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Complications encountered in ultrasonography-guided radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers

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Abstract

Objectives

To evaluate the complication rates and describe the possible complications of ultrasonography-guided radiofrequency ablation (RFA) of benign thyroid nodules (BTN) and recurrent thyroid cancers (RTC), and to compare the complication rates between BTN and RTC.

Methods

This retrospective study reviewed 875 patients who underwent RFA for BTN (746 patients; 83.5%) or RTC (129 patients; 14.7%). Medical records were reviewed for all types of complications occurring during and after the RFA procedure. The baseline characteristics and the complication rates of BTN and RTC were compared.

Results

The overall complication rate was 3.5% (31/875), and the major complication rate was 1.6% (14/875). The major complication rate of RTC was significantly higher than that of BTN (5.4% vs. 0.9%, P = 0.002), while there were no significant differences in the minor complications rate. New complications, such as Horner syndrome, spinal accessory nerve injury, and complications due to lidocaine toxicity, were also revealed.

Conclusions

Various complications of RFA may occur in both BTN and RTC, although the complication rate is low. To understand the broad spectrum of complications and minimise the complications and sequela, the suggested technical tips and cervical anatomy are essential.

Key Points

• The overall complication rate was 3.5% (31/875).

• The major complication rate was 1.6% (14/875).

• The major complication rate of RTC was significantly higher than BTN.

• There were only four patients showing persistent symptoms (0.5%).

• Unreported new complications were also demonstrated.

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Abbreviations

US:

Ultrasonography

RFA:

Radiofrequency ablation

SAN:

Spinal accessory nerve

RLN:

Recurrent laryngeal nerve

TSH:

Thyrotrophin

CCA:

Common carotid artery

VN:

Vagus nerve

mSCG:

Middle cervical sympathetic ganglion

SCM:

Sternocleidomastoid muscle

References

  1. Ji Hong M, Baek JH, Choi YJ et al (2015) Radiofrequency ablation is a thyroid function-preserving treatment for patients with bilateral benign thyroid nodules. J Vasc Interv Radiol 26:55–61

    Article  PubMed  Google Scholar 

  2. Che Y, Jin S, Shi C et al (2015) Treatment of benign thyroid nodules: comparison of surgery with radiofrequency ablation. AJNR Am J Neuroradiol 36:1321–1325

    Article  CAS  PubMed  Google Scholar 

  3. Sung JY, Baek JH, Jung SL et al (2015) Radiofrequency ablation for autonomously functioning thyroid nodules: a multicenter study. Thyroid 25:112–117

    Article  CAS  PubMed  Google Scholar 

  4. Baek JH, Lee JH, Sung JY et al (2012) Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study. Radiology 262:335–342

    Article  PubMed  Google Scholar 

  5. Dupuy DE, Monchik JM, Decrea C, Pisharodi L (2001) Radiofrequency ablation of regional recurrence from well-differentiated thyroid malignancy. Surgery 130:971–977

    Article  CAS  PubMed  Google Scholar 

  6. Monchik JM, Donatini G, Iannuccilli J, Dupuy DE (2006) Radiofrequency ablation and percutaneous ethanol injection treatment for recurrent local and distant well-differentiated thyroid carcinoma. Ann Surg 244:296–304

    Article  PubMed  PubMed Central  Google Scholar 

  7. Baek JH, Kim YS, Sung JY, Choi H, Lee JH (2011) Locoregional control of metastatic well-differentiated thyroid cancer by ultrasound-guided radiofrequency ablation. AJR Am J Roentgenol 197:W331–W336

    Article  PubMed  Google Scholar 

  8. Guenette JP, Monchik JM, Dupuy DE (2013) Image-guided ablation of postsurgical locoregional recurrence of biopsy-proven well-differentiated thyroid carcinoma. J Vasc Interv Radiol 24:672–679

    Article  PubMed  Google Scholar 

  9. Lim HK, Baek JH, Lee JH et al (2015) Efficacy and safety of radiofrequency ablation for treating locoregional recurrence from papillary thyroid cancer. Eur Radiol 25:163–170

    Article  PubMed  Google Scholar 

  10. Kim JH, Yoo WS, Park YJ et al (2015) Efficacy and safety of radiofrequency ablation for treatment of locally recurrent thyroid cancers smaller than 2 cm. Radiology 276:909–918

    Article  PubMed  Google Scholar 

  11. Ha EJ, Baek JH, Lee JH, Kim JK, Shong YK (2011) Clinical significance of vagus nerve variation in radiofrequency ablation of thyroid nodules. Eur Radiol 21:2151–2157

    Article  PubMed  Google Scholar 

  12. Ha EJ, Baek JH, Lee JH (2015) Ultrasonography-based thyroidal and perithyroidal anatomy and its clinical significance. Korean J Radiol 16:749–766

    Article  PubMed  PubMed Central  Google Scholar 

  13. Shin JE, Baek JH, Ha EJ, Choi YJ, Choi WJ, Lee JH (2015) Ultrasound features of middle cervical sympathetic ganglion. Clin J Pain 31:909–913

    Article  PubMed  Google Scholar 

  14. Hong MJ, Baek JH, Kim DY et al (2014) Spinal accessory nerve: ultrasound findings and correlations with neck lymph node levels. Ultraschall Med. doi:10.1055/s-0034-1385673

    PubMed  Google Scholar 

  15. Baek JH, Moon WJ, Kim YS, Lee JH, Lee D (2009) Radiofrequency ablation for the treatment of autonomously functioning thyroid nodules. World J Surg 33:1971–1977

    Article  PubMed  Google Scholar 

  16. Ha EJ, Baek JH, Lee JH et al (2013) Radiofrequency ablation of benign thyroid nodules does not affect thyroid function in patients with previous lobectomy. Thyroid 23:289–293

    Article  CAS  PubMed  Google Scholar 

  17. Jeong WK, Baek JH, Rhim H et al (2008) Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol 18:1244–1250

    Article  PubMed  Google Scholar 

  18. Baek JH, Kim YS, Lee D, Huh JY, Lee JH (2010) Benign predominantly solid thyroid nodules: prospective study of efficacy of sonographically guided radiofrequency ablation versus control condition. AJR Am J Roentgenol 194:1137–1142

    Article  PubMed  Google Scholar 

  19. Na DG, Lee JH, Jung SL et al (2012) Radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: consensus statement and recommendations. Korean J Radiol 13:117–125

    Article  PubMed  PubMed Central  Google Scholar 

  20. Ahmed M, Solbiati L, Brace CL et al (2014) Image-guided tumor ablation: standardization of terminology and reporting criteria--a 10-year update. J Vasc Interv Radiol 25, e1694

    Google Scholar 

  21. Sacks D, McClenny TE, Cardella JF, Lewis CA (2003) Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202

    Article  PubMed  Google Scholar 

  22. Papini E, Guglielmi R, Bizzarri G et al (2007) Treatment of benign cold thyroid nodules: a randomized clinical trial of percutaneous laser ablation versus levothyroxine therapy or follow-up. Thyroid 17:229–235

    Article  CAS  PubMed  Google Scholar 

  23. Yoon HM, Baek JH, Lee JH et al (2014) Combination therapy consisting of ethanol and radiofrequency ablation for predominantly cystic thyroid nodules. AJNR Am J Neuroradiol 35:582–586

    Article  CAS  PubMed  Google Scholar 

  24. Ha EJ, Baek JH, Lee JH (2014) Moving-shot versus fixed electrode techniques for radiofrequency ablation: comparison in an ex-vivo bovine liver tissue model. Korean J Radiol 15:836–843

    Article  PubMed  PubMed Central  Google Scholar 

  25. Park JK, Jeong SY, Lee JH, Lim GC, Chang JW (2011) Variations in the course of the cervical vagus nerve on thyroid ultrasonography. AJNR Am J Neuroradiol 32:1178–1181

    Article  CAS  PubMed  Google Scholar 

  26. Shin JH, Jung SL, Baek JH, Kim JH (2011) Rupture of benign thyroid tumors after radio-frequency ablation. AJNR Am J Neuroradiol 32:2165–2169

    Article  CAS  PubMed  Google Scholar 

  27. Al-Abbadi MA, Youngberg G, Al-Lozi M (2010) Horner syndrome after lymph node fine needle aspiration: which is the culprit? Acta Cytol 54:1058–1059

    Article  PubMed  Google Scholar 

  28. Lee JH, Kim YS, Lee D, Choi H, Yoo H, Baek JH (2010) Radiofrequency ablation (RFA) of benign thyroid nodules in patients with incompletely resolved clinical problems after ethanol ablation (EA). World J Surg 34:1488–1493

    Article  PubMed  Google Scholar 

  29. Pelter MA, Vollmer TA, Blum RL (1989) Seizure-like reaction associated with subcutaneous lidocaine injection. Clin Pharm 8:767–768

    CAS  PubMed  Google Scholar 

  30. Shin JH, Baek JH, Ha EJ, Lee JH (2012) Radiofrequency ablation of thyroid nodules: basic principles and clinical application. Int J Endocrinol 2012:919650

    Article  PubMed  PubMed Central  Google Scholar 

  31. Lee SJ, Jung SL, Kim BS et al (2014) Radiofrequency ablation to treat loco-regional recurrence of well-differentiated thyroid carcinoma. Korean J Radiol 15:817–826

    Article  PubMed  PubMed Central  Google Scholar 

  32. Wang L, Ge M, Xu D et al (2014) Ultrasonography-guided percutaneous radiofrequency ablation for cervical lymph node metastasis from thyroid carcinoma. J Cancer Res Ther 10:C144–C149

    Article  PubMed  Google Scholar 

  33. Park KW, Shin JH, Han BK, Ko EY, Chung JH (2011) Inoperable symptomatic recurrent thyroid cancers: preliminary result of radiofrequency ablation. Ann Surg Oncol 18:2564–2568

    Article  PubMed  Google Scholar 

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Acknowledgements

The scientific guarantor of this publication is Jung Hwan Baek. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43 gil, Songpa-Gu, Seoul, South Korea

    Cherry Kim, Jeong Hyun Lee, Young Jun Choi & Jung Hwan Baek

  2. Department of Radiology, Ansan Hospital, Korea University College of Medicine, 516, Gojan 1-dong, Danwon-gu, Ansan-si, Gyeonggi, South Korea

    Cherry Kim

  3. Department of Endocrinology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43 gil, Songpa-Gu, Seoul, South Korea

    Won Bae Kim

  4. Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43 gil, Songpa-Gu, Seoul, South Korea

    Tae Yon Sung

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  1. Cherry Kim
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Correspondence to Jung Hwan Baek.

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Kim, C., Lee, J.H., Choi, Y.J. et al. Complications encountered in ultrasonography-guided radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers. Eur Radiol 27, 3128–3137 (2017). https://doi.org/10.1007/s00330-016-4690-y

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  • DOI: https://doi.org/10.1007/s00330-016-4690-y

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