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

2005 ◽  
Vol 152 (3) ◽  
pp. 341-345 ◽  
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.

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

2011 ◽  
Vol 165 (1) ◽  
pp. 123-128 ◽  
Author(s):  
Helle Døssing ◽  
Finn Noe Bennedbæk ◽  
Laszlo Hegedüs
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Function ◽  
Thyroid Surgery ◽  
Laser Photocoagulation ◽  
Thyroid Nodules ◽  
Interstitial Laser Photocoagulation ◽  
Nodule Volume ◽  
Interstitial Laser

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.

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

2011 ◽  
Vol 43 (8) ◽  
pp. 797-803 ◽  
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

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

2007 ◽  
Vol 157 (1) ◽  
pp. 95-100 ◽  
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.

Low-Energy Interstitial Laser Photocoagulation for Treatment of Nonfunctioning Thyroid Nodules: Therapeutic Outcome in Relation to Pretreatment and Treatment Parameters

Thyroid ◽  
2006 ◽  
Vol 16 (8) ◽  
pp. 749-755 ◽  
Author(s):  
Gerardo Amabile ◽  
Mario Rotondi ◽  
Giovanni De Chiara ◽  
Antonio Silvestri ◽  
Bruno Di Filippo ◽  
...  
Keyword(s):  
Laser Photocoagulation ◽  
Thyroid Nodules ◽  
Therapeutic Outcome ◽  
Low Energy ◽  
Interstitial Laser Photocoagulation ◽  
Interstitial Laser
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