Volume Reduction Ratio Research Articles

Improvement in thyroid-specific quality of life following radiofrequency ablation of benign thyroid nodules: A USA study

BackgroundRadiofrequency ablation is an effective minimally invasive technique for benign thyroid nodules, with European and Asian studies reporting improved quality of life following treatment. We aimed to assess the thyroid-related quality of life of patients with benign thyroid nodules treated with radiofrequency ablation in the United States. MethodsThis is a prospective single-institution study of patients treated with radiofrequency ablation over a 4-year period. Nodule characteristics and Thyroid-Related Patient-Reported Outcome (ThyPRO)-39 scores were assessed at baseline, 3 months post-procedure, and last follow-up (range: 3–12 months). Wilcoxon signed-rank test was used to assess differences in scores before and after radiofrequency ablation with standardized effect size analysis. ResultsA total of 56 patients with 76 nodules were treated. The median volume reduction ratio at 1, 3, 6, and 12 months was 44.9% (interquartile range: 27.3–57.3), 65.2% (53.5–73.1), 69.7% (63.5–81.9), and 79.6% (66.2–88.9), respectively. At 3-month follow-up, significant improvement (P < .05) was observed for goiter symptoms (28.9 vs 10.8), anxiety (30.7 vs 19.3), and appearance (29.9 vs 10.8). At last follow-up, significant improvement (P < .05) was observed for goiter symptoms (28.9 vs 8.9), anxiety (30.7 vs 22.3), appearance (29.9 vs 10.8), and overall quality of life (30.3 vs 11.1). Effect sizes were moderate for appearance (standardized effect size 0.5–0.8) at last follow-up. ConclusionIn the largest US study to date assessing quality of life following radiofrequency ablation, we observed an expected volume reduction ratio and improvements in thyroid-specific quality of life, particularly in the goiter, anxiety, and appearance domains.

Ultrafiltered Sweet Buttermilk as Additive Replacer in Ice Cream Production.

Sweet buttermilk, a by-product of butter production, remains highly underutilized despite containing some relevant components (i.e., phospholipids) that may have a high biological value and may exert some positive technological functions. The aim of this study was to investigate the possibility of using ultrafiltered (UF) sweet buttermilk at different volume reduction ratios (3 and 5) to replace emulsifiers and/or stabilizers in the production of a novel clean-label ice cream formulation made with sweet buttermilk-based mixtures. The functional, thermo-rheological, and sensory profile of four types of ice creams was investigated. Increasing the degree of sweet buttermilk concentration positively influenced the overrun values and at the same time improved the ice cream's resistance to melting. Also, the thermo-rheological profile during melting was influenced by the presence of UF buttermilk. These differences in techno-functional properties were probably partly caused by the different total phospholipids content caused by UF buttermilk. Some sensory properties (i.e., structure, consistency) were positively related to the utilization of UF buttermilk, while aroma and taste were negatively influenced. This study demonstrated that UF buttermilk can be used as an additive replacer in ice cream production because it enhances the structural and rheological properties of the final product.

Radiofrequency ablation of Bethesda category III thyroid nodules with benign molecular testing: Preliminary findings from a single institution

BackgroundThe efficacy of radiofrequency ablation (RFA) in treating thyroid nodules with indeterminate cytology remains less studied. The objective of this study was to determine the efficacy of RFA in treating nodules with Bethesda III that have been molecularly profiled benign (BIII-MPN). MethodsWe included prospectively enrolled patients who underwent RFA for benign and BIII-MPN thyroid nodules. Primary outcome measures were volume reduction ratio (VRR), symptom score (range 0–10), and cosmetic score (range 0–3) at 1, 3, 6, and 12 months after RFA, as well as complication rates. ResultsA total of 258 nodules in 192 patients were included (benign: 238 in 174; BIII-MPN: 20 in 18). The median VRR differed insignificantly, whereas symptom and cosmetic score improvements were similar between two cohorts. BIII-MPN thyroid nodules were associated with lower rates of infection and temporary voice change. ConclusionOur preliminary findings suggest that RFA may be a feasible management option for BIII-MPN thyroid nodules. However, appropriate will be important to address the important risk of potentially missed malignancies.

Five-year follow-up after a single US-guided high intensity focused ultrasound treatment of breast fibroadenoma

The aim of this study was to evaluate the long-term efficacy of a single ultrasound-guided high-intensity focused ultrasound (US-HIFU) treatment in patients with breast fibroadenoma (FA) in terms of volume and pain reduction as well as palpation findings. From december 2013 until november 2014 27 women with a symptomatic FA were treated in one HIFU-session. Follow-up visits were performed after 7 days, 6 months and 1, 2, 3 and 5 years with clinical examination and ultrasound. One year after the procedure, a core needle biopsy of the residual lesion was offered. There was a significant volume reduction 6 months after HIFU from 1083.10 to 347.13 mm3 (p < 0.0001) with a mean volume reduction ratio (VRR) of 61.63%. Thereafter the FAs showed a further, but no longer significant decrease in size. One patient with an initial incomplete ablation and histologically confirmed persistent vital cells after 1 year showed a strong regrowth after 3 years. Excluding this patient from analysis, the mean VRR at months 12, 24, 36, and 60 was 86.44%, 94.44%, 94.90%, and 97.85%, respectively. Before HIFU, 59.26% of the patients had pain (22.33/100 VAS) which decreased to 6.56/100 after 12 months and remained reduced over the 5 year follow up period. A decrease in palpability from 85.19 to 7.69% was observed within 24 months. A single HIFU intervention let to a substantial reduction in size, pain, and palpability with its most potential effect during the first 12 months. Subsequently, the observed effect remained stable over a 5 year follow up period. Incomplete initial treatment was associated with the risk of regrowth.

Radiofrequency Ablation for the Treatment of Benign Thyroid Nodules: 10-Year Experience.

Background: Longer follow-up after radiofrequency ablation (RFA) of benign thyroid nodules is needed to understand regrowth and other causes of delayed surgery and long-term complications. Methods: This retrospective study included consecutive patients treated with RFA for symptomatic benign nonfunctioning thyroid nodules between March 2007 and December 2010. RFA was performed according to the standard protocol. We followed up patients at 1, 6, and 12 months, then yearly, until August 2022, and calculated the volume reduction ratio (VRR) at each follow-up. We assessed the incidence of regrowth according to three published criteria, delayed surgery, and complications. The Kaplan-Meier method was used to evaluate the cumulative incidence of regrowth, and univariable and multivariable Cox regression analyses were performed to identify risk factors for regrowth. Results: This study included 421 patients (mean age, 47 ± 13 years; 372 women) with 456 nodules (mean volume, 21 ± 23 mL). The median follow-up period was 90 months (interquartile range, 24-143 months). The mean VRR was 81% at 2 years, 90% at 5 years, and 94% at ≥10 years. Overall regrowth was noted in 12% (53/456) of nodules and was treated with repeat RFA (n = 33) or surgery (n = 4) or left under observation (n = 16). Thyroid nodules with ≥20 mL initial volume had significantly higher risk of regrowth compared with nodules with <10 mL initial volume (hazard ratio, 2.315 [95% confidence interval, 1.183-4.530]; p = 0.014 on multivariable Cox regression analysis). Delayed surgery was performed in 6% (26/421) of patients because of regrowth and/or persistent symptoms (n = 4) or newly detected thyroid tumors (n = 22), one benign and 21 malignant. The overall complication rate was 2.4% (10/421), with no procedure-related deaths or long-term complications. Conclusion: RFA is safe and effective for treating benign thyroid nodules, with a high VRR at long-term follow-up. Regular follow-up after initial success is warranted because of the possibility of regrowth of ablated nodules and the need for delayed surgery in some patients.

Microwave Thermal Ablation of Thyroid Nodules with the MONTREAL Technique: Preliminary Clinical Results.

Ultrasound-guided percutaneous Microwave Thermoablation (MWA) is an increasingly popular minimally invasive therapy for the treatment of benign thyroid nodules due to its remarkable heating velocity and resilience to heat sinking. We present a cohort of 26 patients (17 F, 9M, mean age 56.2yy) with 20 goiters (mean volume 34.9cc, min 6.5cc-max 84cc) and 6 autonomously functioning nodules (AFTNs, mean volume 11.6cc, min 3.5cc-max 24cc) treated with MWA, using the moving shot technique and a novel energy delivery algorithm (MONTREAL), based on intra-operative real-time reflectivity measurements: each moving shot was automatically terminated when reflectivity was observed to ramp up. 17G or 18G internally cooled 2.45 GHz applicators were used (AMICA-PROBE, HS HOSPITAL SERVICE SpA), operated at 15-30W. On average, each treatment deposited 9.9±5.5kJ during 696±325s, through 26.7±14.4 moving shots: the mean moving shot duration was 28.1±9.0s, yielding a mean ablation time per unit nodule volume of 34.3±19.1s/cc. No mild nor severe complications were recorded. Post-MWA ultrasound follow-up showed a mean volume reduction ratio of 59.1±10.2% [min 44% - max 80%] at 3 months and of 70.1±8.5% [min 53% - max 91%] at 6 months, with slightly better outcomes in the AFTNs sub-group (volume reduction of 65.3±10.2%/76.0±4.0% at 3/6 months and, in all cases, normal TSH values at 3 months upon pharmacological therapy suspension). MWA treatments of benign nodules with the MONTREAL technique appeared to be safe, fast, and effective. Further research is warranted to confirm these preliminary results.

Comparative efficacy and safety of radiofrequency ablation and microwave ablation in benign thyroid nodule treatment: a systematic review and meta-analysis.

Ultrasound-guided thermal ablation, including radiofrequency ablation (RFA) and microwave ablation (MWA), has become one of the main options for treating benign thyroid nodules (BTNs). To assess the efficacy of thermal ablation of BTNs, we performed a systematic review and meta-analysis of relevant studies. A comprehensive search of MEDLINE, EMBASE, and COCHRANE databases was performed up to September 25, 2023, to identify studies directly comparing RFA and MWA for pathologically proven BTNs and reporting clinical outcomes and complications. Data extraction and quality assessment were independently performed by two radiologists according to PRISMA guidelines. The analysis yielded the serial volume reduction ratios (VRRs) of ablated nodules for up to 12 months, symptom and cosmetic scores, and complications. This analysis included nine studies with 1305 BTNs treated by RFA and 1276 by MWA. VRRs at 1 month, 3 months, and 6 months were similar between RFA and MWA, but RFA showed a significantly higher VRR (83.3%) than MWA (76.9%) at 12 months (p = 0.02). Complication rates showed no significant difference between the two methods. Symptom and cosmetic scores significantly decreased after ablation, without a significant difference between the methods. Subgroup analysis indicated a significantly higher VRR at 12 months for RFA than for MWA for less experienced investigators (≤ 10 years), but no significant difference for more experienced investigators (> 10 years). RFA and MWA are both effective and safe methods for treating BTNs. RFA showed a higher VRR at 12 months and seems more suitable for less experienced investigators. RFA and MWA are both effective and safe treatments for BTNs, with RFA showing a higher VRR at 12 months. Both methods offer minimally invasive and reliable treatment for thyroid nodules. The most effective thermal ablation technique for BTNs remains undetermined. RFA showed a higher VRR at 12 months than MWA. Both techniques are effective for treating thyroid nodules; RFA offers greater benefits, particularly for less experienced investigators.

Clinical analysis of ultrasound‐guided microwave ablation for pediatric thyroid nodules‐ a single center research

AbstractTo provide a new minimally invasive treatment for children with benign thyroid nodules, and to provide clinical data for applying microwave ablation (MWA) to children. A retrospective analysis was conducted on the clinical data of 21 pediatric patients with benign thyroid nodules who underwent ultrasound‐guided MWA at the Children's Hospital affiliated with Chongqing Medical University from July 2022 to August 2023. The safety, clinical efficacy, volume reduction ratio and prognostic value of the treatment were evaluated. The participants were followed for at least 4 months (median 7 months, range 4–16 months). The average (range) ablation time for the 21 patients was only(233.90 ± 184.97) (40–660)seconds, with intraoperative bleeding less than 0.5 mL. No complications such as hoarseness, seizures or coughing during drinking water were observed after ablation treatment. All the participants' hormone reflecting thyroid function remained in the normal ranges after treatment. Besides, these hormones at 12 h after surgery and 1 month after surgery were not statistically different from those before surgery. Immediate postoperative ultrasound imaging showed a significant decrease in volume of benign thyroid nodules, the volume of nodules at 1 month postoperatively (M, 1.39), and the volume of nodules at 4 months postoperatively (M, 0.40) significantly smaller than that before surgery (M, 4.94). Ultrasound‐guided MWA is a new option for the treatment of benign thyroid nodules in children, with advantages such as minimal invasiveness, good clinical effect, high safety, little damage to thyroid function, short operation time, less intraoperative bleeding, low pain sensation and aesthetic appearance.

The Efficacy of Ultrasound-Guided Microwave Ablation for Benign Thyroid Nodules and the Correlation Analysis of Its Influencing Factors

Objective: To investigate the efficacy of ultrasound-guided microwave ablation (MWA) for benign thyroid nodules and to analyze the correlation between treatment outcomes and various influencing factors. Methods: 95 patients with pathologically confirmed benign thyroid nodules（ totally 96 nodules) who underwent MWA under ultrasound guidance were enrolled in this retrospective study. Pre-ablation and post-ablation follow-up examinations including two-dimensional ultrasound, color Doppler, and contrast-enhanced ultrasound were conducted at 1, 3, and 6 months. The clinical efficacy was assessed, including the reduction in nodule volume and the success rate of ablation. Factors that might influence treatment outcomes, such as patient age, gender, nodule size, type, and ablation parameters, were analyzed. Statistical correlations were evaluated using Spearman’s correlation coefficient and multiple regression analysis. Results: MWA has demonstrated favorable efficacy in treating benign thyroid nodules, with a low incidence of complications. Most nodules experienced significant volume reduction or even complete disappearance after treatment (P &lt; 0.05). The average volume reduction ratio (VRR) of benign thyroid nodules undergoing MWA at 1 month, 3 months, and 6 months post-operation were 52.98%±22.23%, 68.18%±19.81%, and 82.39%±15.03%, respectively, with a significant reduction rate (VRR &gt; 50%) observed in 95.8% (92/96) of the nodules (VRR &gt; 50%). Cystic nodules exhibited the most substantial volume reduction following ablation. The initial volume of the nodule, blood flow status, nodule composition, and the energy absorption per unit volume were all related to the postoperative VRR (P &lt; 0.05). Factors such as patient age, gender, and ablation duration did not show significant correlation with ablation efficacy (P＞0.05). Conclusion: MWA is a promising minimally invasive treatment for benign thyroid nodules. The treatment efficacy is closely related to the initial volume of the thyroid nodule, the composition of the nodule, the blood flow situation of the nodule, and the ablation energy per unit volume.

The Efficacy of Ultrasound-Guided Microwave Ablation for Benign Thyroid Nodules and the Correlation Analysis of Its Influencing Factors

Objective: To investigate the efficacy of ultrasound-guided microwave ablation (MWA) for benign thyroid nodules and to analyze the correlation between treatment outcomes and various influencing factors. Methods: 95 patients with pathologically confirmed benign thyroid nodules（ totally 96 nodules) who underwent MWA under ultrasound guidance were enrolled in this retrospective study. Pre-ablation and post-ablation follow-up examinations including two-dimensional ultrasound, color Doppler, and contrast-enhanced ultrasound were conducted at 1, 3, and 6 months. The clinical efficacy was assessed, including the reduction in nodule volume and the success rate of ablation. Factors that might influence treatment outcomes, such as patient age, gender, nodule size, type, and ablation parameters, were analyzed. Statistical correlations were evaluated using Spearman’s correlation coefficient and multiple regression analysis. Results: MWA has demonstrated favorable efficacy in treating benign thyroid nodules, with a low incidence of complications. Most nodules experienced significant volume reduction or even complete disappearance after treatment (P &lt; 0.05). The average volume reduction ratio (VRR) of benign thyroid nodules undergoing MWA at 1 month, 3 months, and 6 months post-operation were 52.98%±22.23%, 68.18%±19.81%, and 82.39%±15.03%, respectively, with a significant reduction rate (VRR &gt; 50%) observed in 95.8% (92/96) of the nodules (VRR &gt; 50%). Cystic nodules exhibited the most substantial volume reduction following ablation. The initial volume of the nodule, blood flow status, nodule composition, and the energy absorption per unit volume were all related to the postoperative VRR (P &lt; 0.05). Factors such as patient age, gender, and ablation duration did not show significant correlation with ablation efficacy (P＞0.05). Conclusion: MWA is a promising minimally invasive treatment for benign thyroid nodules. The treatment efficacy is closely related to the initial volume of the thyroid nodule, the composition of the nodule, the blood flow situation of the nodule, and the ablation energy per unit volume.

A 6-year single-center prospective follow-up study of the efficacy of radiofrequency ablation for thyroid nodules.

Radiofrequency ablation (RFA) is an alternative modality for thyroid nodules (TNs) and many studies have also confirmed its favorable efficacy and safety. The scope of RFA increases in clinical practice and the aim of our study was to evaluate the efficacy of RFA. We conducted a prospective study to evaluate the efficacy of RFA for thyroid nodules between January 2017 and December 2022 at our institution. We assessed the change in nodal volume, volume reduction ratio (VRR), technique effective (TE) rate, complete ablation (CA) rate, and nodal regrowth rate and time after RFA. We performed RFA for 1703 patients with TNs between January 2017 and December 2022, of which a total of 970 eligible patients were enrolled in the study. The preoperative volume of TNs was 6.23 ± 8.11ml, with 821 benign and 149 malignant nodules. The post-RFA TE and adjusted TE rate were 80% and 88.8%, respectively. CA was achieved in 145 (14.9%) patients with a mean time of 18.32± 12.98 months; nodal regrowth occurred in 15 (1.5%) patients with a mean time of 29.80 ± 12.47 months. TNs volume and VRR changed significantly at years 1 and 2 after RFA and stabilized after 5 years. A serious postoperative adverse event occurred in one patient with cervical sympathetic chain injury resulting in Horner's syndrome. A transient or permanent damage of the recurrent laryngeal nerve could not be evaluated due to the lack of postoperative laryngoscopy, and this is a significant limitation of the study. The expanded RFA indications were also effective for TNs, with no significant change in long-term efficacy.

Microwave ablation with hydrodissection used for the treatment of vascular malformations: effectiveness and safety study.

The aim of the study was to investigate the safety, effectiveness, and peripheral nerve protection in ultrasound-guided microwave ablation (US-guided-MWA) for vascular malformations (VMs) closely related to peripheral nerve. From August 2019 to February 2022, 31 patients with 39 VMs received US-guided-MWA. All lesions were confirmed to be closely related to the peripheral nerve by imaging evaluation. Hydrodissection was applied to protect surrounding normal tissue, including peripheral nerves. The patients were followed up at 1day, 2 days, 3 days, 1 week, 1 month, 3 months after operation. Measurements of lesion volume, volume reduction ratio (VRR), sensory and functional abnormalities of adjacent nerves, number of treatments, complication details, personal satisfaction, recurrence, and symptom improvement were recorded. Among the 39 VMs, the maximum volume is 128.58ml, while the minimum volume is 0.99ml. After a mean follow-up of 13.06 ± 4.83 months, the mean numerical rating scale (NRS) score decreased from 5.13 ± 1.65 to 0.53 ± 0.83 (P<0.0001). The mean mass volume was reduced from 18.34 ± 24.68 ml to 1.35 ± 2.09 ml (P=0.0001). The VRR of all lesions was 92.06%. However, the mean number of treatments was only 1.64 ± 0.87. All patients were satisfied with the technique, with a mean satisfaction score (SC) of 9.23 ± 1.13. There were no motor function abnormalities of the related nerves. 10 patients felt numbness in the ablation area after ablation, and gradually recovered after 1 month. US-guided-MWA serves as a novel alternative approach for patients with VMs. Preoperative evaluation of the relationship between VMs and peripheral nerves combined with intraoperative hydrodissection is an effective and safe method to prevent nerve injury.

Trends in thyroid function following radiofrequency ablation of benign, nonfunctioning thyroid nodules: A single institution review

BackgroundRadiofrequency ablation (RFA) effectively reduces volume and improves symptoms of benign, non-functioning thyroid nodules (NFTNs). Given RFA's unclear impact on thyroid function, we examined post-RFA trends in thyroid hormones and antibodies. MethodsA retrospective cross-sectional analysis was conducted of patients treated at Columbia University with RFA for benign NFTNs between August 2019 and July 2023. Thyroid function tests were recorded pre-RFA and repeated 3, 6, and 12 months post-RFA. ResultsWe analyzed 185 patients with 243 benign NFTNs who underwent RFA. Volume reduction ratio increased post-RFA. Mean TSH increased to 2.4 mlU/L (p ​= ​0.005) at 3 months post-RFA and decreased to 1.8 mlU/L (p ​= ​0.551) by 12 months post-RFA. Tg and TPO antibody levels peaked at 6 months post-RFA (103.1 IU/mL, p ​= ​0.868 and 66.6 IU/mL, p ​= ​0.523, respectively). ConclusionsWith expected volume reduction post-RFA, we observed transient relative hypothyroidism as well as transient increases in thyroid antibodies, with normalization of these changes within 12 months.

#780 “In vivo” difference in ultrafiltration coefficient between two same membrane dialyzers: bigger surface area accounts for better dialysis outcomes?

Abstract Background and Aims Ultrafiltration coefficient (KUF) is a measure of dialyzer permeability to water, given by manufacturers, and expressed in milliliters/hour/mmHg of pressure gradient. Most dialyzers used at this moment are classified as high-flow as having a KUF &amp;gt;20 mL/h/mmHg. KUF value of a dialyzer is an “in vitro” measure which does not correlate with “in vivo” measure, stated to be 5-30% less than theoretical KUF. According to this statement, we wanted to study differences between theoretical and real KUF of two dialyzers with the same membrane composition and different surface area. For this task, we chose 2 dialyzers of usual use in our dialysis unit: FX CorDiax 1000 and FX CorDiax 80 (®FMC). These dialyzers have a main difference in Surface area: 2.3 and 1.8 m2, respectively, and have a theoretical KUF of 76 and 64 mL/h/mmHg. Also, both dialyzers differ in intern diameter (210 vs 185 µm). Method A prospective, not randomized trial was conducted. Inclusion criteria were patients in chronic dialysis at our center, in postdilutional online hemodiafiltration with a FX1000 dialyzer. All patients were informed and accepted freely signing an informed consentment. On 2 consecutive weeks, the intermediate dialysis session of the week was performed in a DBB-EXA dialysis monitor (®Nikkiso), first with a FX CorDiax 1000 and next week with a FX CorDiax 80, with habitual patient dialysis parameters (240 minutes). Blood tests were taken previous and after the session to evaluate clearance differences between both filters. During the session, pressure and flow data was recorded, with an “in vivo” KUF measurement given by the monitor. Results Dialysis sessions were performed in 12 patients who met inclusion criteria. Data results are shown in Table 1. Significant differences between FX CorDiax 1000 and FX CorDiax 80 were observed in prefilter pressure (p 0.008), convective volume (p 0.034), prolactin reduction ratio (p 0.012), “in vivo” KUF/ “in vitro” KUF ratio (p 0.002). “In vivo” KUF graphic given by the monitor showed a logarithmic function curve, with a stabilization between the 2nd and 3rd hour of the session. Conclusion In our study, measurement of “in vivo” KUF by Nikkiso monitor showed a slow decrease after 2nd hour of session, probably related with protein cake of membrane pores. “In vivo” KUF measure was approximately a 40-45% of theoretical value given by manufacturer. The “in vivo” KUF/ “in vitro” KUF ratio was higher for the smaller dialyzer, which probably means a higher optimization of its surface area with usual dialysis sessions. Convective volume and prolactin reduction ratio, as parameters of dialysis efficacy, are higher in the dialyzer with higher surface area and inner intern diameter.

Laser ablation for spongiform thyroid nodules: identifying baseline nodule volume and energy to be delivered for successful treatment.

Laser ablation (LA) is a minimally invasive treatment. It has been widely used since the early 2000s to induce volume reduction of symptomatic benign thyroid nodules. Up to 40% of laser-treated nodules have been reported to achieve a volume reduction of <50% (technique inefficacy) at 12 months and tend to regrow over time. This study aimed to assess the optimal baseline volume and energy to be delivered to minimize technique inefficacy. This was a retrospective study. Data were collected, including baseline volume, energy delivered, and 12-month volume reduction ratio (VRR) of spongiform nodules (EU-TIRADS 2) treated with LA between 2010 and 2020. Based on these data, the optimal baseline volume and energy to be delivered were calculated to maximize the rate of nodules with technique efficacy (VRR ≥ 50% at 12-month follow-up). A total of 205 patients with spongiform nodules were included in this study. The energy delivered was positively associated with VRR. However, no association was observed between baseline volume and VRR. Delivering energy ≥500 J/mL to nodules with a mean baseline volume of 11.4 ± 4 mL resulted in technique efficacy in 83% of cases. Treating spongiform nodules with a baseline volume of ≤15 mL and delivering energy ≥500 J/mL are key factors for achieving a relevant rate of technique efficacy.

Efficacy of microwave ablation in the treatment of large benign thyroid nodules: a multi-center study.

To evaluate the efficacy, safety, and improvement of symptoms by ultrasound-guided microwave ablation (MWA) for patients with large benign thyroid nodules (BTNs). Eighty-seven patients with 87 BTNs (≥ 4cm) treated with MWA between April 2015 and March 2021 were enrolled in this retrospective multicenter study, with clinical and ultrasound examinations performed at the 1st, 3rd, 6th, and 12th months. A multivariable linear mixed effects model was employed to explore the alterations in volume and volume reduction ratio (VRR), as well as the potential factors associated with VRR. The mean age of the 87 patients was 45.69 ± 14.21years (range 18-76years), and the ratio of men to women was 1:4.8. The mean volumes were much decreased at the 12th month after ablation compared to the initial volumes (p < .001). The mean VRR was 76.09% at the 12th month. The technique efficacy (VRR > 50%) was 90.80% at the 12th month. A multivariate analysis revealed that VRR was related to the initial volume (p = .015), annular flow (p = .010), and nodule composition (p = .024). The mean symptomatic score decreased from 4.40 ± 0.28 to 0.26 ± 0.06 at the 12th month (p < .001). At the same time, the mean cosmetic score decreased from 3.22 ± 0.10 to 1.31 ± 0.08 (p < .001). MWA could serve as a safe and effective therapy for large BTNs, significantly reducing the volume of BTNs and significantly improving compressive symptoms and appearance problems. Microwave ablation could serve as a safe and effective therapy for large benign thyroid nodules, leading to significant volume reduction and satisfied symptom and cosmetic alleviation period. • This multicenter study investigated the feasibility and safety of microwave ablation for large benign thyroid nodules. • After ablation, the nodule volume was significantly reduced, and patients' symptoms and appearance problems were significantly improved. • Microwave ablation is feasible for large benign thyroid nodules and has been a supplement treatment.

Safety and Clinical Outcomes of Two-Session Catheter-Directed Sclerotherapy Using Ethanol for Endometrioma.

To evaluate the safety and clinical outcome of two-session catheter-directed sclerotherapy (CDS) with 99% ethanol in patients with endometrioma. This prospective study was approved by the institutional review board with written informed consent obtained from all participants and was registered on clinicaltrial.gov. Consecutive patients with ovarian endometrioma between June 2020 and March 2023 were prospectively evaluated for two sessions of CDS. After successful transvaginal ultrasound-guided puncture of the endometrioma, the biopsy needle was exchanged for a 7- or 8.5-F catheter for aspiration and ethanol injection. The catheter was retained in situ for a second session the next day. Endometrioma volume was measured on ultrasound before and 1, 3, and 6 months after CDS, and volume reduction ratio (VRR) was calculated. Serum anti-Müllerian hormone (AMH) was measured before and 6 months after CDS to assess ovarian reserve. Thirty-one endometriomas in 22 patients (mean age, 31.0 years; range, 19-44 years) were treated; 28 endometriomas were successfully treated with two-session CDS, while one session was incomplete in three endometriomas in three patients due to contrast medium leakage or pain. Minor procedure-related complications developed in four patients and resolved spontaneously before discharge on the same day of the second session. No recurrence was identified during follow-up. At the 6-month follow-up, the mean endometrioma diameter decreased from 5.5 ± 1.7 to 1.4 ± 0.9 cm (P < 0.001), and the serum AMH level was lowered without statistical significance (1.37 ± 0.96 ng/mL vs. 1.18 ± 0.92 ng/mL; P = 0.170). VRRs at 1, 3, and 6 months after CDS were 84.3 ± 13.7%, 94.3 ± 5.8%, and 96.4 ± 4.7%, respectively. Two-session CDS with 99% ethanol is safe, feasible, and effective for treating endometrioma with the ovarian function well preserved.

Retention of nine micropollutants covering a wide range of physical-chemical properties using polyelectrolyte multilayer hollow fiber NF membranes

Our work investigates the efficiency of two polyelectrolyte multilayer hollow fiber nanofiltration (NF) membranes for the removal of nine micropollutants (MPs) from pre-treated wastewater. The Square Latin method was used to select the contaminants to study according to their molecular weight, hydrophilicity (log Kow), and charge at environmental pH. NF experiments were carried out in batch mode at 20 °C with a crossflow velocity of 1 m.s−1, and a transmembrane pressure of 3 bar. Retentions of MPs and salts were evaluated at various volume reduction ratios (1, 3 or 6), membrane molecular weight cut-off (400 or 800 Da) and fouling potential of the matrix (ultrapure water, synthetic water, or real pre-treated wastewater). Our study identified the 400 Da membrane as the best option as balance between MPs and salts retention was the most acceptable. With this membrane, two thirds of the investigated MPs showed a retention above 90 %, two MPs had a retention around 60 % and only one MP was retained less than 20 % while monovalent salts had a retention lower than 30 %. Our work identified size exclusion and electrostatic interactions as the main mechanisms involved in MPs retention by the negatively charged membrane. This membrane showed its efficiency to maintain high permeation flux during 24 h-filtration of stream with organic matter content comparable to secondary-treated wastewater to a volume reduction ratio up to 6. At this content, organic matter did not modify retention of micropollutants or salts. The selected membrane is an encouraging tool to produce MPs-free water from pre-treated wastewater without producing a highly saline retentate. In the future, permeate would possibly be employed for REUSE purposes.

Radiofrequency ablation for papillary thyroid microcarcinoma with a trachea-adjacent versus trachea-distant location

Objective To evaluate the outcomes of radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) adjacent to the trachea and compare them with those of PTMC distant from the trachea. Methods Patients who received RFA for solitary low-risk PTMC between June 2014 and July 2020 were reviewed and classified into adjacent and distant groups. To balance between-group confounders, the propensity score matching approach was employed. Volume, volume reduction ratio (VRR), tumor disappearance, complications, and disease progression were assessed and compared between the groups. Furthermore, factors affecting disease progression were evaluated. Results A total of 122 and 470 patients were included in the adjacent and distant groups, respectively. Overall VRR was 99.5% ± 3.1 and cumulative tumor disappearance rate was 99.4% after a mean follow-up time of 40.1 months ± 16.2. Overall disease progression and complications incidence were 3.7% and 1.0%, respectively. No substantial differences were observed between the two groups in the latest volume (0.8 mm3 ± 4.1 vs. 0.9 mm3 ± 4.2, p = .77), VRR (99.7% ± 1.6 vs. 99.5% ± 2.7, p = .75), cumulative tumor disappearance rate (92.6% vs. 94.2%, p = .58), and incidence of disease progression (4.1% vs. 4.5%, p = .70) and complication (1.7% vs. 0.8%, p = .86) after 1:2 matching. Additionally, tracheal adjacency exhibited no association with disease progression in multivariate Cox regression analysis (p = .73). Conclusion For eligible patients with PTMC located adjacent to or distant from the trachea, RFA may offer a safe and effective alternative treatment method.

Radiofrequency ablation for capsular-located versus noncapsular-located papillary thyroid microcarcinoma: a propensity score matching study of 1095 patients.

To assess the safety and efficacy of radiofrequency ablation (RFA) for capsular-located papillary thyroid microcarcinoma (PTMC) in a large cohort and to compare its outcomes with those of noncapsular-located PTMC. We retrospectively reviewed patients who underwent RFA for solitary capsular-located and noncapsular-located low-risk PTMC (n = 1095) from June 2014 to October 2020. To balance confounding variables between capsular and noncapsular groups, we employed the 1:1 propensity score matching approach. We evaluated and compared tumor changes, disease progression, and complications in both groups. Furthermore, we analyzed the association between capsular location and disease progression using multivariable Cox regression. During a mean follow-up time of 29.86 ± 16.14months and 29.73 ± 15.69months, no substantial difference was observed between capsular and noncapsular groups in the latest volume (0.83 ± 3.66 mm3 vs. 0.85 ± 3.67 mm3, p = 0.44) and volume reduction ratio (99.29 ± 4.04% vs. 99.43 ± 3.03%, p = 0.43), and cumulative disappearance rate (87.87% vs. 86.07%, p = 0.31). In addition, no significant differences were observed in complication incidence (1.35% vs. 1.12%, p = 0.76) and progression-free survival (p = 0.53). Based on adjusted multivariate Cox proportional hazard analysis, the association between capsular location and disease progression was nonsignificant (all p > 0.05). This study demonstrates that the short-term outcomes of RFA for capsular-located PTMCs are comparable to those of noncapsular-located PTMCs. These findings indicate that RFA may be a viable and effective alternative for eligible patients with solitary capsular-located PTMC. Radiofrequency ablation may serve as a safe and effective alternative treatment method for eligible patients with capsular-located and noncapsular-located papillary thyroid microcarcinoma. • The safety and efficacy of radiofrequency ablation for capsular-located and noncapsular-located papillary thyroid microcarcinomas were comparable. • Disease progression did not differ significantly between capsular-located and noncapsular-located papillary thyroid microcarcinomas. • The incidence of complications for capsular-located papillary thyroid microcarcinoma was low.