Percutaneous microwave ablation of benign thyroid nodules

2015 ◽  
Vol 54 (01) ◽  
pp. 13-19 ◽  
Author(s):  
F. Nimsdorf ◽  
C. Happel ◽  
H. Ackermann ◽  
F. Grünwald ◽  
H. Korkusuz

SummaryAim: Thyroid nodules represent a common clinical issue. Amongst other minimally invasive procedures, percutaneous microwave ablation (MWA) poses a promising new approach. The goal of this retrospective study is to find out if there is a correlation between volume reduction after 3 months and 99mTcuptake reduction of treated thyroid nodules. Patients, methods: 14 patients with 18 nodules were treated with MWA. Pre-ablative assessment included sonographical and functional imaging of the thyroid with 99mTcpertechnetate and 99mTc-MIBI. Additionally, patients underwent thyroid scintigraphy 24 hours after ablation in order to evaluate the impact of the treatment on a functional level and to ensure sufficient ablation of the targeted area. At a 3-month follow-up, ultrasound examination was performed to assess nodular volume reduction. Results: Mean relative nodular volume reduction after three months was 55.4 ± 17.9% (p < 0.05). 99mTcuptake 24 hours after treatment was 45.2 ± 31.9% (99mTc-MIBI) and 35.7 ± 20.3% (99mTcpertechnetate) lower than prior to ablation (p < 0.05). Correlating reduction of volume and 99mTc-uptake, Pearson's r was 0.41 (p < 0.05) for nodules imaged with 99mTc-MIBI and –0.98 (p < 0.05) for 99mTc-pertechnetate. According to scintigraphy 99.6 ± 22.6% of the determined target area could be successfully ablated. Conclusions: MWA can be considered as an efficient, low-risk and convenient new approach to the treatment of benign thyroid nodules. Furthermore, scintigraphy seems to serve as a potential prognostic tool for the later morphological outcome, allowing rapid evaluation of the targeted area in post-ablative examination.

2017 ◽  
Vol 242 (15) ◽  
pp. 1515-1523 ◽  
Author(s):  
Yu-Jiang Liu ◽  
Lin-Xue Qian ◽  
Dong Liu ◽  
Jun-Feng Zhao

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.


2021 ◽  
Author(s):  
Baoying Xia ◽  
Boyang Yu ◽  
Xiaofei Wang ◽  
Yu Ma ◽  
Feng Liu ◽  
...  

Abstract ObjectiveMicrowave ablation (MWA) is a minimally invasive technique for the treatment of benign thyroid nodules. The purpose of this study was to evaluate the efficacy and safety of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules, and to provide reference for future clinical work.MethodsThis study retrospectively analyzed the patients who received ultrasound-guided microwave ablation for benign thyroid nodules in our hospital from October 2018 to March 2020. A total of 214 patients were included in the study. We assessed thyroid volume changes (represented by volume reduction ratio VRR) , the serum levels of triiodide thyroid hormone (T3), thyroxine (T4) and thyrotropin (TSH) and complications after MWA treatment.ResultsThere were a total of 306 nodules in 214 patients, including 183 (85.51%) females and 31 (14.49%) males. The median diameter and volume of the nodule were 33mm and 8.01ml. The volume reduction ratio(VRR)at 1 month, 3 months, 6 months and 12 months were 40.79%, 60.37%, 74.59% and 85.60%, respectively.(P<0.05) In addition, initial nodular volume were the influencing factors of volume reduction ratio.ConclusionsUltrasound-guided MWA is effective and safe in the treatment of benign thyroid nodules. In addition, it has little damage to surrounding tissues and no effect on thyroid function. Especially for the initial small volume of nodules, treatment is better. Therefore, ultrasound-guided thyroid MWA can be used as one of the main clinical treatment methods for benign thyroid nodules.


2012 ◽  
Vol 166 (6) ◽  
pp. 1031-1037 ◽  
Author(s):  
Bing Feng ◽  
Ping Liang ◽  
Zhigang Cheng ◽  
Xiaoling Yu ◽  
Jie Yu ◽  
...  

PurposeTo obtain the treatment parameters of internally cooled microwave antenna and to evaluate the feasibility of ultrasound-guided percutaneous microwave ablation (MWA) for benign thyroid nodules.Materials and methodsMWAs were performed by microwave antenna (16G) in ex vivo porcine liver. The lesion diameters achieved in different groups (20, 25, and 30 W for 3, 5, 7, 10, and 12 min) were compared. The clinical study was approved by the ethics committee. Written informed consent was obtained from all patients. MWA was performed in 11 patients (male to female ratio=1:10; mean age, 50±7 years) with 11 benign thyroid nodules. Ultrasound scan, laboratory data, and clinical symptoms were evaluated before and 1 day and 1, 3, 6, 9, and 12 months after the procedure.ResultsIn ex vivo study, the ablation lesion at 30 W 12 min tended to have appropriate scope and spherical shape. In clinical study, the follow-up periods ranged from 1 to 9 months. At the last follow-up, the largest diameter decreased from 2.9±1.0 (range, 1.6–4.1) to 1.9±0.7 (range, 0.4–3.0) cm (P<0.01), and the volume decreased from 5.30±4.88 (range, 0.89–14.81) to 2.40±2.06 (range, 0.02–6.35) ml (P<0.01). The volume reduction ratio was 45.99±29.90 (range, 10.56–98.15) %. The cosmetic grading score was reduced from 3.20±0.79 to 2.30±0.95 (P<0.05). One patient experienced temporary nerve palsy and was recovered within 2 months after treatment.ConclusionThe internally cooled microwave antenna can yield ideal ablation lesions, and ultrasound-guided percutaneous MWA is a feasible technique for benign thyroid nodules.


2017 ◽  
Vol 64 (11) ◽  
pp. 1079-1085 ◽  
Author(s):  
Wenjun Wu ◽  
Xiaohua Gong ◽  
Qi Zhou ◽  
Xiong Chen ◽  
Xiaojun Chen ◽  
...  

2014 ◽  
Vol 53 (04) ◽  
pp. 123-130 ◽  
Author(s):  
C. Happel ◽  
K. Heck ◽  
H. Ackermann ◽  
F. Grünwald ◽  
H. Korkusuz

SummaryMicrowave ablation (MWA) is a new minimal invasive method for thermal ablation of benign thyroid nodules. In contrast to well-established radiofrequency ablation (RFA), MWA offers several advantages with similarly successful results. There has not been any use of functional imaging with 99mTc-per- technetate and 99mTc-MIBI-scans as a mere qualitative analysis of this imaging in the field of MWA in Europe until now. The aim of this study has been to demonstrate the feasibility of MWA as well as the applicability of functional imaging to verify effectiveness with a centerspecific score. Patients, methods: 11 patients (5 women, 6 men, average age 62.3 years) with 18 benign thyroid nodules were treated. MWA was operated under local anesthesia with a system working in a wavelength field of 902 to 928 MHz (Avecure MWG881, MedWaves, Inc. San Diego, CA). Pre- and postablative scans were controlled by two specialists in nuclear medicine with longtime work experience. Results: A center specific functional imaging score (CSFIS) was defined, a decrease of 1.4 points at an average was noticeable (range 1-3 points). In 66.7% (n = 12) of all nodules the score decreased by 1 point, 27.8% (n = 5) by 2 points and 5.6% (n = 1) by 3 points. The treatment was well tolerated and no severe complications were observed. Conclusion: The preliminary data suggests that MWA is an effective method to treat benign thyroid nodules. Functional imaging is a promising technique for early verification of effectiveness of thermal ablation.


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