Abstract
Purpose
Radiofrequency ablation has been advocated as an alternative to radioiodine and/or surgery for the treatment of autonomously functioning benign thyroid nodules. However, only a few studies have measured radiofrequency ablation efficacy on autonomously functioning benign thyroid nodules. The aim of this work was to evaluate the 12-month efficacy of a single session of radiofrequency ablation (performed with the moving shot technique) on solitary autonomously functioning benign thyroid nodules.
Methods
Thirty patients with a single, benign autonomously functioning benign thyroid nodules, who were either unwilling or ineligible to undergo surgery and radioiodine, were treated with radiofrequency ablation between April 2012 and May 2015. All the patients underwent a single radiofrequency ablation, performed with the 18-gauge needle and the moving shot technique. Clinical, laboratory, and ultrasound evaluations were scheduled at baseline, and after 1, 3, 6, and 12 months from the procedure.
Results
A single radiofrequency ablation reduced thyroid nodule volume by 51, 63, 69, and 75 % after 1, 3, 6, and 12 months, respectively. This was associated with a significant improvement of local cervical discomfort and cosmetic score. As for thyroid function, 33 % of the patients went into remission after 3 months, 43 % after 6 months, and 50 % after 12 months from the procedure. This study demonstrates that a single radiofrequency ablation allowed us to withdraw anti-thyroid medication in 50 % of the patients, who remained euthyroid afterwards.
Conclusion
This study shows that a single radiofrequency ablation was effective in 50 % of patients with autonomously functioning benign thyroid nodules. Patients responded gradually to the treatment. It is possible that longer follow-up studies might show greater response rates.
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References
H. Gharib, L. Hegedus, C.M. Pacella, J.H. Baek, E. Papini, Clinical review: nonsurgical, image-guided, minimally invasive therapy for thyroid nodules. J. Clin. Endocrinol. Metab. 98(10), 3949–3957 (2013)
E. Papini, C.M. Pacella, L. Hegedus, Diagnosis of endocrine disease: thyroid ultrasound (US) and US-assisted procedures: from the shadows into an array of applications. Eur. J. Endocrinol. 170(4), R133–R146 (2014)
R. Garberoglio, C. Aliberti, M. Appetecchia, M. Attard, G. Boccuzzi, F. Boraso, G. Borretta, G. Caruso, M. Deandrea, M. Freddi, G. Gallone, G. Gandini, G. Gasparri, C. Gazzera, E. Ghigo, M. Grosso, P. Limone, M. Maccario, L. Mansi, A. Mormile, P.G. Nasi, F. Orlandi, D. Pacchioni, C.M. Pacella, N. Palestini, E. Papini, M.R. Pelizzo, A. Piotto, T. Rago, F. Riganti, L. Rosato, R. Rossetto, A. Scarmozzino, S. Spiezia, O. Testori, R. Valcavi, A. Veltri, P. Vitti, M. Zingrillo, Radiofrequency ablation for thyroid nodules: which indications? The first Italian opinion statement. J. Ultrasound 18(4), 423–430 (2015)
J.H. Baek, H.J. Jeong, Y.S. Kim, M.S. Kwak, D. Lee, Radiofrequency ablation for an autonomously functioning thyroid nodule. Thyroid 18(6), 675–676 (2008)
M. Deandrea, P. Limone, E. Basso, A. Mormile, F. Ragazzoni, E. Gamarra, S. Spiezia, A. Faggiano, A. Colao, F. Molinari, R. Garberoglio, US-guided percutaneous radiofrequency thermal ablation for the treatment of solid benign hyperfunctioning or compressive thyroid nodules. Ultrasound Med. Biol. 34(5), 784–791 (2008)
S. Spiezia, R. Garberoglio, F. Milone, V. Ramundo, C. Caiazzo, A.P. Assanti, M. Deandrea, P.P. Limone, P.E. Macchia, G. Lombardi, A. Colao, A. Faggiano, Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid 19(3), 219–225 (2009)
A. Faggiano, V. Ramundo, A.P. Assanti, F. Fonderico, P.E. Macchia, C. Misso, F. Marciello, V. Marotta, M. Del Prete, E. Papini, G. Lombardi, A. Colao, S. Spiezia S, Thyroid nodules treated with percutaneous radiofrequency thermal ablation: a comparative study. J. Clin. Endocrinol. Metab. 97(12), 4439–4445 (2012)
J.H. Baek, W.J. Moon, Y.S. Kim, J.H. Lee, D. Lee, Radiofrequency ablation for the treatment of autonomously functioning thyroid nodules. World J. Surg. 33, 1971–1977 (2009)
S. Bernardi, C. Dobrinja, B. Fabris, G. Bazzocchi, N. Sabato, V. Ulcigrai, M. Giacca, E. Barro, N. De Manzini, F. Stacul, Radiofrequency ablation compared to surgery for the treatment of benign thyroid nodules. Int. J. Endocrinol. 2014, 934595 (2014)
Y. Che, S. Jin, C. Shi, L. Wang, X. Zhang, Y. Li, J.H. Baek, Treatment of benign thyroid nodules: comparison of surgery with radiofrequency ablation. AJNR Am. J. Neuroradiol. 36(7), 1321–1325 (2015)
J.Y. Sung, J.H. Baek, S.L. Jung, J.H. Kim, K.S. Kim, D. Lee, W.B. Kim, D.G. Na, Radiofrequency ablation for autonomously functioning thyroid nodules: a multicenter study. Thyroid 25(1), 112–117 (2015)
P. Adams, T. Ghanem, R. Stachler, F. Hall, V. Velanovich, I. Rubinfeld, Frailty as a predictor of morbidity and mortality in inpatient head and neck surgery. JAMA. Otolaryngol. Head Neck Surg. 139(8), 783–789 (2013)
D.G. Na, J.H. Lee, S.L. Jung, J.H. Kim, J.Y. Sung, J.H. Shin, E.K. Kim, J.H. Lee, D.W. Kim, J.S. Park, K.S. Kim, S.M. Baek, Y. Lee, S. Chong, J.S. Sim, J.Y. Huh, J.I. Bae, K.T. Kim, S.Y. Han, M.Y. Bae, Y.S. Kim, J.H. Baek, Radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: consensus statement and recommendations. Korean J. Radiol. 13(2), 117–125 (2012)
C. Dobrinja, S. Bernardi, B. Fabris, R. Eramo, P. Makovac, G. Bazzocchi, L. Piscopello, E. Barro, N. de Manzini, D. Bonazza, M. Pinamonti, F. Zanconati, F. Stacul, Surgical and pathological changes after radiofrequency ablation of thyroid nodules. Int J. Endocrinol. 2015, 576576 (2015)
M. Ahmed, L. Solbiati, C.L. Brace, D.J. Breen, M.R. Callstrom, J.W. Charboneau, M.H. Chen, B.I. Choi, T. de Baere, G.D. Dodd 3rd, D.E. Dupuy, D.A. Gervais, D. Gianfelice, A.R. Gillams, F.T. Lee Jr., E. Leen, R. Lencioni, P.J. Littrup, T. Livraghi, D.S. Lu, J.P. McGahan, M.F. Meloni, B. Nikolic, P.L. Pereira, P. Liang, H. Rhim, S.C. Rose, R. Salem, C.T. Sofocleous, S.B. Solomon, M.C. Soulen, M. Tanaka, T.J. Vogl, B.J. Wood, S.N. Goldberg, International working group on image-guided tumor ablation, interventional oncology sans frontieres expert panel, technology assessment committee of the society of interventional radiology, standard of practice committee of the c, interventional radiological society of europe, image-guided tumor ablation: standardization of terminology and reporting criteria--a 10-year update. Radiology 273(1), 241–260 (2014)
H. Gharib, E. Papini, R. Valcavi, H.J. Baskin, A. Crescenzi, M.E. Dottorini, D.S. Duick, R. Guglielmi, C.R. Hamilton Jr., M.A. Zeiger, M. Zini, Nodules A.A.E.T.F.O.T. nodules, American association of clinical endocrinologists, associazione medici endocrinologi, and European thyroid association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr. Pract. 12(1), 63–102 (2006)
F. von Muller, C. Happel, J. Reinhardt, W.T. Kranert, B. Bockisch, D. Groner, H. Ackermann, F. Grunwald, Evaluation of fear of radiation and isolation before and after radioiodine therapy. Thyroid 24(7), 1151–1155 (2014)
S. Bernardi, V. Lanzilotti, G. Papa, N. Panizzo, C. Dobrinja, B. Fabris, F. Stacul, Full-thickness skin burn caused by radiofrequency ablation of a benign thyroid nodule. Thyroid 26(1), 183–184 (2016)
J.H. Baek, J.H. Lee, J.Y. Sung, J.I. Bae, K.T. Kim, J. Sim, S.M. Baek, Y.S. Kim, J.H. Shin, J.S. Park, D.W. Kim, J.H. Kim, E.K. Kim, S.L. Jung, D.G. Na, Korean society of thyroid radiology, complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study. Radiology 262(1), 335–342 (2012)
S.J. Bonnema, L. Hegedus, Radioiodine therapy in benign thyroid diseases: effects, side effects, and factors affecting therapeutic outcome. Endocr. Rev. 33(6), 920–980 (2012)
L. Rosato, N. Avenia, P. Bernante, M. De Palma, G. Gulino, P.G. Nasi, M.R. Pelizzo, L. Pezzullo, Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J. Surg. 28(3), 271–276 (2004)
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Stella Bernardi declares that she has no conflict of interest. Fulvio Stacul declares that he has no conflict of interest. Andrea Michelli declares that he has no conflict of interest. Fabiola Giudici declares that she has no conflict of interest. Giulia Zuolo declares that she has no conflict of interest. Nicolò de Manzini declares that he has no conflict of interest. Chiara Dobrinja declares that she has no conflict of interest. Fabrizio Zanconati declares that he has no conflict of interest. Bruno Fabris declares that he has no conflict of interest.
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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Azienda Ospedaliero-Universitaria di Trieste–Ospedali Riuniti di Trieste, Trieste Italy) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Bernardi, S., Stacul, F., Michelli, A. et al. 12-month efficacy of a single radiofrequency ablation on autonomously functioning thyroid nodules. Endocrine 57, 402–408 (2017). https://doi.org/10.1007/s12020-016-1174-4
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DOI: https://doi.org/10.1007/s12020-016-1174-4