Ablation Of Thyroid Nodules Research Articles

The Adoption of Ultrasound-guided Radiofrequency Ablation of Thyroid Nodules in the United States.

The Adoption of Ultrasound-guided Radiofrequency Ablation of Thyroid Nodules in the United States.

Neural monitoring during ultrasound-guided radiofrequency ablation of thyroid nodules

Background Intraoperative neurological monitoring is important in locating and assessing nerves during surgery. This study aimed to investigate the feasibility of neural monitoring during ultrasound-guided radiofrequency ablation (RFA) of thyroid nodules. Methods From February 2019 to August 2019, 16 patients (age, 42.8 ± 15.9 years; range, 17–74 years) with benign thyroid nodules who underwent ultrasound-guided RFA with neural monitoring in Zhongshan Hospital, Xiamen University, were included. A neuromonitoring system stimulated the vagus nerve to obtain electromyographic (EMG) signals and predict the function of recurrent laryngeal nerves (RLNs) during RFA. The hydrodissection technique was used to protect the RLN area. Thyroid nodules were treated with the moving-shot technique. The EMG signal value results were recorded and analyzed. All patients underwent laryngoscopic investigation 1 day after the procedure. Results Twenty vagus nerves were stimulated preprocedure and postprocedure, and the EMG signals were successfully recorded (100%). The mean initial (before ablation) and final (final ablation) vagus nerve amplitudes were 612.7 ± 130.4 μV (range, 455–882 μV) and 592.7 ± 127.3 μV (range, 410–817 μV), respectively. Based on the EMG signals, all 20 RLNs were judged to be in good condition, consistent with the postprocedure laryngoscopic results. The maximum lesion size and volume at 6 months after RFA were significantly lesser than those at baseline (p < 0.05). The volume reduction rate was 68.5% ± 21.5% (range, 13.0–97.3%). Cosmetic and symptom scores were significantly lower than those at baseline. No complications from neural monitoring occurred. Conclusions Neural monitoring during ultrasound-guided RFA of thyroid nodules is feasible to predict RLN function.

Radiofrequency Ablation of Thyroid Nodules: A Long-Term Prospective Study of 24 Patients.

To evaluate the volume reduction rate (VRR) of thyroid nodules over a long period of time after radiofrequency (RF) ablation treatment in both solid and mixed nodules; to determine ablation parameters; and to evaluate complications and success rates and safety of RF ablation. In this prospective study, 24 patients (83% females and 17% males; age 50.17 ± 13.6 years) underwent ultrasound-guided percutaneous RF ablation of benign thyroid nodules with radiologic follow-up at 1, 3, 6, 12, 24, and 36 months after treatment. All patients presented with compressive or cosmetic complaints and with Thyroid Imaging Reporting and Data System 1 or 2 nodules under ultrasound and were confirmed to be Bethesda Category II after 2 fine-needle aspirations. A total of 24 nodules (54.2% solid, 37.5% solid predominance, and 8.3% cystic predominance) were included in this study. Significant results in VRR (%) were found at 24 months and 36 months of 69.92 ± 19.23 and 76.84 ± 15.92, respectively. Furthermore, a logarithmic relationship was found when VRR was plotted over time, in both solid and mixed nodules. No correlations were found with any of the ablation parameters. The success rate reached 72.22% at 12 months, and the total complication rate was 16.67% (12.5% minor complications and 4.2% major complications-1 laryngeal nerve palsy), reaching an 83.3% safety. RF ablation can be an alternative treatment modality in the management of benign symptomatic thyroid nodules. The results show that it is a safe and effective treatment if trans-isthmic approach and moving-shot techniques are correctly followed.

Laser photocoagulation therapy for thyroid nodules: long-term outcome and predictors of efficacy.

The aim of the present study was to retrospectively evaluate the efficacy of interstitial laser photocoagulation (ILP) ablation of thyroid nodules during a 6-year follow-up period and to identify possible predictors of the final outcome. Forty-three outpatients (38 women) were assigned to ILP therapy. The study group included euthyroid patients with benign thyroid nodules. Thyroid size, nodule volume and features, and autoimmune test were collected at baseline. Patients underwent US control after the ILP procedure and 1month, 6months, 12months later and then annually. During the follow-up, two distinct groups of patients emerged: the responders (N = 33) and the non-responder (N = 10) ones to ILP. In the responder group, the nodule volume significantly decreased during the follow-up, but a trend toward a slight increase in nodule volume was recorded up to the end of follow-up. No significant decrease in nodule volume was observed in the non-responder group. Neither baseline clinical nor demographic features were significantly different between responders and non-responders groups. In the whole group of patients, the energy delivered per mL of nodule tissue was significantly correlated with the percent volume decrease at the end of follow-up. Interstitial laser photocoagulation is a safe technique able to reduce byabout 50% the volume of benign thyroid nodules in the majority of treated patients. However, due to the great variability of results, an active follow-up is required. The only independent predictor of ILP outcome is the energy delivered per mL of nodule tissue.

Effect of perithyroidal lignocaine infusion (PLI) to pain experienced during high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules.

To assess whether perithyroidal lignocaine infusion (PLI) could provide additional analgesia in high-intensity focused ultrasound (HIFU) treatment of benign thyroid nodules for patients already receiving their usual intravenous doses of Pethidine and Diazemuls. Two hundred and five patients who underwent HIFU ablation for a benign thyroid nodule were analyzed. Among them, 104 (50.7%) patients received PLI in addition to their boluses of Pethidine and Diazemuls before treatment (group I), while the rest (n = 101, 49.3%) received intravenous Pethidine and Diazemuls only (group II). After treatment, patients were asked to rate their overall pain experience on a visual analogue scale (VAS) (0-100) (0, no pain; 100, worse possible pain) during treatment. Binary logistic regression was performed to evaluate significant determinants for treatment pain including demographics, doses of medications, and treatment parameters. VAS was significantly lower in group I (51.30 vs. 63.79, p = 0.002). In the multivariate analysis, older age at treatment (OR = 1.036, 95%CI = 1.008-1.065, p = 0.011), lower BMI (OR = 1.202, 95%CI = 1.083-1.334, p = 0.001), higher Diazemuls dose (OR = 1.066, 95%CI = 1.018-1.114, p = 0.006), and use of PLI (OR = 2.096, 95%CI = 1.121-3.922, p = 0.020) were independent determinants of less treatment pain. PLI can provide additional analgesia in patients already receiving their usual intravenous doses of Pethidine and Diazemuls during HIFU ablation of benign thyroid nodules. Older age, lower body mass index, and greater Diazemuls (i.e., a sedative) dose are significantly associated with less treatment pain. • PLI provided an additional analgesic effect in HIFU ablation of thyroid nodules. • Older age and lower BMI were significantly associated with less pain. • Higher doses of Diazemuls lessened pain during HIFU ablation.

Radiofrequency ablation of thyroid nodules: “Good Clinical Practice Recommendations” for Austria

The present "Good Clinical Practice Recommendations" relate to radiofrequency ablation (RFA) training, execution, and quality control, as well as to pre- and postinterventional standards of care. They are aimed at all physicians who intend to learn to perform, or who are already conducting RFA interventions as well as at thyroid specialists providing pre- and postoperative care to RFA patients in Austria. Adoption of these recommendations is strongly encouraged by the afore-listed professional associations.All RFA interventionists who adhere to these standards shall be listed on ahomepage linked to these professional associations entitled "RFA centers in compliance with the GCP recommendations of the ÖSDG/OGNMB/ÖGES/OEGCH-ACE." This will ensure harmonization of RFA training and quality control in the performance of the treatment in Austria.

Radiofrequency ablation of thyroid nodules

The treatment goals of Image-guided intervention for thyroid nodule are the relief of symptoms by reducing the nodule volume and the maintaining of symptom free status without regrowth of treated lesion. Thus, it is basically not indicated for the nodules which are not related to the patient's discomfort even they are large. And up to now, except for few limited cases impossible to get surgery, the applications for the malignant disease and follicular neoplasm have not been established firmly. For this reason, preoperative cytopathologic and ultrasonographic evaluations are important to confirm that the target lesion is benign. Thermal ablation is one category of it and consists of radiofrequency ablation (RFA), laser ablation, microwave ablation and high-intensity-focus-ultrasound. RFA for benign thyroid nodules have been reported to have a high efficacy with a low complication rate. Its efficacy is generally evaluated by volume reduction rate. Reported short-term results are 50-80% volume reduction at 6 months, 79-90% at 2 years, and 93% at 4 years. Recurrence rates after the procedure have been reported 5.6%. All recurrent cases showed regrowth of the incompletely treated nodule margin. For this reason, it is recommended to ablate the nodule completely to minimize recurrence. The multiple sessions are needed to get the well-ablated nodule without damaging the adjacent tissues. In this presentation, we can discuss how to make a plan before and after thyroid RFA to reach more successful treatment goal, minimizing the recurrence and the complications.

Management strategy for nerve damage during radiofrequency ablation of thyroid nodules

Objective: The aim of this study was to introduce a management strategy for nerve damage occurring during radiofrequency ablation (RFA).Methods: From January 2016 to October 2017, 17 patients who experienced the symptoms of nerve damage during RFA were enrolled in this study. If damage to nerves was suspected during RFA, ablation was stopped immediately, and a cold solution of 5% dextrose was injected directly into the space where the nerves were located until symptoms improved. Patients were followed up after the procedure until symptoms had resolved. The clinical data of patients who received a cold dextrose solution injection for nerve damage were compared with those who did not receive such an injection.Results: Of 17 patients who experienced nerve damage, 12 received an injection of cold dextrose solution shortly after the emergence of symptoms. While resolution of symptoms was seen in all 17 patients, the mean time to recovery was significantly faster in the 12 patients who received treatment with an injection of cold dextrose solution than in those patients who did not receive such a treatment (p value = .041).Conclusions: In the event of thermal damage to adjacent nerve structures during RFA, the direct injection of a cold dextrose solution is a simple and effective treatment that can result in rapid symptom resolution.

Cyto-inactivation instantly induced by microwave ablation on thyroid nodules

Objective: To explore the effect of microwave ablation on thyroid nodules cell activity by the reaction of key enzyme of cell activation. Methods: From November 2017 to February 2018, 104 patients with 120 thyroid nodules underwent ultrasound-guided microwave ablation at Super-minimally Invasive Medicals, Shanghai International Medical Center, aged 14-55 years, 42 males and 62 females.Twice core needle biopsy were performed before and after thermal ablation.The specimen were using hematoxylin and eosin (HE) staining and enzyme histochemical staining with include succinate dehydrogenase (SDH) and nicotinamide adeninedinucleotide phosphate diaphorase (NADPH-d), respectively, and observe under microscope. Results: Enzyme histochemical staining showed that the positive rate of SDH and NADPH-d in the marginal region and transitional region were 100% before ablation, and were 0% immediately after ablation.The positive rate of SDH and NADPH-d histochemical staining in the same area before and immediately after ablation was statistically significant (P<0.05). Shortly after microwave ablation, the tissue structure and cell morphology showed no obvious alteration in HE stained sections, but in sections with enzyme histochemical staining, the activity of SDH and NADPH-d in ablated tissue disappeared.The accuracy rate of pathologic diagnosis was 100% after ablation. Conclusions: SDH and NADPH-d enzyme activity may be better in evaluating the short-term efficacy of microwave ablation of thyroid nodules than HE staining.

Comparison between microwave ablation and bipolar radiofrequency ablation in benign thyroid nodules: differences in energy transmission, duration of application and applied shots

Purpose: Comparison between different thermal ablation systems for thyroid nodules regarding their different procedural characteristics such as treatment-time, number of shots and energy transmission in the context of their clinical performance such as complication rate and volume reduction after three months.Methods: A total of 60 patients with 65 nodules underwent thermal ablation of thyroid nodules with either microwave ablation (MWA) (9 male, 15 female and mean age 57 ± 13 years) or radiofrequency ablation (RFA) (12 male, 24 female and mean age 54 ± 12 years).Results: Mean initial volume (MWA: 23.90 ± 17.35 ml; RFA: 29.44 ± 30.09 ml), energy transmission (MWA: 13.56 ± 10.17 kJ; RFA: 15.12 ± 13.45 kJ), energy transmission per ml (MWA: 0.85 ± 1.01 kJ/ml; RFA: 0.65 ± 0.32 kJ/ml), power (MWA: 22.69 ± 12.32 J/s; RFA: 20.97 ± 7.86 J/s) and duration of ablation (MWA: 618 ± 304 s; RFA: 695 ± 463 s) were not statistically different (p > .05). MWA required significantly less shots (MWA: 3 ± 1; RFA: 6 ± 3) than RFA (p < .05). At three-months follow-up a significant mean nodular volume reduction of 53.54 ± 15.40% after MWA and 51.21 ± 16.58% after RFA (p < .05) was measured. However, mean nodular volume reduction was not significantly different between both systems (p > .05). One patient treated by MWA reported a transient Horner’s syndrome, which recovered without any further treatment. Major complications such as nodule rupture, infection or persisting nerve injuries did not occur.Conclusion: Both systems are suitable to treat thyroid nodules and show no significant difference in the duration of application, energy transmission and volume reduction. However, MWA requires less shots to treat the whole nodule.

Monopolar Radiofrequency Ablation of Thyroid Nodules: A Prospective Austrian Single-Center Study.

Background: Monopolar radiofrequency ablation is currently deemed an exotic treatment option for benign thyroid nodules in many central European countries. The aim of this study was to evaluate prospectively the safety and efficacy of this method in a large patient cohort following its introduction in Austria.Methods: Peri- and post-interventional complications were analyzed for 277 patients. Efficacy was determined for 300 and 154 nodules at 3 and 12 months post treatment, respectively. All treatments were performed with an internally cooled 18G radiofrequency electrode using a free-hand, “moving-shot” technique following subcutaneous and local perithyroidal anesthesia.Results: Mean patient age (SD) was 52 ± 12.9 years (75% female), and overall mean baseline nodule volume (SD) was 13.8 ± 15.9 mL. Nodules were visible in 62.8% of patients, 40% had a symptom score ≥4 on a 10-point visual analogue scale, and 14.4% had hyperthyroidism. Mean overall nodule volume reduction rates (VRR) at 3 and 12 months were 68 ± 16% and 82 ± 13%, respectively (p < 0.001). At 12 months, 81% of nodules exhibited a VRR of ≥70%, with 10%, 6%, and 2% of nodules showing VRRs of 60–70%, 50–60%, and ≤50%, respectively. Subgroup analysis according to baseline nodule size (≤10 mL to >30 mL) or baseline nodule composition (solid, mixed, cystic) revealed significantly higher VRRs for smaller and cystic nodules. Moreover, nodule shrinkage was accompanied by significantly improved symptom and cosmetic scores after 3 and 12 months (p < 0.001). Of 32 hyperthyroid patients, 27 (84%) were euthyroid, four had subclinical hyperthyroidism, and one had subclinical hypothyroidism at last follow-up. Post-procedural complications were absent in 83% of patients, minimal in 12.9%, moderate and reversible in 3.2% (1.8% voice change, 0.7% hyperthyroidism, 0.3% wound infection treated with antibiotics, 0.3% epifascial hematoma), and irreversible in 0.7% (one case with hypothyroidism and one with a wound infection treated by surgery).Conclusions: It is concluded that a single treatment course with monopolar radiofrequency ablation is both safe and highly effective in terms of nodule volume reduction, relief of local symptoms, and (in patients with hyperthyroidism) restoration of euthyroid function. In no case was a prescription of thyroid medication required among those patients who were euthyroid at baseline.

Evaluation of pain during high-intensity focused ultrasound ablation of benign thyroid nodules.

To assess severity and factors of pain during high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules. 128 patients who underwent a HIFU ablation for a benign thyroid nodule were analysed. All patients received a bolus of intravenous pethidine and diazepam before treatment. After treatment, patients were asked to rate their overall pain experience on a visual analogue scale (0-100) (0 = no pain; 100 = worse possible pain) during treatment, 2 h after treatment and the following morning. Binary logistic regression was performed to evaluate associated factors for pain including patient demographics, nodule size, body mass index (BMI) and treatment parameters. At T1, median (range) pain score was 65.0 (0.00-100.00). Only 16 (12.5 %) patients had a pain score of zero. In multivariate analysis, only lower BMI (OR 1.265, 95 % CI 1.102-1.452, p=0.001) and longer nodule diameter (OR 1.462, 95 % CI 1.071-1.996, p=0.017) were independent factors for pain score at T1 ≤ 65.0. A moderate to severe amount of pain was reported during ablation of benign thyroid nodules in over 50 % of patients. Patients' BMI and length of nodule diameter were independent variables for pain during HIFU ablation. • Pain was moderate to severe during HIFU ablation of thyroid nodules. • Only one in eight patients reported no pain during ablation. • Level of energy per pulse did not affect pain. • Patients with lower BMI and larger nodules had less pain.

Risk Assessment and Hydrodissection Technique for Radiofrequency Ablation of Thyroid Benign Nodules.

Purpose: This retrospective study aimed to explore the importance of risk assessment and hydrodissection pre-treatment for radiofrequency ablation of thyroid nodules and initially establish the concept of thyroid nodule risk assessment and the corresponding ablation norms.Method: Based on the specific location of thyroid nodules, risk assessment and the corresponding preventive measures for thyroid ablation were established. During the period of 2015.10-2017.5, a total of 382 patients were enrolled to compare the safety and efficacy of the ablation for patients with or without risk assessment and the corresponding preventive measures. Statistical analysis encompassed Independent T test for continuous variables and Fisher's exact test/Chi-square test for categorical variables.Result: Of all 382 patients, 188 patients underwent ablation with risk assessment and the corresponding preventive measures before ablation and 194 without, respectively. The patient characteristics, risk grading, ablation time, thyroid function after ablation and the complete ablation rate showed no statistical differences exsisted between two groups (P>0.05). The complication in very high risk nodules was avoided in the group of patients with risk assessment and preventive measures before ablation.Conclusion: It is a very safe and effective way to carry out radiofrequency ablation after pre-treatment of thyroid nodules by hydrodissection technique according to risk assessment. It will provide clinicians with greater help in the ablation treatment of thyroid nodules, and improve the safety of the thyroid ablation.

The Place of Elastography in Evaluating the Efficacy of Radiofrequency Ablation of Thyroid Nodules

The usage of radiofrequency ablation (RFA) therapy and elastography to treat thyroid nodules has been increasing recently. Elastography specifically measures the stiffness of tissue using ultrasonography (US). The aim of the present study was to evaluate the relationship between the elastography values of thyroid nodules and the efficacy of RFA therapy. Ultrasonography was performed on 49 patients who had a thyroid nodule with a diameter of 1 cm or greater before RFA therapy. The RFA was performed under local anesthesia, and elastography was used to measure the stiffness of the normal thyroid tissue, sternocleidomastoid muscle (SCM) and thyroid nodules three months after RFA. The nodule diameter significantly decreased three months after RFA (P < 0.05). According to a cross-evaluation of the mean elastography rates, the thyroid/SCM and nodule/thyroid elastography rates had an inverse relationship (P: 0.009). However, the thyroid/SCM elastography rates and nodule/SCM elastography rates (P: 0.022) and the thyroid/SCM elastography rates and the rates of reduction (%) of the nodule diameter before and three months after RFA (P: 0.016) had positive relationships. In conclusion, RFA therapy is more effective in patients with thyroid nodules if there are high thyroid tissue/SCM rates in elastography.

Thermal ablation of thyroid nodules: are radiofrequency ablation, microwave ablation and high intensity focused ultrasound equally safe and effective methods?

This study compares volume reduction of benign thyroid nodules three months after Radiofrequency Ablation (RFA), Microwave Ablation (MWA) or High Intensity Focused Ultrasound (HIFU) to evaluate which of these methods is the most effective and safe alternative to thyroidectomy or radioiodine therapy. Ninety-four patients (39 male, 55 female) with a total of 118 benign, symptomatic thyroid nodules were divided into three subgroups. HIFU was applied to 14 patients with small nodules. The other 80 patients were divided up into two groups of 40 patients each for RFA and MWA in the assumption that both methods are comparable effective. The pre-ablative and post-ablative volume was measured by ultrasound. RFA showed a significant volume reduction of nodules of 50 % (p<0.05), MWA of 44 % (p<0.05) and HIFU of 48 % (p<0.05) three months after ablation. None of the examined ablation techniques caused serious or permanent complications. RFA, MWA and HIFU showed comparable results considering volume reduction. All methods are safe and effective treatments of benign thyroid nodules. • Thermal Ablation can be used to treat benign thyroid nodules • Thermal Ablation can be an alternative to thyroidectomy or radioiodine therapy • Radiofrequency Ablation, Microwave Ablation, High Intensity Focused Ultrasound are safe and effective.

Further Investigation on High-intensity Focused Ultrasound (HIFU) Treatment for Thyroid Nodules: Effectiveness Related to Baseline Volumes

Several minimally invasive thermal techniques have been developed for the treatment of benign thyroid nodules. A new technique for this indication is high-intensity focused ultrasound (HIFU). The aim of this study was to assess effectiveness in varying preablative nodule volumes and whether outcome patterns that were reported during studies with other thermal ablative procedures for thyroid nodule ablation would also apply to HIFU. Over the last 2 years, 19 nodules in 15 patients (12 women) whose average age was 58.7 years (36-80) were treated with HIFU in an ambulatory setting. Patients with more than one nodule were treated in multiple sessions on the same day. The mean nodule volume was 2.56 mL (range 0.13-7.67 mL). The therapeutic ultrasound probe (Echopulse THC900888-H) used in this series functions with a frequency of 3 MHz, reaching temperatures of approximately 80°C-90°C and delivering an energy ranging from 87.6 to 320.3 J per sonication. To assess the effectiveness of thermal ablation, nodular volume was measured at baseline and at 3-month follow-up. The end point of the study was the volume reduction assessment after 3 months' follow-up. Therapeutic success was defined as volume reduction of more than 50% compared to baseline. This study was retrospectively analyzed using the Wilcoxon signed rank test and Kendall tau. The median percentage volume reduction of all 19 nodules after 3 months was 58%. An inverse correlation between preablative nodular volume and percentage volume shrinking was found (tau = -0.46, P < .05). Therapeutic success was achieved in 10 out of 19 patients (53%). HIFU of benign thyroid nodules can be carried out as an alternative therapy for nodules ≤3 mL if patients are refusing surgery or radioiodine therapy.

High-intensity focused ultrasound for thyroid nodule ablation: the evidence to date

High-intensity focused ultrasound for thyroid nodule ablation: the evidence to date Roussanka D Kovatcheva,1 Katja Zaletel,2 1Department of Thyroid and Metabolic Bone Disorders, Clinical Center of Endocrinology, Medical University, Sofia, Bulgaria; 2Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia Abstract: Thyroid nodules are common in occurrence and most of them are benign in nature. Some of these nodules are to be treated as they continue to grow or cause undesirable symptoms. Recently, several minimally invasive thermal ablation techniques have been introduced to overcome the complications of traditional methods such as surgery. High-intensity focused ultrasound (HIFU) is the latest advance in treatment modalities, which is a noninvasive procedure that permits localized target destruction without affecting the surrounding tissues. HIFU is currently used in the treatment of various solid malignant and benign tumors. The purpose of this review is to provide an introduction to the literature, principles, and advances of HIFU therapy of benign thyroid nodules, as well as to provide a discussion on its efficacy, complications, and future. Keywords: thyroid nodule, high-intensity focused ultrasound, ultrasound guidance, ablation techniques

Microwave ablation for thyroid nodules: a new string to the bow for percutaneous treatments?

Thyroid nodules are a fairly common finding in general population and, even if most of them are benign, a treatment can be however necessary. In the last years, non surgical minimally invasive techniques have been developed to treat this pathology, starting from percutaneous ethanol injection (PEI), to laser ablation (LA), radiofrequency ablation (RFA) and, most recently, microwave ablation (MWA). We reviewed all medical literature searching in pubmed.gov the terms "microwave" & "thyroid". We found three original studies concerning MWA treatment, for a total of 263 patients (mean age 51.0 years; range, 15-80 years; male to female ratio 2.55) and 522 nodules. A total of 522 nodules (338 solid, 22 cystic, 162 mixed) in 263 patients were treated. Studies have shown a mean reduction in volume of thyroid nodules ranging from 45.9% to 65%. No study reported a significant and definitive change in laboratory parameters, except for one case (Heck et al.). No studies have reported major complications after procedure. MWA is a new, promising technique among the minimally invasive treatments of thyroid nodules. Actually, the larger diameter of MW antenna seems to be the major limiting factor in the use of this technique. More studies are necessary to evaluate feasibility, safety and efficacy of the procedure.

Experimental morphological evaluation of the effectiveness of bipolar radiofrequency ablation for thyroid nodules

Over the recent decade, the method of radiofrequency ablation has been increasingly used for treatment of thyroid nodules. However, there is clear need for additional morphological experimental works on evaluating the effectiveness of application of different devices. This work presents results of investigation of an original device operating on the principle of bipolar radiofrequency ablation, and its high effectiveness in eliminating thyroid nodules with different consistencies and malignancy potentials has been proven, which offers broad prospects for introducing the patented radiofrequency-ablation applicator into practice, alongside other methods of minimally invasive surgery.

Cooled microwave ablation of thyroid nodules: Initial experience

ObjectiveTo evaluate if internally cooled microwave ablation (cMWA) is a safe and effective method for treatment of benign and malign thyroid nodules. Methods9 patients with 11 symptomatic cold benign thyroid nodules and 1 recurrent thyroid carcinoma ranging in volume from 9.1 to 197ml (mean size 52± 57ml) were treated with cMWA. The mean age of the patients was 59 years. Pain during the treatment was measured on a 10-point scale. Side effects revealed by ultrasound or patients’ complaints were documented. Periablative efficacy was measured 24h after cMWA as change (Δ) in serum thyreoglobulin (Tg). Nodule elasticity was measured on a 4-point scale, blood circulation and echogenicity on a 3-point scale. ResultsAll patients tolerated cMWA well. Median pain intensity averaged 2.1±0.8 (range: 1–3). Postablative hematoma was observed in all cases. In no cases ablation led to hoarseness, superficial burns, nodule ruptures, vagal reactions or dysphagia. cMWA lead to a significant decrease of blood circulation, nodule echogenicity and a significant increase of elasticity (Δ = 1.1 ± 0.33; 0.8 ± 0.4 and 1.1 ± 0.6 points)(p<0.05). An average increase of 4495ng/ml Tg was measured (p<0.05). ConclusionscMWA is an effective and secure method for treatment of thyroid nodules.