Multicenter Study of Benign Thyroid Nodules with Radiofrequency Ablation: Results of 762 Cases over 4 Years in Taiwan

Background: To evaluate the effectiveness and safety of radiofrequency ablation (RFA) treatment for benign thyroid nodules (BTNs) in five medical centers in Taiwan. Methods: From April 2016 to July 2020, 762 patients underwent ultrasound guided RFA treatment of 826 benign thyroid nodules at five medical centers in Taiwan. The RFA procedure was performed by radiologists, otolaryngologists, or surgeons. Patients were grouped into three subgroups according to the initial volume of BTNs. The volume reduction ratio (VRR) of each nodule, and complications were analyzed at 1, 3, and 6 months after RFA treatment and the three groups compared. Results: The large nodular group showed greater VRR compared to the other two groups at first 1-month follow-up. At 6-months follow-up, there was no significant difference of VRR among the three groups. Goiters with difference in size can attain a successful VRR (>50%) although different specialists demonstrated variable VRR after 6-months follow-up. A total of 40 (4.8%) complications were reported. All patients recovered spontaneously without surgery intervention. Conclusions: The reliability and safety of RFA for benign thyroid nodules had been established. RFA has gradually become an alternative to surgery in the treatment of benign thyroid nodules in Taiwan.

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Efficacy and safety of radiofrequency ablation for benign thyroid nodules in patients with previous thyroid lobectomy

BMC Medical Imaging ◽

10.1186/s12880-021-00577-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lin Yan ◽

Mingbo Zhang ◽

Fang Xie ◽

Jun Ma ◽

Jing Xiao ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Symptom Score ◽

Thyroid Function ◽

Thyroid Nodules ◽

Efficacy And Safety ◽

Thyroid Lobectomy ◽

The Mean ◽

Benign Thyroid Nodules ◽

Benign Thyroid

Abstract Background Radiofrequency ablation (RFA) is recommended for the treatment of benign thyroid nodules. However, data on the clinical role of RFA for benign thyroid nodules in patients with history of thyroid lobectomy are insufficient. The purpose of this study was to evaluate the efficacy and safety of radiofrequency ablation (RFA) for benign thyroid nodules in patients who had previously undergoing thyroid lobectomy. Methods From May 2015 to October 2018, a total of 20 patients (19 females, 1 male, mean age 49.50 ± 14.26 years, range 22–74 years) with 20 benign thyroid nodules (mean volume 15.04 ± 21.17 ml, range 0.40–69.67 ml) who had undergone previous thyroid lobectomy were included in this retrospective study. Patients were followed up at 3, 6, 12 months after RFA and every 12 months thereafter by ultrasound, clinical evaluation and thyroid function. Volume, volume reduction rate (VRR), symptom score and cosmetic score were evaluated. Results During the mean follow-up time of 21.24 ± 16.41 months, the mean nodule volume decreased significantly from 15.04 ± 21.17 ml to 1.29 ± 1.17 ml (P = 0.018) with a mean VRR of 85.41 ± 12.17%. Therapeutic success was achieved in a single session for all thyroid nodules. The symptom score (P = 0.001) and cosmetic score (P = 0.001) were both significantly reduced at the last follow-up. The levels of free triiodothyronine (fT3), free thyroxine (fT4) and thyroid stimulating hormone were not significantly different at the last follow-up from those prior to treatment (all P > 0.05). No life-threatening complications or sequelae occurred after RFA. Conclusions As a minimally invasive modality, RFA was a safe, effective, and thyroid function-preserving option for patients with symptomatic benign thyroid nodules after a previous lobectomy.

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Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients

European Radiology ◽

10.1007/s00330-008-0880-6 ◽

2008 ◽

Vol 18 (6) ◽

pp. 1244-1250 ◽

Cited By ~ 224

Author(s):

Woo Kyoung Jeong ◽

Jung Hwan Baek ◽

Hyunchul Rhim ◽

Yoon Suk Kim ◽

Min Sook Kwak ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Thyroid Nodules ◽

Benign Thyroid Nodules ◽

Benign Thyroid

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Management of bleeding associated with radiofrequency ablation of benign thyroid nodules

Journal of International Medical Research ◽

10.1177/0300060520937526 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052093752

Author(s):

Kunpeng Hu ◽

Yufan Lian ◽

Jinfen Wang ◽

Wenchao Li ◽

Zhicheng Yao ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Thyroid Nodules ◽

Effective Management ◽

Voice Change ◽

Life Threatening ◽

The Mean ◽

Benign Thyroid Nodules ◽

Benign Thyroid ◽

Clinical Strategy

Objective This study was performed to explore the effective management of bleeding associated with radiofrequency ablation (RFA) of benign thyroid nodules. Methods Thirty-five patients with benign thyroid nodules who were treated with ultrasound-guided RFA from July 2015 to December 2016 at the Third Affiliated Hospital of Sun Yat-sen University were retrospectively reviewed. The technique efficacy, bleeding, and other complications were assessed during the follow-up period. Results The mean technique efficacy was 55.6%±22.8% at 1 month and 24.1%±17.1% at 6 months after the procedure. One case of an intranodular haematoma and two cases of voice change (>1 month) were observed. All patients recovered with corresponding treatment. Conclusion Although the incidence of haemorrhage is low, serious haematomas are life-threatening. Therefore, having a comprehensive understanding of the potential complications, an accurate clinical strategy, and adequate technical skills may prevent or help to properly manage these complications.

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

Experimental Biology and Medicine ◽

10.1177/1535370217727477 ◽

2017 ◽

Vol 242 (15) ◽

pp. 1515-1523 ◽

Cited By ~ 21

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.

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

Frontiers in Endocrinology ◽

10.3389/fendo.2021.638880 ◽

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

Frontiers in Endocrinology ◽

10.3389/fendo.2021.622996 ◽

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.

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Radiofrequency ablation for benign thyroid nodules: 600 patients - five years follow-up single center experience

Endocrine Abstracts ◽

10.1530/endoabs.73aep890 ◽

2021 ◽

Author(s):

Vyacheslav Solovov

Keyword(s):

Radiofrequency Ablation ◽

Thyroid Nodules ◽

Single Center ◽

Single Center Experience ◽

Benign Thyroid Nodules ◽

Benign Thyroid

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Evaluation of Ethanol Injection, Radiofrequency Ablation, and Levothyroxine Therapy in the Management of Benign Thyroid Nodules

10.21203/rs.3.rs-94756/v1 ◽

2020 ◽

Author(s):

Alireza Arefzadeh ◽

hossein ghanaati ◽

Mahsa Alborzi Avankai ◽

Alireza Abrishami ◽

Hamidreza Niazkar ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Treatment Group ◽

Thyroid Nodules ◽

Volume Reduction ◽

The Other ◽

Single Session ◽

Ethanol Injection ◽

Injection Group ◽

Benign Thyroid Nodules ◽

Benign Thyroid

Abstract Background: Thyroid nodules are a common clinical finding. Even though there are various accepted treatments for the benign thyroid nodules, there are alternative methods for managing these patients with fewer expenses and also minimum complications. This study aims to compare the volume decline of radiofrequency (RF) ablation and single-session ethanol ablation (EA) and the effects of levothyroxine therapy for benign thyroid nodule treatment.Materials: In this clinical trial, 90 patients with benign thyroid nodules in different centers in Tehran, Iran, from December 6, 2018, to December 6, 2019, were included. Patients who had met the inclusion criteria were selected and randomly allocated into three groups (each of 30) of a single session of radiofrequency ablation (Group 1), a single session of ethanol injection (Group 2), or a 6-month LT4 treatment (Group 3). Thyroid tests, including TSH, T4, T3, anti-TPO, T3RU, and serum Calcitonin level, were recorded at baseline and again at 1, 3, and six months. Nodule volume was also assessed through sonography at baseline and the other checkpoints.Results: The mean volume reduction after 6 months of intervention for ethanol injection group, radiofrequency ablation group, and LT4 treatment group were 72.2%, 83.4%, and 21.8%, respectively. There was a significant relationship between mean volume reduction and months (1, 3, and six) (P<0.001).Conclusions: Although radiofrequency ablation therapy is the best modality for managing benign thyroid nodules in our study, it is more expensive than the other modalities despite comparable therapeutic effects.

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