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Analysis and prediction of regrowth in benign thyroid nodules undergoing radiofrequency ablation: a retrospective study with a 5-year follow-up

  • Ultrasound
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European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate the 5-year follow-up results of radiofrequency ablation (RFA) for benign thyroid nodules (BTNs), and construct pre- and postablation nomogram models to predict regrowth in BTNs undergoing RFA.

Methods

According to the occurrence of regrowth, BTNs were divided into two subgroups, the regrowth group and the nonregrowth group, and the variables were compared between these two subgroups. Then, univariate and multivariate Cox regression analyzes were utilized to filter the independent prognostic factors of regrowth, which then were introduced into the pre- and postablation prognostic nomograms, respectively. The discrimination powers and prediction performances of the nomograms were appraised by receiver operating characteristic (ROC) curves and calibration charts.

Results

The 5-year mean volume reduction rate was 88.80%, with a complication rate of 0.35% (7/200). Within 5 years of follow-up, the regrowth rate was 19% (38/200). Pre- and postablation prognostic nomograms were established to predict the probability of nonregrowth at 1, 3, and 5 years after RFA. The preablation nomogram included initial volume, perinodular vascularity, and high enhancement ring. The postablation nomogram incorporated total volume, perinodular vascularity, and energy applied per volume. The area under the ROC curves and concordance index values of these models were all above 0.7, indicating that the prognostic nomograms achieved satisfactory discrimination powers and prediction performances.

Conclusion

RFA for BTNs has long-term efficacy and safety under the influence of key techniques. The pre- and postablation nomograms constructed in the present study might facilitate clinical decision-making before RFA and for the follow-up management after RFA.

Key Points

• Perinodular vascularity, rather than intranodular vascularity was an independent predictor of regrowth, both before and after the RFA procedure.

• A high enhancement ring on preablation contrast-enhanced ultrasound was an independent predictor of regrowth.

• Pre- and postablation nomograms might facilitate clinical decision-making before RFA and follow-up management after RFA.

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Abbreviations

AUC:

Area under the curve

BTNs:

Benign thyroid nodules

CEUS:

Contrast-enhanced ultrasound

EAV:

Energy applied per volume

HER:

High enhancement ring

IAR:

Initial ablation rate

IPF:

Independent prognostic factor

RFA:

Radiofrequency ablation

ROC:

Receiver operating characteristic

RVR:

Residual vital ratio

US:

Ultrasound

Va:

Ablation volume

VRR:

Volume reduction rate

Vt:

Total volume

Vv:

Vital volume

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Ultrasound, Medical School of Chinese PLA, Beijing, China

    Yi Li, Wen Li, Bo Jiang & Jiahang Zhao

  2. Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Yi Li, Wen Li, Bo Jiang, Jiahang Zhao, Yan Zhang & Yukun Luo

Authors
  1. Yi Li
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  2. Wen Li
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  3. Bo Jiang
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  4. Jiahang Zhao
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  5. Yan Zhang
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  6. Yukun Luo
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Corresponding authors

Correspondence to Yan Zhang or Yukun Luo.

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Guarantor

The scientific guarantor of this publication is Yukun Luo.

Conflict of interest

The authors declare no competing interests.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

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

Ethical approval

Institutional Review Board approval was obtained by the Institutional Review Board of People’s Liberation Army General Hospital (approval number: S2019-211–01).

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• retrospective

• diagnostic or prognostic study

• performed at one institution

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Li, Y., Li, W., Jiang, B. et al. Analysis and prediction of regrowth in benign thyroid nodules undergoing radiofrequency ablation: a retrospective study with a 5-year follow-up. Eur Radiol 33, 5615–5624 (2023). https://doi.org/10.1007/s00330-023-09481-8

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  • DOI: https://doi.org/10.1007/s00330-023-09481-8

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