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Successful radiofrequency ablation strategies for benign thyroid nodules

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Abstract

Purpose

This study aimed to evaluate the effectiveness of ultrasound (US)-guided radiofrequency ablation (RFA) treatment of benign thyroid nodules in consecutive large number series. To find out whether there is any difference according to the nature of the nodules, nodules were subdivided into two groups of predominantly solid vs. predominantly cystic lesions.

Methods

We retrospectively analyzed clinical data of thyroid nodules receiving percutaneous RFA treatment in our institution. We subdivided data into two groups according to the nodule’s sonographic characteristics. We defined therapeutic success as a volume reduction rate >50% at 6 months post-RFA. The second ablation was performed in case where <50% VRR was achieved at 6 months. The primary endpoint was to identify factors prognosticating response to RFA treatment.

Results

A total of 1000 patients with 1619 thyroid nodules received US-guided RFA treatment. A volume reduction of >50% (therapeutic success) after the first ablation was 78.9% vs. 78.2% (p = 0.439) and 91.4% vs. 93.4% (p = 0.148) after the final ablation for predominantly cystic vs. predominantly solid lesions, respectively, with comparable post-interventional morbidity. RFA sessions were more frequent in the solid group than in the cystic group. Small volume of thyroid nodule (<4 mL) was the only factor significantly associated with therapeutic success in the multivariate analysis (OR 1.848; 95% CI 1.537–2.789, p = 0.030).

Conclusion

RFA was effective in reducing the volume of benign thyroid nodules volume with non-inferior result in PS group comparing to PC group and can be considered a principal treatment method for treating benign thyroid nodules, including cystic nodules.

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References

  1. H. Gharib, E. Papini, R. Paschke, D.S. Duick, R. Valcavi, L. Hegedus, P. Vitti, A.A.E.T.Fo.T. Nodules, 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, 1–50 (2010). 5 Suppl

    Article  CAS  PubMed  Google Scholar 

  2. S. Guth, U. Theune, J. Aberle, A. Galach, C.M. Bamberger, Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur. J. Clin. Invest. 39, 699–706 (2009)

    Article  CAS  PubMed  Google Scholar 

  3. R. Smith-Bindman, D.L. Miglioretti, E. Johnson, C. Lee, H.S. Feigelson, M. Flynn, R.T. Greenlee, R.L. Kruger, M.C. Hornbrook, D. Roblin, L.I. Solberg, N. Vanneman, S. Weinmann, A.E. Williams, Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996-2010. JAMA 307, 2400–2409 (2012)

    Article  CAS  Google Scholar 

  4. American Thyroid Association Guidelines Taskforce on Thyroid, Nodules and Differentiated Thyroid Cancer, D.S. Cooper, G.M. Doherty, B.R. Haugen, R.T. Kloos, S.L. Lee, S.J. Mandel, E.L. Mazzaferri, B. McIver, F. Pacini, M. Schlumberger, S.I. Sherman, D.L. Steward, R.M: Tuttle, Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19, 1167–1214 (2009)

    Article  Google Scholar 

  5. C.C. Tsai, D. Pei, Y.J. Hung, T.F. Wang, W.C. Tsai, C.Y. Yao, M.C. Hsieh, S.W. Kuo, The effect of thyroxine-suppressive therapy in patients with solitary non-toxic thyroid nodules -- a randomised, double-blind, placebo-controlled study. Int. J. Clin. Pract. 60, 23–26 (2006)

    Article  CAS  PubMed  Google Scholar 

  6. N. Lima, M. Knobel, H. Cavaliere, C. Sztejnsznajd, E. Tomimori, G. Medeiros-Neto, Levothyroxine suppressive therapy is partially effective in treating patients with benign, solid thyroid nodules and multinodular goiters. Thyroid 7, 691–697 (1997)

    Article  CAS  PubMed  Google Scholar 

  7. H. Gharib, L. Hegedus, C.M. Pacella, J.H. Baek, E. Papini, Clinical review: Nonsurgical, image-guided, minimally invasive therapy for thyroid nodules. J. Clin. Endocrinol. Metab. 98, 3949–3957 (2013)

    Article  CAS  PubMed  Google Scholar 

  8. A. Bergenfelz, S. Jansson, A. Kristoffersson, H. Martensson, E. Reihner, G. Wallin, I. Lausen, Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients. Lange. Arch. Surg. 393, 667–673 (2008)

    Article  CAS  Google Scholar 

  9. L. Hegedus, Therapy: a new nonsurgical therapy option for benign thyroid nodules? Nat. Rev. Endocrinol. 5, 476–478 (2009)

    Article  PubMed  Google Scholar 

  10. E. Papini, R. Guglielmi, G. Bizzarri, F. Graziano, A. Bianchini, C. Brufani, S. Pacella, D. Valle, C.M. Pacella, Treatment of benign cold thyroid nodules: a randomized clinical trial of percutaneous laser ablation versus levothyroxine therapy or follow-up. Thyroid 17, 229–235 (2007)

    Article  CAS  PubMed  Google Scholar 

  11. M. Deandrea, P. Limone, E. Basso, A. Mormile, F. Ragazzoni, E. Gamarra, S. Spiezia, A. Faggiano, A. Colao, F. Molinari, R. Garberoglio, US-guided percutaneous radiofrequency thermal ablation for the treatment of solid benign hyperfunctioning or compressive thyroid nodules. Ultrasound Med. Biol. 34, 784–791 (2008)

    Article  PubMed  Google Scholar 

  12. S.M. Kim, J.H. Baek, Y.S. Kim, J.Y. Sung, H.K. Lim, H. Choi, J.H. Lee, Efficacy and safety of ethanol ablation for thyroglossal duct cysts. AJNR Am. J. Neuroradiol. 32, 306–309 (2011)

    Article  CAS  PubMed  Google Scholar 

  13. E.J. Ha, J.H. Baek, K.W. Kim, J. Pyo, J.H. Lee, S.H. Baek, H. Dossing, L. Hegedus, Comparative efficacy of radiofrequency and laser ablation for the treatment of benign thyroid nodules: systematic review including traditional pooling and Bayesian network meta-analysis. J. Clin. Endocrinol. Metab. 100, 1903–1911 (2015)

    Article  CAS  PubMed  Google Scholar 

  14. D.E. Dupuy, S.N. Goldberg, Image-guided radiofrequency tumor ablation: challenges and opportunities--part II. J. Vasc. Interv. Radiol. 12, 1135–1148 (2001)

    Article  CAS  PubMed  Google Scholar 

  15. J.H. Baek, H.J. Jeong, Y.S. Kim, M.S. Kwak, D. Lee, Radiofrequency ablation for an autonomously functioning thyroid nodule. Thyroid 18, 675–676 (2008)

    Article  PubMed  Google Scholar 

  16. W.K. Jeong, J.H. Baek, H. Rhim, Y.S. Kim, M.S. Kwak, H.J. Jeong, D. Lee, Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur. Radiol. 18, 1244–1250 (2008)

    Article  PubMed  Google Scholar 

  17. C.W. Fuller, S.A. Nguyen, S. Lohia, M.B. Gillespie, Radiofrequency ablation for treatment of benign thyroid nodules: systematic review. Laryngoscope 124, 346–353 (2014)

    Article  PubMed  Google Scholar 

  18. W.J. Moon, J.H. Baek, S.L. Jung, D.W. Kim, E.K. Kim, J.Y. Kim, J.Y. Kwak, J.H. Lee, J.H. Lee, Y.H. Lee, D.G. Na, J.S. Park, S.W. Park, Korean Society of Thyroid Radiology, Korean Society of Radiology, Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations. Korean J. Radiol. 12, 1–14 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  19. J.Y. Sung, Y.S. Kim, H. Choi, J.H. Lee, J.H. Baek, Optimum first-line treatment technique for benign cystic thyroid nodules: ethanol ablation or radiofrequency ablation? AJR Am. J. Roentgenol. 196, W210–W214 (2011)

    Article  PubMed  Google Scholar 

  20. E.J. Ha, J.H. Baek, J.H. Lee, Moving-shot versus fixed electrode techniques for radiofrequency ablation: comparison in an ex-vivo bovine liver tissue model. Korean J. Radiol. 15, 836–843 (2014)

    Article  PubMed  PubMed Central  Google Scholar 

  21. R. Cesareo, V. Pasqualini, C. Simeoni, M. Sacchi, E. Saralli, G. Campagna, R. Cianni, Prospective study of effectiveness of ultrasound-guided radiofrequency ablation versus control group in patients affected by benign thyroid nodules. J. Clin. Endocrinol. Metab. 100, 460–466 (2015)

    Article  CAS  PubMed  Google Scholar 

  22. G. Mauri, L. Cova, C.G. Monaco, L.M. Sconfienza, S. Corbetta, S. Benedini, F. Ambrogi, V. Milani, A. Baroli, T. Ierace, L. Solbiati, Benign thyroid nodules treatment using percutaneous laser ablation (PLA) and radiofrequency ablation (RFA). Int. J. Hyperthermia (2016). https://doi.org/10.1080/02656736.2016.1244707

  23. M. Radzina, V. Cantisani, M. Rauda, M.B. Nielsen, C. Ewertsen, F. D’Ambrosio, P. Prieditis, S. Sorrenti, Update on the role of ultrasound guided radiofrequency ablation for thyroid nodule treatment. Int. J. Surg. 41(Suppl 1), S82–S93 (2017).

    Article  Google Scholar 

  24. J.H. Shin, J.H. Baek, J. Chung, E.J. Ha, J.H. Kim, Y.H. Lee, H.K. Lim, W.J. Moon, D.G. Na, J.S. Park, Y.J. Choi, S.Y. Hahn, S.J. Jeon, S.L. Jung, D.W. Kim, E.K. Kim, J.Y. Kwak, C.Y. Lee, H.J. Lee, J.H. Lee, J.H. Lee, K.H. Lee, S.W. Park, J.Y. Sung, Korean Society of Thyroid Radiology, Korean Society of Radiology, Ultrasonography diagnosis and imaging-based management of thyroid nodules: Revised Korean Society of Thyroid Radiology Consensus Statement and Recommendations. Korean J. Radiol. 17, 370–395 (2016)

    Article  PubMed  PubMed Central  Google Scholar 

  25. J.H. Lee, Y.S. Kim, D. Lee, H. Choi, H. Yoo, J.H. Baek, Radiofrequency ablation (RFA) of benign thyroid nodules in patients with incompletely resolved clinical problems after ethanol ablation (EA). World J. Surg. 34, 1488–1493 (2010)

    Article  PubMed  Google Scholar 

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Acknowledgements

This work was supported by a Korea University grant (K1710691).

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Author notes

  1. These authors contributed equally: Gee Mun Lee, Ji Young You.

Authors and Affiliations

  1. Kangbuk Seoul Surgery, Seoul, Korea

    Gee Mun Lee

  2. Department of Surgery, KUMC Thyroid Center, Korea University Hospital, Korea University College of Medicine, Seoul, Korea

    Ji Young You, Hoon Yub Kim & Hong Kyu Kim

  3. Department of Surgery, Seoul Metropolitan Government – Seoul National University Boramae Medical Center, Seoul, Korea

    Young Jun Chai

  4. Division for Endocrine and Minimal Invasive Surgery, Department of Human Pathology in Adulthood and Childhood “G. Barresi’, University Hospital “G. Martino”, University of Messina, Messina, Italy

    Gianlorenzo Dionigi

  5. Department of Otolaryngology – Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Ralph P. Tufano

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  1. Gee Mun Lee
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Correspondence to Hoon Yub Kim.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this retrospective study, formal consent is not required.

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Lee, G.M., You, J.Y., Kim, H.Y. et al. Successful radiofrequency ablation strategies for benign thyroid nodules. Endocrine 64, 316–321 (2019). https://doi.org/10.1007/s12020-018-1829-4

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