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mRECIST criteria to assess recurrent thyroid carcinoma treatment response after radiofrequency ablation: a prospective study

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Abstract

Purpose

Surgical removal is recommended for recurrent thyroid carcinomas (RTCs) unable to uptake radioiodine and/or not responsive to chemotherapy. However, repeated neck dissection is difficult for surgeons. Thus, radiofrequency ablation (RFA) was proposed for RTCs. The aim of this prospective study is to assess RTC treatment response after RFA, according to well-established criteria.

Methods

Sixteen lesions in 13 patients were treated by RFA. All patients refused/were excluded from repeated surgery or other conventional therapy. CT and US examinations were performed before RFA to evaluate lesion volume and vascularization. All RFA procedures were performed under US-guidance by an 18-gauge, electrode. Treatment response was evaluated by CT, according to RECIST 1.1 and to mRECIST guidelines; CT examinations were performed during follow-up (6–18 months); the volume of residual vital tumour tissue and the percentage of necrotic tissue were estimated by contrast enhanced CT.

Results

RFA was well tolerated by all patients; in two cases laryngeal nerve paralysis was observed. Mean pre-treatment volume was 4.18 ± 3.53 ml. Vital tumour tissue and percentage of necrosis at 6, 12 and 18 months were 0.18 ± 0.25, 0.11 ± 0.13, 0.29 ± 0.40 ml and 91.9 ± 11.1, 90.4 ± 13.3, 80.8 ± 23.1%. According to RECIST 1.1, target lesion response was classified as complete response (CR) in one case, partial response (PR) in 11/16, stable disease in 4/16 cases. According to mRECIST, 11/16 cases were classified as CR and the remaining 5 as PR.

Conclusion

RFA is a safe procedure to treat the viable tumour tissue and to reduce the RTC volume; as to the criteria to assess treatment response, mRECIST appears to be more accurate.

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Funding

No competing financial interests exist.

Author information

Authors and Affiliations

  1. Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine, University of Pisa, Via Paradisa, 2, Cisanello Hospital, 56100, Pisa, Italy

    S. Mazzeo, R. Cervelli, G. Tarantini, C. Cappelli, R. Cioni & D. Caramella

  2. Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

    R. Elisei, E. Molinaro & P. Vitti

  3. General Surgery, Department of Surgical Pathology, Medical, Molecular and Critical Area, University of Pisa, Pisa, Italy

    D. Galleri & L. De Napoli

  4. Department of Anesthesia, University of Pisa, Pisa, Italy

    C. Comite

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  1. S. Mazzeo
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  2. R. Cervelli
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Corresponding author

Correspondence to S. Mazzeo.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The study was approved by our Ethical Committee.

Informed consent

All patients signed an informed consent to be enroled in the study and to perform the RFA procedure.

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Mazzeo, S., Cervelli, R., Elisei, R. et al. mRECIST criteria to assess recurrent thyroid carcinoma treatment response after radiofrequency ablation: a prospective study. J Endocrinol Invest 41, 1389–1399 (2018). https://doi.org/10.1007/s40618-018-0886-0

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  • DOI: https://doi.org/10.1007/s40618-018-0886-0

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