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

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.

scholarly journals Management of bleeding associated with radiofrequency ablation of benign thyroid nodules

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.

scholarly journals SUN-LB83 Outpatient Radiofrequency Ablation Is a Safe and Effective Treatment Option for Benign Thyroid Nodules in North America

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jules Aljammal ◽  
Shahzad Ahmad ◽  
Iram Hussain
Keyword(s):  
Radiofrequency Ablation ◽  
Thyroid Nodules ◽  
Hormone Replacement ◽  
P Value ◽  
Free T4 ◽  
Thyroid Hormone Replacement ◽  
The Mean ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Abstract Background: Radiofrequency ablation (RFA) of thyroid nodules is a non-mainstream treatment option for benign thyroid nodules. Studies in Asia and Europe (1) have demonstrated RFA to be an effective outpatient alternative to surgery, however, these results have not been reproduced in North America. Hypothesis: RFA of symptomatic benign thyroid nodules can reduce morbidity associated with thyroidectomies, without sacrificing favorable clinical outcomes. Methodology: A retrospective review of 11 patients (all female and Caucasian) with 13 thyroid nodules treated with RFA in our practice was conducted (Nov 2018 - Oct 2019). The 9 nontoxic nodules were biopsied twice, and 4 toxic adenomas were biopsied once; all had benign cytopathology results prior to RFA. RFA was done under local anesthesia/conscious sedation, with follow-up telephone call after 2 days to assess complications (pain, voice change, hematoma/swelling, skin burns). Nodule volume in mL (length x depth x width in cm x 0.525), cosmetic score (2), and thyroid function tests (TSH and free T4) were recorded pre-procedure, and 6 - 10 weeks post procedure. The volume reduction rate (VRR) was calculated as follows: [(baseline volume - final volume)/baseline volume] x 100 (%). Results: The mean age of the patients was 45 years; 7 were euthyroid (not on thyroid hormone replacement), and 4 had hyperthyroidism. The mean volume of treated thyroid nodules decreased from 12.3 cc to 5.6 cc, with a mean VRR of ~ 54%. Thyroid nodules with volumes less than 10 cc (smaller) had a VRR of ~ 75%, whereas nodules with volumes more than 10 cc (larger) had a VRR of ~ 50%. The VRR between smaller and larger nodules (p-value: 0.11), and toxic adenomas and nontoxic thyroid nodules (p-value: 0.26), was not significantly different. 3 out of 4 patients with toxic adenomas normalized their TSH levels; 1 patient normalized free T4 levels, but TSH remained suppressed. None of the patients developed hypothyroidism. The cosmetic scores (indicating visible or palpable mass) improved by 50%. All patients had complete resolution of compressive symptoms. Minimal discomfort only reported at time of procedure. No complications were reported at the 2-day, or the 6-10-week follow-up. Conclusions: Outpatient RFA is a safe and effective treatment for benign thyroid nodules and toxic adenomas. There were no complications in our study, however, this may be limited by the small sample size and relatively short follow-up duration. Advantages of RFA include avoiding lifelong thyroid hormone replacement and complications of surgery and/or general anesthesia. We propose that RFA be considered as a first-line therapy for the treatment of benign thyroid nodules for these reasons. References: (1) Feldkamp, et al. Exp Clin Endocrinol Diabetes. 2020 Jan 7. doi: 10.1055/a-1075-2025. (2) Dobnig, et al. Thyroid. 2018 Apr;28(4):472-480. doi: 10.1089/thy.2017.0547.

scholarly journals Efficacy and safety of ultrasound (US)-guided radiofrequency ablation of benign thyroid nodules

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Mai S. Abd El-Galil ◽  
Ali H. Ali ◽  
Raef M. Botros ◽  
Yasser I. Abd El-Khaleq ◽  
Osama M. A. Hetta
Keyword(s):  
Radiofrequency Ablation ◽  
Thyroid Function ◽  
Thyroid Nodules ◽  
Volume Reduction ◽  
Rf Ablation ◽  
Efficacy And Safety ◽  
Invasive Treatment ◽  
Life Threatening ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Abstract Background We evaluated 45 benign thyroid nodules of 40 patients treated with radiofrequency (RF) ablation and followed up for 6 months. The inclusion criteria included unilateral or bilateral thyroid nodules with compression symptoms or cosmetic problems, cytological confirmation of benignity without atypical cells, and patient refusal or unfit for surgery. There was no predilection for the size, number, ultrasound nature of the nodules, (solid, cystic, or complex). RF ablation was performed using Mygen (M-3004) RF generator from RF Medical Co., Ltd, South Korea. The volume of the nodules and clinical problems were evaluated before and after the procedure. Complications and factors related to volume reduction were evaluated. The purpose of the study is to evaluate the efficacy and safety of US-guided radiofrequency (RF) ablation in the treatment of benign thyroid nodules. Results The volume reduction ratio (%) of the thyroid nodules was statistically significant. The mean VRR was 58.41 ± 15.27SD at 1 month, 73.26 ± 11.22SD at 3 months, and 82.54 ± 12.49SD at 6 months. P value was < 0.001. The radiofrequency ablation did not affect the normal thyroid function of the 38 patients who were euthyroid at the start of the study. Thyroid function normalized 1 month after ablation of the two autonomously functioning thyroid nodules. The compressive symptoms resolved in 22 patients (55%) and improved in the rest of the 18 patients (45%) with the median decreased from 8 (IQR 6–9), range 4–10 before treatment to 0 (IQR 0–1), range 0–3 after 6 months. Cosmetic problems improved in all 40 patients by P value < 0.001. The procedure had no sustained or life-threatening complications. Conclusions RF ablation was effective in reducing the size of the benign thyroid nodules and in controlling nodule-related compressive symptoms as well as cosmetic problems. There were no major complications sustained and no life-threatening complications or sequelae happened. RF ablation can be used as an alternative non-surgical minimally invasive treatment for patients with benign thyroid nodules.

Efficacy and Safety of Radiofrequency Ablation Performed by an Endocrinologist for Benign Thyroid Nodules

2015 ◽  
Vol 8 (2) ◽  
pp. 183 ◽  
Author(s):  
Tae Hyun Kim ◽  
Se-Mi Kim ◽  
Ah-Lon Jung ◽  
Seung Ki Moon ◽  
Dong Hoon Yang ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Thyroid Nodules ◽  
Efficacy And Safety ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

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

2008 ◽  
Vol 18 (6) ◽  
pp. 1244-1250 ◽  
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

scholarly journals Reproducibility of Ablated Volume Measurement Is Higher with Contrast-Enhanced Ultrasound than with B-Mode Ultrasound after Benign Thyroid Nodule Radiofrequency Ablation—A Preliminary Study

2020 ◽  
Vol 9 (5) ◽  
pp. 1504 ◽  
Author(s):  
Simone Schiaffino ◽  
Francesca Serpi ◽  
Duccio Rossi ◽  
Valerio Ferrara ◽  
Ciriaco Buonomenna ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Thyroid Nodules ◽  
Observer Agreement ◽  
Contrast Enhanced Ultrasound ◽  
Limits Of Agreement ◽  
Contrast Enhanced ◽  
The Mean ◽  
Preliminary Study ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

The reproducibility of contrast-enhanced ultrasound (CEUS) and standard B-mode ultrasound in the assessment of radiofrequency-ablated volume of benign thyroid nodules was compared. A preliminary study was conducted on consecutive patients who underwent radiofrequency ablation (RFA) of benign thyroid nodules between 2014 and 2016, with available CEUS and B-mode post-ablation checks. CEUS and B-mode images were retrospectively evaluated by two radiologists to assess inter- and intra-observer agreement in the assessment of ablated volume (Bland–Altman test). For CEUS, the mean inter-observer difference (95% limits of agreement) was 0.219 mL (-0.372–0.809 mL); for B-mode, the mean difference was 0.880 mL (-1.655–3.414 mL). Reproducibility was significantly higher for CEUS (85%) than for B-mode (27%). Mean intra-observer differences (95% limits of agreement) were 0.013 mL (0.803–4.097 mL) for Reader 1 and 0.031 mL (0.763–3.931 mL) for Reader 2 using CEUS, while they were 0.567 mL (-2.180–4.317 mL, Reader 1) and 0.759 mL (-2.584–4.290 mL, Reader 2) for B-mode. Intra-observer reproducibility was significantly higher for CEUS (96% and 95%, for the two readers) than for B-mode (21% and 23%). In conclusion, CEUS had higher reproducibility and inter- and intra-observer agreement compared to conventional B-mode in the assessment of radiofrequency-ablated volume of benign thyroid nodules.

Radiofrequency Ablation Is a Thyroid Function–Preserving Treatment for Patients with Bilateral Benign Thyroid Nodules

2015 ◽  
Vol 26 (1) ◽  
pp. 55-61 ◽  
Author(s):  
Min Ji Hong ◽  
Jung Hwan Baek ◽  
Young Jun Choi ◽  
Jeong Hyun Lee ◽  
Hyun Kyung Lim ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Thyroid Function ◽  
Thyroid Nodules ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

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

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 &lt; 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 &lt; 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 &lt; 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 &gt;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.

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.

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