cosmetic complaints. After 12--96 months (median 38 months) of ILP, 21 patients (29%) had thyroid surgery because of an unsatisfactory result. All had benign histology. Thyroid function was unaltered throughout and side effects were restricted to mild local pain.ConclusionUS-guided ILP results in a satisfactory long-term clinical response in the majority of patients with a benign solitary solid cold thyroid nodule. Further large-scale studies should aim at optimizing selection criteria for ILP, preferably in randomized studies.

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Effect of ultrasound-guided interstitial laser photocoagulation on benign solitary solid cold thyroid nodules – a randomised study

Acta Endocrinologica ◽

10.1530/eje.1.01865 ◽

2005 ◽

Vol 152 (3) ◽

pp. 341-345 ◽

Cited By ~ 85

Author(s):

Helle Døssing ◽

Finn Noe Bennedbæk ◽

Laszlo Hegedüs

Keyword(s):

Thyroid Nodule ◽

Thyroid Function ◽

Laser Photocoagulation ◽

Thyroid Nodules ◽

Control Group ◽

Randomised Study ◽

Interstitial Laser Photocoagulation ◽

Nodule Volume ◽

Interstitial Laser ◽

Cold Thyroid Nodules

Aim: To evaluate the efficacy of ultrasound (US)-guided interstitial laser photocoagulation (ILP) on thyroid function, nodule size and patient satisfaction in benign solitary solid cold thyroid nodules by comparing one ILP session with no treatment in a prospective randomised study. Materials and methods: Thirty euthyroid outpatients with a benign solitary solid and a scintigraphically cold thyroid nodule causing local discomfort were assigned to one session of ILP (n = 15) or observation (n = 15) and followed for 6 months. Thyroid nodule volume and total thyroid volume were assessed by US and thyroid function was determined by routine assays before and during follow-up. Pressure and cosmetic complaints before and at 6 months were evaluated on a visual analogue scale. ILP was performed under US guidance and with an output power of 2.5–3.5 W. Results: In the ILP group, the nodule volume decreased from 8.2 ml (6.1; 11.9) (median; quartiles) to 4.8 ml (3.0; 6.6) after 6 months (P = 0.001). The overall median reduction was 44% (37; 52), which correlated with a significant decrease in pressure symptoms as well as cosmetic complaints. In the control group, a non-significant increase in median nodule volume of 7% (0; 34) after 6 months was seen. No major side-effects were seen in the ILP group. There was no correlation between thermal energy deposition and nodule volume reduction. Thyroid function was unaltered throughout. Conclusion: US-guided ILP, given as a single treatment, resulted in a satisfactory clinical response in the majority of patients with a benign solitary solid cold thyroid nodule, and may become a clinically relevant alternative to surgery in selected patients.

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Interstitial laser photocoagulation for benign thyroid nodules: Time to treat large nodules

Lasers in Surgery and Medicine ◽

10.1002/lsm.21114 ◽

2011 ◽

Vol 43 (8) ◽

pp. 797-803 ◽

Cited By ~ 27

Author(s):

Gerardo Amabile ◽

Mario Rotondi ◽

Barbara Pirali ◽

Rosa Dionisio ◽

Lucio Agozzino ◽

...

Keyword(s):

Laser Photocoagulation ◽

Thyroid Nodules ◽

Interstitial Laser Photocoagulation ◽

Interstitial Laser ◽

Benign Thyroid Nodules ◽

Benign Thyroid

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

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530319666190206123156 ◽

2019 ◽

Vol 19 (7) ◽

pp. 1041-1045 ◽

Cited By ~ 6

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.

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Interstitial Laser Photocoagulation (ILP) of Benign Cystic Thyroid Nodules—A Prospective Randomized Trial

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2013-1503 ◽

2013 ◽

Vol 98 (7) ◽

pp. E1213-E1217 ◽

Cited By ~ 29

Author(s):

Helle Døssing ◽

Finn Noe Bennedbæk ◽

Laszlo Hegedüs

Keyword(s):

Randomized Trial ◽

Laser Photocoagulation ◽

Thyroid Nodules ◽

Prospective Randomized Trial ◽

Interstitial Laser Photocoagulation ◽

Interstitial Laser

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Long-term Efficacy of Ultrasound-Guided Laser Ablation for Benign Solid Thyroid Nodules. Results of a Three-Year Multicenter Prospective Randomized Trial

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2014-1826 ◽

2014 ◽

Vol 99 (10) ◽

pp. 3653-3659 ◽

Cited By ~ 73

Author(s):

E. Papini ◽

T. Rago ◽

G. Gambelunghe ◽

R. Valcavi ◽

G. Bizzarri ◽

...

Keyword(s):

Laser Ablation ◽

Side Effects ◽

Thyroid Function ◽

Thyroid Nodules ◽

Local Symptom ◽

Group 2 ◽

Volume Decrease ◽

Group 1

Abstract Background: The aim of the present trial on ultrasound (US)-guided laser ablation therapy (LAT) of solid thyroid nodules is to assess long-term clinical efficacy, side effects, and predictability of outcomes in different centers operating with the same procedure. Patients: Two hundred consecutive patients were randomly assigned to a single LAT session (group 1, 101 cases) or to follow-up (group 2, 99 cases) at four thyroid referral centers. Entry criteria were: solid thyroid nodule with volume of 6–17 mL, repeat benign cytological findings, normal thyroid function, no autoimmunity, and no thyroid gland treatment. Methods: Group 1: LAT was performed in a single session with two optical fibers, a 1064 nm Nd-YAG laser source, and an output power of 3 W. Volume and local symptom changes were evaluated 1, 6, 12, 24, and 36 months after LAT. Side effects and tolerability of treatment were registered. Group 2: Follow-up with no treatment. Results: One patient was lost to follow-up in each group. Group 1: Volume decrease after LAT was −49 ± 22%, −59 ± 22%, −60 ± 24%, and −57 ± 25% at 6, 12, 24, and 36 months, respectively (P < .001 vs baseline). LAT resulted in a nodule reduction of >50% in 67.3% of cases (P < .001). Local symptoms decreased from 38 to 8% of cases (P = .002) and cosmetic signs from 72 to 16% of cases (P = .001). Baseline size, presence of goiter (P = .55), or US findings (fluid component ≤ 20% [P = .84], halo [P = .46], vascularization [P = .98], and calcifications [P = .06]) were not predictive factors of a volume decrease > 50%. The procedure was well tolerated in most (92%) cases. No changes in thyroid function or autoimmunity were observed. In group 2, nodule volume increased at 36 months (25 ± 42%; P = .04). The efficacy and tolerability of the procedure were similar in different centers. Conclusions: A single LAT treatment of solid nodules results in significant and persistent volume reduction and local symptom improvement, in the absence of thyroid function changes.

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Effect of Ultrasound-Guided Interstitial Laser Photocoagulation on Benign Solitary Solid Cold Thyroid Nodules: One versus Three Treatments

Thyroid ◽

10.1089/thy.2006.16.763 ◽

2006 ◽

Vol 16 (8) ◽

pp. 763-768 ◽

Cited By ~ 53

Author(s):

Helle Døssing ◽

Finn Noe Bennedbæk ◽

Laszlo Hegedüs

Keyword(s):

Laser Photocoagulation ◽

Thyroid Nodules ◽

Ultrasound Guided ◽

Interstitial Laser Photocoagulation ◽

Interstitial Laser ◽

Cold Thyroid Nodules

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Randomized prospective study comparing a single radioiodine dose and a single laser therapy session in autonomously functioning thyroid nodules

Acta Endocrinologica ◽

10.1530/eje-07-0094 ◽

2007 ◽

Vol 157 (1) ◽

pp. 95-100 ◽

Cited By ~ 55

Author(s):

Helle Døssing ◽

Finn Noe Bennedbæk ◽

Steen Joop Bonnema ◽

Peter Grupe ◽

Laszlo Hegedüs

Keyword(s):

Thyroid Nodule ◽

Thyroid Nodules ◽

Randomized Study ◽

Thyroid Volume ◽

Interstitial Laser Photocoagulation ◽

Autonomously Functioning Thyroid Nodules ◽

Nodule Volume ◽

Present Design ◽

Hot Thyroid Nodules ◽

Serum Tsh

Objective: To compare the efficacy of interstitial laser photocoagulation (ILP) with radioiodine in hot thyroid nodules. Design: Thirty consecutive outpatients with subclinical or mild hyperthyroidism and a scintigraphically solitary hot nodule with extraglandular suppression were randomized to either one ILP session or one radioiodine (131I) dose. Methods: ILP was performed under continuous ultrasound-guidance and with an output power of 2.5–3.5 W. 131I was given as a single dose based on thyroid volume and a 24-h thyroid 131I uptake. Thyroid function and nodule volume were evaluated at inclusion and at 1, 3 and 6 months after treatment. Results: Normalization of serum TSH was achieved in 7 out of 14 patients in the ILP group and in all 15 patients in the 131I group (P=0.0025). In the ILP group, mean thyroid nodule volume reduction was 44±5% (s.e.m.; P<0.001), and in the 131I group 47±8% (P<0.001), within 6 months, without between-group difference (P=0.73). The mean reduction of total thyroid volume was 7±5% in the ILP group (P=0.20) and 26±8% (P=0.006) in the 131I group (P=0.06 between-group). Two patients in the 131I group developed hypothyroidism but no major side effects were seen. Conclusions: This first randomized study, comparing ILP with standard therapy, demonstrates that ILP and 131I therapy approximately halves thyroid nodule volume within 6 months; but in contrast to 131I, extranodular thyroid volume is unaffected by ILP and no patient developed hypothyroidism. Using the present design, ILP seems inferior to 131I therapy in normalization of serum TSH. The potential value of ILP as a non-surgical alternative to 131I needs further investigation.

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Long-Term Outcome of Microwave Ablation for Benign Thyroid Nodules: A 48-Month Follow-up Study

10.21203/rs.3.rs-1070053/v1 ◽

2021 ◽

Author(s):

Jia-Rui Du ◽

Wen-Hui Li ◽

Cheng-Hai Quan ◽

Deng-Ke Teng ◽

Hui Wang

Keyword(s):

Thyroid Function ◽

Microwave Ablation ◽

Thyroid Nodules ◽

Reduction Rate ◽

Long Term Results ◽

Long Term Outcome ◽

Benign Thyroid Nodules ◽

Benign Thyroid

Abstract Purpose The short-term effects of microwave ablation (MWA) in the treatment of benign thyroid nodules (BTNs) were satisfactory in previous studies. However, as a slowly progressing disease, the long-term efficacy of MWA for BTNs at present is not clear. Our study aim was to assess the long-term results of MWA for BTNs after a 48-month follow-up. Methods From June 2015 to September 2017, 148 patients had 148 BTNs lesions. All patients were from China-Japan Union Hospital of Jilin University. Careful ultrasound examinations were performed 1 day, 1 month, 3 months, 6 months, 12 months, and every 6 months after MWA. The volume, volume reduction rate (VRR) recurrence rate of the ablated area and thyroid function were recorded. Results The mean volume of the 148 nodules were 15.6±9.4 cm3 (range: 1.3-48.9 cm3) and 0.6±0.6 cm3 (range: 0-3.5 cm3) before and 48 months after MWA, respectively, for a nodule VRR of 96.9±2.5% (range: 90.4-100%). Two patients (1.35%) had recurrence after MWA. Compared with that before MWA, no significant variation in thyroid function was observed after MWA. Five patients experienced complications (3.38%): two patients (1.35%) had bleeding, two patients (1.35%) had ear pain and toothache during MWA, and one patient (0.68%) had hoarseness after MWA. No cases of oesophageal injury, tracheal injury, infection, skin burn, etc., were reported during or after MWA. Conclusions Over long-term follow-up, MWA is an effective method for treating BTNs and is expected to be a potential first-line treatment.

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