Safety Of Ultrasound-guided Radiofrequency Ablation Research Articles

Retrospective Analysis of the Efficacy and Safety of Ultrasound-Guided Radiofrequency Ablation in the Treatment of Papillary Thyroid Microcarcinoma: A Follow-Up Study of Continuous Postoperative Surveillance and Large-Sample Data.

To retrospectively evaluate the efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) in the treatment of papillary thyroid microcarcinoma (PTMC) through a follow-up study of continuous postoperative surveillance and large-sample data. The efficacy of ultrasound-guided RFA was evaluated by measuring the tumor volume reduction rate (VRR), tumor disappearance rate, and disease progression in 358 patients with low-risk unifocal PTMC who underwent ultrasound-guided RFA at Hangzhou Weja Hospital, while the safety was evaluated by measuring their complications. The VRR was -745.69 ± 1012.69 (%), -150.35 ± 395.5 (%), 46.47 ± 138.74 (%), 92.95 ± 27.88 (%), 97.78 ± 10.99 (%), and 99.27 ± 3.82 (%), respectively, at 1, 3, 6, 12, 18, and 24 months after RFA. The corresponding tumor disappearance rate was 1.68%, 9.78%, 43.85%, 82.68%, 92.59%, and 95.63%, respectively. No local recurrence, new tumors, lymph node metastasis, distant metastasis, and deaths caused by recurrent/metastatic PTMC were found at the last follow-up. Except for 3 cases (0.84%) with thickening or hoarseness of voice and 3 cases (0.84%) with coughing during drinking water, no other complications were found. Ultrasound-guided RFA has good efficacy and safety for the treatment of low-risk unifocal PTMC and can be promoted for use in patients who meet the required indications.

Comparison of the efficacy and safety of ultrasound-guided radiofrequency ablation and microwave ablation for the treatment of unifocal papillary thyroid microcarcinoma: a retrospective study

Purpose This study aimed to compare the efficacy and safety of ultrasound-guided RFA and MWA in the treatment of unifocal PTMC. Methods This retrospective study included 512 patients with 512 unifocal papillary thyroid microcarcinomas (PTMCs) who underwent RFA (n = 346) and MWA (n = 166) between January 2021 and December 2021. The volumes of the ablation areas were measured during follow-up, and the volume reduction rates were evaluated. The ablation duration, volume of hydrodissection, and ablation-related complications were also compared between the groups. Results All lesions received complete ablation and no local or distant recurrences were observed in the two groups. A larger volume of isolation liquid was used for RFA than for MWA (p = 0.000). Hoarseness occurred in seven patients who underwent RFA (p = 0.102). At the 1-week follow-up, the mean volume of the areas ablated by RFA was smaller than that of the areas ablated by MWA (p = 0.049). During follow-ups at months 3, 9, 12, 15, and 18, the mean volumes of the ablated areas were larger in the RFA group than in the MWA group (all, p < 0.05). The mean volume of the ablated lesions increased slightly at the 1-week follow-up and then decreased at 1 month after ablation in both groups. The absorption curve of the ablated lesions in the RFA group was similar to that in the MWA group. Conclusions RFA and MWA are both efficient and safe methods for treating unifocal PTMC. They may be alternative techniques for patients who are not eligible or are unwilling to undergo surgery.

Long-term results of radiofrequency ablation for locally recurrent papillary thyroid carcinoma

Objective To evaluate the long-term efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) for treating locally recurrent papillary thyroid cancer (PTC). Methods This retrospective study involved 32 patients with pathologically confirmed locally recurrent PTC. The ablation zone was assessed by contrast-enhanced ultrasound (CEUS) after RFA. At baseline, 6 and 12 months and every 6 months or 12 months thereafter, the following results were recorded: recurrence rate, largest diameter, volume, volume reduction rate (VRR) of recurrent lesions, serum thyroglobulin (Tg) level and complications. Results 58 recurrent lesions in 32 patients were successfully ablated with RFA. The mean follow-up time was 73.19 ± 12.68 months (range, 60 to 98 months). At the last follow-up, almost all ablated lesions disappeared completely, and only one lesion showed scar-like changes. Nine (28.13%) patients developed new locally recurrent tumors; they were successfully treated with repeat RFA sessions. No new recurrent lesions were found during the follow-up. The largest diameter and volume of recurrent lesions decreased from 13.71 ± 6.48 mm and 520.43 ± 627.85 mm3 to 0 each at the end of observation period (p < .001). The average VRRs at 6, 12, 24, 36, 48, 60 months and last follow-up after RFA were 54.17%, 72.90%, 82.28%, 89.30%, 92.57%, 96.60%, 96.88%, 98.14% and 100% respectively. The median of serum Tg level was decreased from 1.48 ng/mL to 0.00 ng/mL (p < .05). No complications were reported during the follow-up. Conclusions US-guided RFA is an effective and safe option for treating locally recurrent PTC in selected patients, with favorable long-term outcomes.

Comparison of ultrasound-guided radiofrequency ablation and hepatectomy for colorectal liver metastasis: A protocol for systematic review and meta-analysis.

Colorectal cancer (CRC) is one of the most frequently occurring malignancy tumors. Surgical treatment has made great progress in CRC liver metastasis (CRLM), including radiofrequency ablation (RFA), and hepatectomy. We perform a protocol for systematic review and meta-analysis to compare the efficacy and safety of ultrasound-guided RFA and hepatectomy in treating CRLM. This systematic review protocol will be reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P) 2015 Statement. The protocol has been registered in PROSPERO (CRD42022371561). PubMed, EMBASE, MEDLINE, the Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang Database, ClinicalTrials.gov trials registry, and Chinese Clinical Trial Registry will be searched from January 1980 to December 2022. Only randomized controlled trials will be included. Cochrane systematic evaluation tool is used to assess the risk of bias. The RevMan 5.3 software (Cochrane Collaboration, Oxford, UK) will be applied to conduct the meta-analyses. The results of this systematic review and meta-analysis will be publicly available and published in a peer-reviewed journal. This study may provide more convincing evidence to help surgeons make decisions when dealing with CRLM.

Efficacy and safety of radiofrequency ablation for primary and secondary hyperparathyroidism with or without previous parathyroidectomy: a retrospective study

Introduction This study aimed to investigate and compare the therapeutic efficacy and safety of ultrasound-guided radiofrequency ablation (RFA), between primary hyperparathyroidism (PHPT) and secondary hyperparathyroidism (SHPT) patients, with or without previous parathyroidectomy (PTX). Subjects and Methods A total of 21 patients (7 PHPT, 14 SHPT) underwent RFA for hyperparathyroidism (HPT) at Kaohsiung Chang Gung Memorial Hospital, Taiwan. Five of the 14 SHPT patients had previously received PTX. The laboratory data, volume change of each parathyroid nodule, symptomatic scores, and complications were analyzed and compared between all groups at 1 and 7 days, and at 1, 3, 6, and 12 months after RFA. Results After RFA, the volume reduction ratio (VRR) for all patients at the last follow-up was 93.76%, and clinical symptoms significantly improved. At 12 months, all PHPT patients achieved successful treatment of intact PTH (iPTH). In SHPT patients, the mean iPTH value significantly decreased 1-day post-RFA, subsequently exhibiting a transient rebound which proceeded to decrease, with 57.1% reaching successful treatment standards. SHPT patients with PTX showed a lower complication score, shorter ablation time, higher iPTH baseline and outcomes, and lower VRR, compared to patients without PTX. The serum calcium level significantly decreased to normal range in 85.7% of all patients at 12 months. Severe hypocalcemia occurred in 23.8% at 1 week, and all were corrected with calcium supplements. Conclusions RFA demonstrates a therapeutic efficacy similar to PTX. It can thus be considered an effective alternative treatment for PHPT, SHPT, or post-PTX patients who are unsuitable for another PTX.

Efficacy and Safety of Ultrasound-Guided Radiofrequency Ablation for Primary Hyperparathyroidism: A Prospective Study.

ObjectiveTo assess the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) in patients with primary hyperparathyroidism (PHPT).Materials and MethodsThis prospective study enrolled 39 participants (14 male, 25 female; mean age, 59.5 ± 15.3 [range, 18–87] years) between September 1, 2018, and January 31, 2021. All participants had parathyroid lesions causing PHPT, proven biochemically and through imaging. The imaging features of the PHPT nodules, including the shape, margin, size, composition, and location, were evaluated before treatment. Serum intact parathyroid hormone, calcium, and phosphorus levels; parathyroid nodule volume; and PHPT-related symptoms were recorded before and after treatment. We calculated the technical success, biochemical cure, and clinical cure rates for these patients. Complications were evaluated during and after the ablation.ResultsComplete ablation was achieved in 38 of the 39 nodules in the 39 enrolled participants. All the patients were treated in one session. The technical success rate was 97.4% (38/39). The mean follow-up duration was 13.2 ± 4.6 (range, 6.0–24.9) months. At 6 and 12 months post-RFA, the biochemical cure rates were 82.1% (32/39) and 84.4% (27/32), respectively, and the clinical cure rates were 100% (39/39) and 96.9% (31/32), respectively. Only 2.6% (1/39) of the patients had recurrent PHPT. At 1, 3, 6, and 12 months after technically successful RFA, 44.7% (17/38), 34.3% (12/35), 15.8% (6/38), and 12.5% (4/32) of participants, respectively, had elevated eucalcemic parathyroid hormone levels. Recurrent laryngeal nerve paralysis occurred in 5.1% (2/39) of the patients, who recovered spontaneously within 1–3 months.ConclusionUS-guided RFA was effective and safe for PHPT patients. RFA may be an alternative treatment tool for patients who cannot tolerate or refuse to undergo surgery.

Efficacy and safety of ultrasound-guided radiofrequency ablation for low-risk papillary thyroid microcarcinoma in patients aged 55 years or older: a retrospective study

Purpose To evaluate the efficacy and safety of radiofrequency ablation for low-risk papillary thyroid microcarcinoma (PTMC) in patients aged 55 years or older. Methods This retrospective study included 95 patients aged 55 years or older who underwent radiofrequency ablation (RFA) for PTMCs between June 2014 and January 2019. Incidence and duration of postoperative complications were recorded and evaluated. Tumor volume and volume reduction rate (VRR) changes were calculated. Patients were also closely monitored for tumor recurrence, regrowth, and lymph node metastasis. Results All nodules were completely ablated. The mean initial volume of the ablated thyroid nodules was 107.27 ± 99.10 mm3, and the volume decreased significantly during the follow-up time. The VRR in 1st, 3rd, 6th, 12th, 18th, 24th and 36th month were −591.64 ± 623.65%, −170.89 ± 319.51%, 9.74 ± 128.43%, 77.99 ± 45.26%, 99.35 ± 3.61%, 99.45 ± 3.05% and 99.78 ± 1.54%, respectively. No patient had any life-threatening complications. One patient had lymph node metastasis and one had a recurrence; both underwent a second radiofrequency ablation treatment and achieved satisfactory treatment results. Conclusions Our study suggests that radiofrequency ablation is a safe and effective option for low-risk PTMC in patients aged 55 years or older who are at a high risk of general anesthesia and postoperative complications or those who refuse surgery.

Treatment efficiency of thyroid benign nodules by ultrasound-guided radiofrequency ablation

Objective To explore the effectiveness and safety of ultrasound-guided radiofrequency ablation (RFA) in treatment of thyroid benign nodules. Methods We analyze 573 patients with thyroid benign nodules from June 2014 to September 2017 treated by RFA at Department Ⅱof Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University. Among these patients, there were 75 males and 498 females, with a median age of 45 years old. All patients were diagnosed as thyroid benign nodules by ultrasound-guided fine needle aspiration biopsy before RFA. A total of 750 benign tumors were treated. To evaluate the thyroid function of the patients before RFA and 3 months after it, and to observe the changes of thyroid benign nodules by ultrasound at 3, 6, 12 months after RFA. The paired t-test was used to compare the measurement data with normal distribution, and Wilcoxon's signed rank test was used to compare the measurement data with non-normal distribution. To calculate the volume change and reduction rate of thyroid benign nodules. Results RFA was successfully completed in all patients, the volume reduction rate was 67%(48%, 83%) in the 3rd month after RFA, in the 6th month was 81%(67%, 91%), in the 12th month was 89%(80%, 95%). Eighteen patients felt pain during RFA, but the pain was alleviated after stopping ablation. Three patients′ tone decreased, but recovered in a week. Hoarseness occurred in 6 patients and recovered in 3 months. Three patients had neck hemorrhage, which was managed with simple compression of the neck. Conclusions RFA is an effective and safe treatment for thyroid benign nodules and has obvious advantages such as less invasiveness, having no influence in thyroid functions. It is clinically prospective for application. Key words: Retrospective studies; Thyroid neoplasms; Biopsy, needle; Radiofrequency ablation; Ultrasound guided

Impact of Radiofrequency Ablation in the management of symptomatic uterine myoma

OBJECTIVES:To evaluate the feasibility and safety of Ultrasound-guided radiofrequency ablation in the treatment of women with symptomatic uterine fibroids.DESIGN: Prospective interventional clinical trial study. METHODS:Forty women with symptomatic uterine fibroids underwent Ultrasound-guided radiofrequency ablation. Primary Outcome measures are changes in fibroid-related symptoms and tumor size after the procedure measured at baseline, 3 and 6 months after the intervention. Secondary Outcome measures are recurrence of fibroid symptoms following the procedure ( Time Frame: Baseline to 6 months ) and operative complications ( Time Frame: Baseline to 6 weeks ).RESULTS:The 40 patients, fulfilled the follow-up evaluations post-ablation. The mean uterine fibroid volume reduction rate was 40% at 3 months and 60% at 6 months post-ablation. symptoms, especially bleeding were statistically significantly declined. No severe complications such as penetration or burn injuries of the nearby organs were detected.CONCLUSION:Ultrasound-guided radiofrequency ablation is effective in reducing fibroid symptoms and size. Ultrasound-guided radiofrequency ablation ablation is a promising new treatment option for Leiomyomas and should be further evaluated.

Ultrasound-guided radiofrequency ablation for treatment of Morton's neuroma: initial experience

To assess the efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) for treatment of symptomatic Morton's neuroma. Patients with symptomatic Morton's neuroma of the foot were referred for treatment with RFA, prior to consideration for surgery. All neuromas were proven by ultrasound imaging and had a trial of conservative management including orthotic support and/or steroid injections. Ultrasound-guided RFA was performed as an outpatient procedure under local anaesthetic. Patients were followed up at 8 weeks and 8 months. Outcomes were assessed with a visual analogue scale (VAS) score, Manchester-Oxford Foot and Ankle Questionnaire, overall patient satisfaction, and complications. Twenty-two neuromas were treated with RFA under ultrasound guidance. The VAS score at 8 weeks was significantly lower than the VAS score pre-procedure (p<0.001, Wilcoxon signed ranks test) and the VAS score at 8 months was significantly lower than the VAS score at 8 weeks (p=0.008, Wilcoxon signed ranks test). At 8 months, 89% of treated patients were satisfied with the procedure outcome. No significant adverse effects were recorded. Ultrasound-guided RFA is safe, with excellent initial results in treatment of symptomatic Morton's neuroma. Further studies on long-term outcomes and comparison to other management options will be required to establish its role in management of symptomatic Morton's neuroma.

Effect of chronic lymphocytic thyroiditis on the efficacy and safety of ultrasound-guided radiofrequency ablation for papillary thyroid microcarcinoma.

BackgroundChronic lymphocytic thyroiditis (CLT) is an autoimmune disease commonly associated with papillary thyroid carcinoma characterized by a smaller primary tumor size at presentation. The efficacy and safety of ultrasound‐guided radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) coexisting with CLT is still unknown.MethodsSixty patients with unifocal PTMC were enrolled and classified into PTMC and PTMC+CLT groups (n = 30/group). CLT was diagnosed histopathologically. The ablation area exceeded the tumor margins, and was evaluated by US and contrast‐enhanced US (CEUS) for residual tumor to prevent recurrence. Three months after ablation, US‐guided core‐needle biopsy was performed to assess the presence of residual and recurrent cancer. Preoperative and postoperative data on patients and tumors were recorded and analyzed.ResultsThere were no differences between groups in age, sex, preoperative tumor volume, ablation time, or ablation power (P > 0.05). There was also no significant difference in postoperative ablation zone volume between the groups at the 1‐, 3‐, 6‐, 12‐, and 18‐month follow‐ups (P > 0.05). The volume reduction rate significantly differed between the two groups at month 3 (P = 0.03). The ablation area could not be identified on US and CEUS at 9.8 ± 5.0 and 10.0 ± 4.8 months in the PTMC and PTMC + CLT groups, respectively (P = 0.197). No serious complications occurred during and after ablation. No residual cancer cells were found on biopsy after ablation.ConclusionsRFA was effective in patients with PTMC+CLT, and its therapeutic efficacy and safety were similar to those in patients with PTMC without CLT.

Efficacy and Safety of Ultrasound-Guided Radiofrequency Ablation for Treating Low-Risk Papillary Thyroid Microcarcinoma: A Prospective Study.

Papillary thyroid microcarcinoma (PTMC) has a high incidence and a good prognosis. Surgical operation for all PTMC might be an overtreatment. The objective of this study was to evaluate the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) for treating low-risk PTMC. Ninety-eight PTMC in 92 patients were included in this study. US and contrast-enhanced ultrasound (CEUS) examinations were performed before ablation. RFA was performed using the moving-shot technique. The ablation area exceeded the tumor edge to prevent marginal residue and recurrence. Patients were followed at 1, 3, 6, and 12 months and every six months thereafter. US and CEUS examinations were used to evaluate the ablation area. At three months after ablation, US-guided core-needle biopsy (CNB) was performed in the center, at the edge of the ablation area, and in the surrounding thyroid parenchyma to exclude recurrence. The mean tumor volume was 118.8 ± 106.9 mm3. The mean volume reduction ratio (VRR) was 0.47 ± 0.27, 0.19 ± 0.16, 0.08 ± 0.11, 0.04 ± 0.10, and 0 at 1, 3, 6, 12, and 18 months after RFA, respectively. Significant differences in the VRR were found between every two follow-up times before six months (p < 0.01), and no significant differences in the VRR were found between six months and after 12 months (p = 0.42). Of all the nodules, 10 (41.7%) resolved in six months, and 23 (95.8%) resolved in 12 months. No residual or recurrent tumor tissue was detected in RFA area or in residual thyroid tissue during follow-up. No suspicious metastatic lymph nodes were detected. The histological pathology results of US-guided CNB confirmed the absence of residual or recurrent tumor. No major complications were encountered. RFA can effectively eliminate low-risk PTMC with a very small complication rate. RFA may be an alternative strategy for the treatment of PTMC.

Locoregional Control of Metastatic Well-Differentiated Thyroid Cancer by Ultrasound-Guided Radiofrequency Ablation

The purpose of this study was to evaluate the efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) in the control of metastatic well-differentiated thyroid carcinoma in patients for whom surgery is not feasible. Between December 2004 and June 2008, 12 metastatic differentiated thyroid carcinomas (mean diameter, 13.8 mm; range, 4-28 mm) in 10 patients (six women, four men; mean age, 44.8 years) were treated with RFA. The inclusion criteria for RFA were fewer than three metastatic tumors confirmed with ultrasound-guided fine-needle aspiration biopsy, no metastatic tumor beyond the neck at RFA, and infeasibility of surgery. A radiofrequency generator and 18-gauge internally cooled electrodes with a 7-cm shaft length and 0.5- and 1-cm active tips were used depending on the size of the targeted tumors. Ten of the 12 metastatic tumors (83%) were treated in a single session of RFA, and the other two required two sessions. The ablation time ranged from 60 to 900 seconds. After treatment, the mean largest diameter decreased significantly from 13.8 ± 7.0 mm to 3.3 ± 3.9 mm (p = 0.002), as did mean volume, from 55.5 ± 50.3 mm(3) to 5.7 ± 9.3 mm(3) (p = 0.002). At the last follow-up evaluation, the serum thyroglobulin concentration had decreased in 7 of 10 patients. One patient had dysphonia immediately after RFA of a left surgical bed. Although surgery is the standard treatment of locally metastatic thyroid cancer, RFA is effective for locoregional control of metastatic well-differentiated thyroid carcinoma in patients for whom surgery is infeasible.

Percutaneous radiofrequency ablation for liver tumors: Is it safer and more effective in low‐risk areas than in high‐risk areas?

To evaluate the feasibility and safety of ultrasound-guided radiofrequency ablation (RFA) of hepatic tumors in high-risk areas (in caudate lobe, adjacent to the hilum, capsular surface, gallbladder or diaphragm) in comparison with those in low-risk areas. A total of 526 patients with hepatic tumor treated with ultrasound-guided cool-tip RFA between October 2001 and October 2008 were included. The patients were divided into two groups according to the tumor location: group I (high-risk areas, 163 patients); group II (low-risk areas, 363 patients). The two groups had similar baseline characteristics. Repeated RFA was adopted if complete ablation (CA) was not achieved. In group I, 20 cases had tumors close to the hilum, 11 in the caudate, 79 adjacent to the capsule, 24 near the gallbladder and 29 cases against the diaphragm. The percentage of patients with primary hepatic tumors in group I was higher than that in group 2 (80.4% vs 56.2%, P < 0.01). More patients in group I felt pain (61.3%, 100/163) than in group II (33.1%, 120/363) (P < 0.01). There was no mortality or major complications in either group. No significant differences were found in the CA rate and the minor complications between the two groups. RESULTS for RFA using cool-tip electrodes for liver tumors in high-risk areas are comparable to those in low-risk areas in the aspects of CA, complications and mortality.

Radiofrequency Ablation for an Autonomously Functioning Thyroid Nodule

Radiofrequency Ablation for an Autonomously Functioning Thyroid Nodule