Abstract No. 505 Image-guided radiofrequency ablation of benign thyroid nodules: a literature review

Abstract

The purpose of the study is to evaluate the efficacy, safety and utility of radiofrequency ablation (RFA) in the treatment of benign thyroid nodules (TNs). Four health databases were screened using a search strategy including MeSH terms from 2000-2018: PUBMED, EMBASE, WEB OF SCIENCE, and COCHRANE. Reference lists were manually reviewed. Studies identified were screened in duplicate in three stages: title review, abstract review and full-text review to determine eligibility. In 28 studies including 2639 patients, the ability of RFA treatment to reduce the volume of benign TNs ranged from 49.7% after 6 months to 93.5% after 48 months. Initial nodule volume was not predictive of RFA efficacy as it did not appear to correlate with volume reduction, while lower percent of solidarity in nodules was. With regards to number of RFA treatment sessions, RFA energy delivered per nodule volume, and training of RFA operators, there were many differences in the studies with no consensus or significant superiority being demonstrated. Regrowth of incompletely treated TNs poses a disadvantage to RFA treatment, occurring in up to 5.6% of some studies. There were no reports of life-threatening events; however, minor side effects of pain and a sensation of heat as well as infrequent complications of voice change, hematoma, vomiting, and skin burns did occur. This is in contrast to surgery, the traditional treatment of RFA, which has significantly more complications. RFA is an efficacious treatment of TNs with study results showing tremendous promise. Although some of the literature suggests treating smaller and cystic TNs with short and powerful sessions of RFA for greater efficacy, the effect of these factors still remains controversial. Further studies, with longer follow-up periods, are needed to continue elucidating the efficacy, safety, and techniques of RFA as well as the characteristics of TNs which would respond best to treatment. RFA might not necessarily replace surgery as of yet, although it would be a promising candidate. Instead, it can be an effective complementary or alternative treatment in TN management.