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Radiofrequency Ablation for Benign Thyroid Nodules: 1-Year Follow-Up in 184 Patients

  • Nguyen Lam Vuong
  • Le Quang Dinh
  • Ho Tat Bang
  • Tran Thi Mai Thuy
  • Nguyen Hoang Bac
  • Tran Thanh VyEmail author
Original Scientific Report

Abstract

Background

Benign thyroid nodules are common, and must be treated when symptomatic. Non-surgical minimally invasive modalities, including radiofrequency ablation (RFA), have been widely used with good results. The factors related to the efficacy of RFA are still debated. This study was to evaluate the safety, efficacy and related factors of RFA in the treatment of benign thyroid nodules.

Methods

A retrospective single-center study was conducted on 251 benign thyroid nodules in 184 patients treated with RFA. The procedure was performed under ultrasound (US) guidance using the trans-isthmic approach and the moving-shot technique. Clinical and US examinations were performed at 1, 3, 6, 12 months, and then at 6 month intervals. Study outcomes were volume reduction ratio (VRR) and complications.

Results

There were 153 women and 31 men included in the study. The mean age was 43.9 years. The median initial largest diameter and volume of nodules were 30 mm and 6.18 ml. The median length of follow-up was 12 months. Two minor complications were found. The mean VRR was 66.8; 74.3; and 81% after 3, 6, and 12 months, respectively. Initial solidity was a factor related to the efficacy: cystic nodules had higher VRR compared to solid ones.

Conclusions

RFA is safe, effective and can be used as a routine treatment for benign thyroid nodules. More prospective multicenter studies with long-term follow-up are required to improve the safety and efficacy of RFA.

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Gharib H, Papini E, Paschke R et al (2010) American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. J Endocrinol Invest 33:1–50CrossRefGoogle Scholar
  2. 2.
    Hegedus L (2004) Clinical practice. The thyroid nodule. N Engl J Med 351:1764–1771CrossRefGoogle Scholar
  3. 3.
    Arora N, Scognamiglio T, Zhu B et al (2008) Do benign thyroid nodules have malignant potential? An evidence-based review. World J Surg 32:1237–1246.  https://doi.org/10.1007/s00268-008-9484-1 CrossRefGoogle Scholar
  4. 4.
    Miccoli P, Minuto MN, Ugolini C et al (2008) Minimally invasive video-assisted thyroidectomy for benign thyroid disease: an evidence-based review. World J Surg 32:1333–1340.  https://doi.org/10.1007/s00268-008-9479-y CrossRefGoogle Scholar
  5. 5.
    J-h Kim, Baek JH, Lim HK et al (2018) 2017 thyroid radiofrequency ablation guideline: Korean Society of thyroid radiology. Korean J Radiol 19:632–655CrossRefGoogle Scholar
  6. 6.
    Bandeira-Echtler E, Bergerhoff K, Richter B (2014) Levothyroxine or minimally invasive therapies for benign thyroid nodules. Cochrane Database Syst Rev.  https://doi.org/10.1002/14651858.CD004098.pub2 Google Scholar
  7. 7.
    Mainini AP, Monaco C, Pescatori LC et al (2017) Image-guided thermal ablation of benign thyroid nodules. J Ultrasound 20:11–22CrossRefGoogle Scholar
  8. 8.
    Lee JH, Kim YS, Lee D et al (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.  https://doi.org/10.1007/s00268-010-0565-6 CrossRefGoogle Scholar
  9. 9.
    Spiezia S, Garberoglio R, Milone F et al (2009) Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid 19:219–225CrossRefGoogle Scholar
  10. 10.
    Valcavi R, Tsamatropoulos P (2015) Health-related quality of life after percutaneous radiofrequency ablation of cold, solid, benign thyroid nodules: a 2-year follow-up study in 40 patients. Endocr Pract 21:887–896CrossRefGoogle Scholar
  11. 11.
    Che Y, Jin S, Shi C et al (2015) Treatment of benign thyroid nodules: comparison of surgery with radiofrequency ablation. AJNR Am J Neuroradiol 36:1321–1325CrossRefGoogle Scholar
  12. 12.
    Cesareo R, Naciu AM, Iozzino M et al (2018) Nodule size as predictive factor of efficacy of radiofrequency ablation in treating autonomously functioning thyroid nodules. Int J Hyperth 34:617–623CrossRefGoogle Scholar
  13. 13.
    Deandrea M, Garino F, Mormile A et al (2018) Radiofrequency ablation for benign thyroid nodules according to different US features: an Italian multicentre prospective study. Eur J Endocrinol 180(1):79–87Google Scholar
  14. 14.
    Dobnig H, Amrein K (2018) Monopolar radiofrequency ablation of thyroid nodules: a prospective Austrian single-center study. Thyroid 28:472–480CrossRefGoogle Scholar
  15. 15.
    Jung SL, Baek JH, Lee JH et al (2018) Efficacy and safety of radiofrequency ablation for benign thyroid nodules: a prospective multicenter study. Korean J Radiol 19:167–174CrossRefGoogle Scholar
  16. 16.
    Lee GM, You JY, Kim HY et al (2018) Successful radiofrequency ablation strategies for benign thyroid nodules. Endocrine 64(2):316–321CrossRefGoogle Scholar
  17. 17.
    Lim HK, Lee JH, Ha EJ et al (2013) Radiofrequency ablation of benign non-functioning thyroid nodules: 4-year follow-up results for 111 patients. Eur Radiol 23:1044–1049CrossRefGoogle Scholar
  18. 18.
    Sim JS, Baek JH, Cho W (2018) Initial ablation ratio: quantitative value predicting the therapeutic success of thyroid radiofrequency ablation. Thyroid 28:1443–1449CrossRefGoogle Scholar
  19. 19.
    Baek JH, Kim YS, Lee D et al (2010) Benign predominantly solid thyroid nodules: prospective study of efficacy of sonographically guided radiofrequency ablation versus control condition. AJR Am J Roentgenol 194:1137–1142CrossRefGoogle Scholar
  20. 20.
    Baek JH, Moon WJ, Kim YS et al (2009) Radiofrequency ablation for the treatment of autonomously functioning thyroid nodules. World J Surg 33:1971–1977CrossRefGoogle Scholar
  21. 21.
    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 18:1244–1250CrossRefGoogle Scholar
  22. 22.
    Ahmed M, Solbiati L, Brace CL et al (2014) Image-guided tumor ablation: standardization of terminology and reporting criteria—a 10-year update. Radiology 273:241–260CrossRefGoogle Scholar
  23. 23.
    Aysan E, Idiz UO, Akbulut H et al (2016) Single-session radiofrequency ablation on benign thyroid nodules: a prospective single center study: radiofrequency ablation on thyroid. Langenbecks Arch Surg 401:357–363CrossRefGoogle Scholar
  24. 24.
    Bernardi S, Stacul F, Michelli A et al (2017) 12-Month efficacy of a single radiofrequency ablation on autonomously functioning thyroid nodules. Endocrine 57:402–408CrossRefGoogle Scholar
  25. 25.
    Cervelli R, Mazzeo S, De Napoli L et al (2017) Radiofrequency ablation in the treatment of benign thyroid nodules: an efficient and safe alternative to surgery. J Vasc Interv Radiol 28:1400–1408CrossRefGoogle Scholar
  26. 26.
    Cheng Z, Che Y, Yu S et al (2017) US-guided percutaneous radiofrequency versus microwave ablation for benign thyroid nodules: a prospective multicenter study. Sci Rep 7:9554CrossRefGoogle Scholar
  27. 27.
    Hamidi O, Callstrom MR, Lee RA et al (2018) Outcomes of radiofrequency ablation therapy for large benign thyroid nodules: a mayo clinic case series. Mayo Clin Proc 93:1018–1025CrossRefGoogle Scholar
  28. 28.
    Kohlhase KD, Korkusuz Y, Groner D et al (2016) Bipolar radiofrequency ablation of benign thyroid nodules using a multiple overlapping shot technique in a 3-month follow-up. Int J Hyperth 32:511–516CrossRefGoogle Scholar
  29. 29.
    Korkusuz Y, Groner D, Raczynski N et al (2018) Thermal ablation of thyroid nodules: are radiofrequency ablation, microwave ablation and high intensity focused ultrasound equally safe and effective methods? Eur Radiol 28:929–935CrossRefGoogle Scholar
  30. 30.
    Li XL, Xu HX, Lu F et al (2016) Treatment efficacy and safety of ultrasound-guided percutaneous bipolar radiofrequency ablation for benign thyroid nodules. Br J Radiol 89:20150858CrossRefGoogle Scholar
  31. 31.
    Mauri G, Cova L, Monaco CG et al (2016) Benign thyroid nodules treatment using percutaneous laser ablation (PLA) and radiofrequency ablation (RFA). Int J Hyperth 33(3):295–299CrossRefGoogle Scholar
  32. 32.
    Oddo S, Felix E, Mussap M et al (2018) Quality of life in patients treated with percutaneous laser ablation for non-functioning benign thyroid nodules: a prospective single-center study. Korean J Radiol 19:175–184CrossRefGoogle Scholar
  33. 33.
    Pacella CM, Mauri G, Cesareo R et al (2017) A comparison of laser with radiofrequency ablation for the treatment of benign thyroid nodules: a propensity score matching analysis. Int J Hyperth 33:911–919Google Scholar
  34. 34.
    Tang X, Cui D, Chi J et al (2017) Evaluation of the safety and efficacy of radiofrequency ablation for treating benign thyroid nodules. J Cancer 8:754–760CrossRefGoogle Scholar
  35. 35.
    Yue WW, Wang SR, Lu F et al (2017) Radiofrequency ablation vs. microwave ablation for patients with benign thyroid nodules: a propensity score matching study. Endocrine 55:485–495CrossRefGoogle Scholar
  36. 36.
    Zhao CK, Xu HX, Lu F et al (2017) Factors associated with initial incomplete ablation for benign thyroid nodules after radiofrequency ablation: first results of CEUS evaluation. Clin Hemorheol Microcirc 65:393–405CrossRefGoogle Scholar
  37. 37.
    Chung SR, Suh CH, Baek JH et al (2017) Safety of radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: a systematic review and meta-analysis. Int J Hyperth 33:920–930Google Scholar
  38. 38.
    Xiaoyin T, Ping L, Dan C et al (2018) Risk assessment and hydrodissection technique for radiofrequency ablation of thyroid benign nodules. J Cancer 9:3058CrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  1. 1.Department of Medical Statistics and Informatics, Faculty of Public HealthUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
  2. 2.Thoracic and Vascular DepartmentUniversity Medical Center at Ho Chi Minh CityHo Chi Minh CityVietnam
  3. 3.Department of Medical Imaging, Faculty of MedicineUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
  4. 4.University Medical Center at Ho Chi Minh CityHo Chi Minh CityVietnam
  5. 5.Department of Cardiovascular and Thoracic Surgery, Faculty of MedicineUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam

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