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.
Similar content being viewed by others
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
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
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
Sung JY, Baek JH, Jung SL et al (2015) Radiofrequency ablation for autonomously functioning thyroid nodules: a multicenter study. Thyroid 25:112–117
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
Dupuy DE, Monchik JM, Decrea C, Pisharodi L (2001) Radiofrequency ablation of regional recurrence from well-differentiated thyroid malignancy. Surgery 130:971–977
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
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
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
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
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
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
Ha EJ, Baek JH, Lee JH (2015) Ultrasonography-based thyroidal and perithyroidal anatomy and its clinical significance. Korean J Radiol 16:749–766
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
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
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
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
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
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
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
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
Sacks D, McClenny TE, Cardella JF, Lewis CA (2003) Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202
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
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
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
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
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
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
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
Pelter MA, Vollmer TA, Blum RL (1989) Seizure-like reaction associated with subcutaneous lidocaine injection. Clin Pharm 8:767–768
Shin JH, Baek JH, Ha EJ, Lee JH (2012) Radiofrequency ablation of thyroid nodules: basic principles and clinical application. Int J Endocrinol 2012:919650
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
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
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
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.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
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
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-016-4690-y