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Efficacy of microwave ablation in the treatment of large benign thyroid nodules: a multi-center study

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Abstract

Objective

To evaluate the efficacy, safety, and improvement of symptoms by ultrasound-guided microwave ablation (MWA) for patients with large benign thyroid nodules (BTNs).

Methods

Eighty-seven patients with 87 BTNs (≥ 4 cm) treated with MWA between April 2015 and March 2021 were enrolled in this retrospective multicenter study, with clinical and ultrasound examinations performed at the 1st, 3rd, 6th, and 12th months. A multivariable linear mixed effects model was employed to explore the alterations in volume and volume reduction ratio (VRR), as well as the potential factors associated with VRR.

Results

The mean age of the 87 patients was 45.69 ± 14.21 years (range 18–76 years), and the ratio of men to women was 1:4.8. The mean volumes were much decreased at the 12th month after ablation compared to the initial volumes (p < .001). The mean VRR was 76.09% at the 12th month. The technique efficacy (VRR > 50%) was 90.80% at the 12th month. A multivariate analysis revealed that VRR was related to the initial volume (p = .015), annular flow (p = .010), and nodule composition (p = .024). The mean symptomatic score decreased from 4.40 ± 0.28 to 0.26 ± 0.06 at the 12th month (p < .001). At the same time, the mean cosmetic score decreased from 3.22 ± 0.10 to 1.31 ± 0.08 (p < .001).

Conclusion

MWA could serve as a safe and effective therapy for large BTNs, significantly reducing the volume of BTNs and significantly improving compressive symptoms and appearance problems.

Clinical relevance statement

Microwave ablation could serve as a safe and effective therapy for large benign thyroid nodules, leading to significant volume reduction and satisfied symptom and cosmetic alleviation period.

Key Points

• This multicenter study investigated the feasibility and safety of microwave ablation for large benign thyroid nodules.

• After ablation, the nodule volume was significantly reduced, and patients’ symptoms and appearance problems were significantly improved.

• Microwave ablation is feasible for large benign thyroid nodules and has been a supplement treatment.

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Abbreviations

BTN:

Benign thyroid nodule

CEUS:

Contrast-enhanced ultrasound

CNB:

Core needle biopsy

FNA:

Fine-needle aspiration

MWA:

Microwave ablation

US:

Ultrasound

VRR:

Volume reduction ratio

References

  1. Radzina M, Cantisani V, Rauda M et al (2017) Update on the role of ultrasound guided radiofrequency ablation for thyroid nodule treatment. Int J Surg 41(Suppl 1):S82-s93

    Article  PubMed  Google Scholar 

  2. Hegedüs L (2004) Clinical practice. The thyroid nodule. N Engl J Med 351:1764–1771

    Article  PubMed  Google Scholar 

  3. Papini E, Monpeyssen H, Frasoldati A, Hegedüs L (2020) 2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules. Eur Thyroid J 9:172–185

    Article  PubMed  PubMed Central  Google Scholar 

  4. Kim JH, Baek JH, Lim HK et al (2018) 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology. Korean J Radiol 19:632–655

    Article  PubMed  PubMed Central  Google Scholar 

  5. Haugen BR, Alexander EK, Bible KC et al (2016) 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 26:1–133

    Article  PubMed  PubMed Central  Google Scholar 

  6. Agyekum EA, Fu JH, Xu FJ et al (2021) Ultrasound-guided thermal ablation of thyroid nodules: technicalities progress and clinical applications, especially in malignant thyroid nodules. Front Oncol 11:761005

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bernardi S, Stacul F, Zecchin M, Dobrinja C, Zanconati F, Fabris B (2016) Radiofrequency ablation for benign thyroid nodules. J Endocrinol Invest 39:1003–1013

    Article  CAS  PubMed  Google Scholar 

  8. Li N, Huber TC (2023) Radiofrequency ablation for benign thyroid nodules: radiology in training. Radiology 306:54–63

    Article  PubMed  Google Scholar 

  9. Na DG, Lee JH, Jung SL et al (2012) Korean Society of Thyroid Radiology (KSThR); Korean Society of Radiology. Radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: consensus statement and recommendations. Korean J Radiol 13(2):117–125. https://doi.org/10.3348/kjr.2012.13.2.117

  10. Kim JH, Baek JH, Lim HK, Na DG (2019) Summary of the 2017 thyroid radiofrequency ablation guideline and comparison with the 2012 guideline. Ultrasonography 38:125–134

    Article  PubMed  Google Scholar 

  11. Lee M, Baek JH, Suh CH et al (2021) Clinical practice guidelines for radiofrequency ablation of benign thyroid nodules: a systematic review. Ultrasonography 40:256–264

    Article  PubMed  Google Scholar 

  12. Muhammad H, Santhanam P, Russell JO (2021) Radiofrequency ablation and thyroid nodules: updated systematic review. Endocrine 72:619–632

    Article  CAS  PubMed  Google Scholar 

  13. Orloff LA, Noel JE, Stack BC Jr et al (2022) Radiofrequency ablation and related ultrasound-guided ablation technologies for treatment of benign and malignant thyroid disease: an international multidisciplinary consensus statement of the American Head and Neck Society Endocrine Surgery Section with the Asia Pacific Society of Thyroid Surgery, Associazione Medici Endocrinologi, British Association of Endocrine and Thyroid Surgeons, European Thyroid Association, Italian Society of Endocrine Surgery Units, Korean Society of Thyroid Radiology, Latin American Thyroid Society, and Thyroid Nodules Therapies Association. Head Neck 44:633–660

    Article  PubMed  Google Scholar 

  14. 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  PubMed Central  Google Scholar 

  15. Deandrea M, Garino F, Alberto M et al (2019) Radiofrequency ablation for benign thyroid nodules according to different ultrasound features: an Italian multicentre prospective study. Eur J Endocrinol 180:79–87

    Article  CAS  PubMed  Google Scholar 

  16. Sung JY, Kim YS, Choi H, Lee JH, Baek JH (2011) Optimum first-line treatment technique for benign cystic thyroid nodules: ethanol ablation or radiofrequency ablation? AJR Am J Roentgenol 196:W210-214

    Article  PubMed  Google Scholar 

  17. Park HS, Baek JH, Park AW, Chung SR, Choi YJ, Lee JH (2017) Thyroid radiofrequency ablation: updates on innovative devices and techniques. Korean J Radiol 18:615–623

    Article  PubMed  PubMed Central  Google Scholar 

  18. 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 

  19. Ahmed M, Solbiati L, Brace CL et al (2014) Image-guided tumor ablation: standardization of terminology and reporting criteria–a 10-year update. Radiology 273:241–260

    Article  PubMed  Google Scholar 

  20. Mauri G, Pacella CM, Papini E et al (2019) Image-guided thyroid ablation: proposal for standardization of terminology and reporting criteria. Thyroid 29:611–618

    Article  PubMed  Google Scholar 

  21. Xia B, Yu B, Wang X et al (2021) Conspicuousness and recurrence related factors of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules. BMC Surg 21:317

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Lin WC, Kan NN, Chen HL et al (2020) Efficacy and safety of single-session radiofrequency ablation for benign thyroid nodules of different sizes: a retrospective study. Int J Hyperthermia 37:1082–1089

    Article  PubMed  Google Scholar 

  23. Jin H, Fan J, Liao K, He Z, Li W, Cui M (2018) A propensity score matching study between ultrasound-guided percutaneous microwave ablation and conventional thyroidectomy for benign thyroid nodules treatment. Int J Hyperthermia 35:232–238

    Article  PubMed  Google Scholar 

  24. Spiezia S, Garberoglio R, Milone F et al (2009) Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid 19:219–225

    Article  PubMed  Google Scholar 

  25. Wang B, Han ZY, Yu J et al (2017) Factors related to recurrence of the benign non-functioning thyroid nodules after percutaneous microwave ablation. Int J Hyperthermia 33:459–464

    Article  PubMed  Google Scholar 

  26. 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 19:167–174

    Article  PubMed  PubMed Central  Google Scholar 

  27. Dong P, Wu XL, Sui GQ et al (2021) The efficacy and safety of microwave ablation versus lobectomy for the treatment of benign thyroid nodules greater than 4 cm. Endocrine 71:113–121

    Article  CAS  PubMed  Google Scholar 

  28. 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 55:485–495

    Article  CAS  PubMed  Google Scholar 

  29. Dobnig H, Amrein K (2018) Monopolar radiofrequency ablation of thyroid nodules: a prospective Austrian single-center study. Thyroid 28:472–480

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Cai W, Liu S, Yu X et al (2021) Is partial ablation appropriate for benign thyroid nodules? A retrospective study with long-term follow-up after microwave ablation. Int J Hyperthermia 38:923–930

    Article  CAS  PubMed  Google Scholar 

  31. 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 

  32. 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 

  33. Sung JY, Baek JH, Kim KS et al (2013) Single-session treatment of benign cystic thyroid nodules with ethanol versus radiofrequency ablation: a prospective randomized study. Radiology 269:293–300

    Article  PubMed  Google Scholar 

  34. Offi C, Garberoglio S, Antonelli G et al (2020) The ablation of thyroid nodule’s afferent arteries before radiofrequency ablation: preliminary data. Front Endocrinol (Lausanne) 11:565000

    Article  PubMed  Google Scholar 

  35. 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 

  36. Lim HK, Lee JH, Ha EJ, Sung JY, Kim JK, Baek JH (2013) Radiofrequency ablation of benign non-functioning thyroid nodules: 4-year follow-up results for 111 patients. Eur Radiol 23:1044–1049

    Article  PubMed  Google Scholar 

  37. Hu K, Wu J, Dong Y, Yan Z, Lu Z, Liu L (2019) Comparison between ultrasound-guided percutaneous radiofrequency and microwave ablation in benign thyroid nodules. J Cancer Res Ther 15:1535–1540

    Article  CAS  PubMed  Google Scholar 

  38. Dou JP, Yu J, Cheng ZG et al (2021) Symptomatic aseptic necrosis of benign thyroid lesions after microwave ablation: risk factors and clinical significance. Int J Hyperthermia 38:815–822

    Article  CAS  PubMed  Google Scholar 

  39. Zhi X, Zhao N, Liu Y, Liu JB, Teng C, Qian L (2018) Microwave ablation compared to thyroidectomy to treat benign thyroid nodules. Int J Hyperthermia 34:644–652

    Article  PubMed  Google Scholar 

  40. Lang BHH, Wong CKH, Ma EPM, Woo YC, Chiu KW (2019) A propensity-matched analysis of clinical outcomes between open thyroid lobectomy and high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules. Surgery 165:85–91

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by grant 82102044 from the National Scientific Foundation Committee of China (NSFC).

Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head & Neck Surgery, The Sixth Medical Center of PLA General Hospital & PLA Medical College, 28 Fuxing Road, Beijing, 100853, China

    Yuan-Cheng Cang & Lei Chen

  2. Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & PLA Medical College, 28 Fuxing Road, Beijing, 100853, China

    Fang-Ying Fan, Yang Liu, Jian-ming Li, Chuan Pang, Ping Liang & Jie Yu

  3. Department of Ultrasound, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, China

    Dong Xu

  4. Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, 193 Lianhe Road, Dalian, Liaoning, 116011, China

    Ying Che

  5. Department of Ultrasound, Lishui People’s Hospital, 15 Dazhong Street, Lishui, 323000, China

    Chun-Lai Zhang

  6. Department of Ultrasound Intervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China

    Gang Dong

Authors
  1. Yuan-Cheng Cang
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  11. Jie Yu
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  12. Lei Chen
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Contributions

Dr. Jie Yu had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

• Study concept and design: Yuan-Cheng Cang, Jie Yu, and Lei Chen

• Acquisition of data: Yuan-Cheng Cang, Dong Xu, Ying Che, Chun-Lai Zhang, Gang Dong, Yang Liu, Fang-Ying Fan

• Analysis and interpretation of data: Yuan-Cheng Cang, Jie Yu

• Drafting of the manuscript: Yuan-Cheng Cang and Jie Yu

• Critical revision of the manuscript for important intellectual content: Yuan-Cheng Cang, Jie Yu, Zhi-Gang Cheng, Fang-Yi Liu, Xiao-Ling Yu, Zhi-Yu Han, and Ping Liang

The data involved in this article was not shared. Data generated or analyzed during the study are available from the corresponding author by request.

Corresponding authors

Correspondence to Jie Yu or Lei Chen.

Ethics declarations

Guarantor

Dr. Jie Yu had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Conflict of interest

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.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all patients in this study.

Ethical approval

The study was approved by five hospitals’ ethics committees, including Chinese PLA General Hospital, Cancer Hospital of the University of Chinese Academy of Sciences, the First Affiliated Hospital of Dalian Medical University; Lishui people’s Hospital, and the First Affiliated Hospital of Zhengzhou University, and written informed consent was obtained from each patient before treatment.

Study subjects or cohorts overlap

No study subjects or cohorts have been previously reported.

Methodology

• retrospective

• diagnostic or prognostic study

• multicenter study

Additional information

Publisher's Note

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Jie Yu and Lei Chen are co-corresponding authors of the article.

Supplementary Information

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Supplementary file1 (PDF 211 KB)

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Cang, YC., Fan, FY., Liu, Y. et al. Efficacy of microwave ablation in the treatment of large benign thyroid nodules: a multi-center study. Eur Radiol (2024). https://doi.org/10.1007/s00330-024-10614-w

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