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Benign Thyroid Nodule Laser Ablation

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Image-guided Laser Ablation

Abstract

Surgery is the traditional treatment for thyroid nodules that keep growing over time and are associated with local symptoms. Yet, the direct and indirect expenses due to thyroidectomy and its long-term consequences, the risk of temporary or permanent complications, and the potential adverse influence on the quality of life are important concerns. Due to these considerations, a few image-guided minimally invasive procedures have been proposed for an office-based treatment of nodules that even if benign thyroid nodules are symptomatic or cause cosmetic concern. Among these techniques, US-guided laser thermal ablation (LA) is the most thoroughly assessed and is currently an easy accessible procedure in several thyroid specialized centers in Europe and Asia.

In solid nonfunctioning thyroid nodules, a laser ablation session results in a volume shrinkage that usually ranges from 60% to 80%, followed by the improvement of pressure symptoms. LA is effective for the management of small-size hyperfunctioning nodules that are associated with incomplete suppression of the surrounding thyroid tissue. So this treatment is not followed by irradiation or loss of thyroid function and is especially appealing in young patients. On the other hand, repeated LA treatments are needed to normalize thyroid function in large-size hyperfunctioning lesions. Thus, for these nodules, LA is indicated only as a combined treatment with radioiodine in order to attain a more rapid volume decrease. Notably, these treatments do not require general anesthesia and do not result in any damage to the skin and cervical structures.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy

    Enrico Papini, Rinaldo Guglielmi & Agnese Persichetti

  2. Department of Diagnostic Imaging and Interventional Radiology, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy

    Claudio Maurizio Pacella

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  1. Enrico Papini
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  2. Rinaldo Guglielmi
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  3. Agnese Persichetti
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  4. Claudio Maurizio Pacella
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Editors and Affiliations

  1. Department of Interventional Radiology, Ospedale Regina Apostolorum, Albano Laziale, Rome, Italy

    Claudio Maurizio Pacella

  2. Department of Ultrasound, Zhejiang University, Hangzhou, China

    Tian'an Jiang

  3. Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy

    Giovanni Mauri

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Papini, E., Guglielmi, R., Persichetti, A., Pacella, C.M. (2020). Benign Thyroid Nodule Laser Ablation. In: Pacella, C., Jiang, T., Mauri, G. (eds) Image-guided Laser Ablation. Springer, Cham. https://doi.org/10.1007/978-3-030-21748-8_7

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