Evaluation of Ultrasound-Guided Radiofrequency Ablation as a Treatment Option for Papillary Thyroid Microcarcinoma in the Isthmus: A Retrospective Study

BackgroundAbout 3–9.2% of papillary thyroid carcinomas (PTC) are found in the isthmus, which has unique anatomic properties, making treatment more challenging. The aim of this study was to evaluate the treatment and undesirable effects of ultrasound-guided radiofrequency ablation (RFA) for PTC in the isthmus.MethodsThis retrospective case series study assessed 112 patients with single papillary thyroid microcarcinoma in the isthmus, pathologically diagnosed before RFA at the General Hospital of Chinese PLA in 2014–2018. Follow-up was performed by contrast-enhanced ultrasound (CEUS) and ultrasound examinations at 1, 3, and 6 months and every 6 months thereafter. The complete ablation (CAR), disappearance (DR), and volume reduction (VRR) rates of nodules, the incidence of complications, and the rate of lymph-node metastasis were recorded.ResultsThe CAR of the tumors was 100%. During follow-up, the volume of coagulation necrosis gradually decreased. DRs at 1, 3, 6, 12, and 18 months after RFA were 0.8% (1/112), 10.7% (12/112), 51.7% (58/112), 91.0% (102/112), and 100% (112/112), respectively. The VRR evaluated by ultrasound and CEUS gradually increased. One recurrent case (0.8%) was found at 7 months after RFA. No complications, lymph node metastasis confirmed by ultrasound, and abnormal thyroid function were observed.ConclusionsThis retrospective study shows that RFA is beneficial for the treatment of PTMC in the isthmus.

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Long-Term Efficacy of Ultrasound-Guided Percutaneous Laser Ablation for Low-Risk Papillary Thyroid Microcarcinoma: A 5-Year Follow-Up Study

BioMed Research International ◽

10.1155/2021/6616826 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Kai Peng ◽

Ping Zhou ◽

Wengang Liu

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Low Risk ◽

Papillary Thyroid ◽

Ultrasound Guided ◽

Node Metastasis ◽

Thyroid Microcarcinoma ◽

Percutaneous Laser Ablation

Objective. To evaluate the long-term efficacy and safety of ultrasound-guided percutaneous laser ablation (PLA) for the treatment of low-risk papillary thyroid microcarcinoma (PTMC). Methods. From June 2012 to May 2015, 105 patients with solitary, pathologically confirmed PTMC lesions were treated with ultrasound-guided PLA. Nodule location, nodule volume, thyroid function, and clinical symptoms were evaluated before ablation. Contrast-enhanced ultrasound (CEUS) was performed 1 h after treatment to evaluate whether the ablation was complete. Ultrasound examination was performed at 1, 3, 6, and 12 months after ablation and every 6 months thereafter to determine the size of the ablation area and search for recurrence in the thyroid parenchyma and lymph node metastasis. Thyroid function was examined before and 1 month after ablation. Fine needle aspiration biopsy was performed for any suspicious metastatic lymph nodes and recurrent lesions in the thyroid. Results. All 105 lesions were completely inactivated after one ablation, making the success rate for single ablation 100%. The average ablation time was 2.78 ± 1.05 min, and the average ablation energy was 505 ± 185 J. All patients could tolerate and complete the ablation. No serious complications occurred during the treatment; only minor side effects such as pain and local discomfort were reported. The volume reduction rates were − 781.14 ± 653.29 % at 1 h posttreatment and − 268.65 ± 179.57 % , − 98.39 ± 76.58 % , 36.78 ± 30.32 % , 75.55 ± 21.81 % , 96.79 ± 10.57 % , and 100% at 1, 3, 6, 12, 18, and 24 months after ablation, respectively. This rate remained 100% at the later follow-up times. Overall, 28 (26.67%), 74 (70.48%), 96 (91.43%), and 103 (100%) were completely absorbed by 6, 12, 18, and 24 months after PLA. One patient developed another lesion 12 months after ablation, and two patients had central cervical lymph node metastasis 24 months after ablation. Conclusion. PLA is a safe and effective alternative clinical treatment for low-risk PTMC.

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