2022 Taiwan clinical multicenter expert consensus and recommendations for thyroid radiofrequency ablation

Wang, Lin; Chen, WenChieh; Wang, Pei‐Wen; Chan, Yi‐Chia; Chang, Yen‐Hsiang; Chen, Harn-Shen; Chen, Szu-Tah; Chen, Wei-Chih; Cheng, Kai-Lun; Chi, Shun‐Yu; Chiang, Pi-Ling; Chou, Chen‐Kai; Chou, Feng-Fu; Huang, Shun‐Chen; Liu, Feng-Hsuan; Luo, Sheng‐Dean; Tseng, Fen‐Yu; Wang, Chih‐Yuan; Wang, Wen‐Hung; Wu, Mei‐Hwan

doi:10.14366/usg.22126

Cited by 12 publications

(2 citation statements)

References 187 publications

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“…2020년 이후로 유럽, 미국, 대만 등 세계 각지에서 갑상선암에 대한 고주파 절제술의 역할에 대한 가이드라인들을 제시하고 있으며, 특히 미세유두암에 대한 고주파 절제술의 임상 적용에 대해 다소 논란은 있지만, 그 가능성에 대한 기대가 점점 더 증가되는 실정이다( 44 45 46 47 ).…”

Section: 갑상선암의 고주파 절제술에 대한 진료지침unclassified

Application of Radiofrequency Ablation to Thyroid Cancer: Past, Present, and Future

Kim

2023

J Korean Soc Radiol

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발생률이 높고, 예후는 좋지만 재발을 잘하는 경향이 있는 갑상선암에서도 전통적인 치료법은 수술이다. 하지만, 2000년대 초반부터, 간암, 폐암, 신장암에서와 마찬가지로 고주파 절제술이 원발 갑상선암 및 재발 갑상선암에 적용되기 시작했다. 원발암에서는 1 cm 이하 크기의 미세유두암 저위험군에서 수술 불가능한 경우에 대한 많은 연구가 이뤄져 왔고, 1 cm보다 더 크고 4 cm 이하의 다양한 군에 대해서도 일부 연구가 시행되었으며, 전반적으로 모두 양호한 결과를 보고하였다. 재발암에 대해서도 주로는 국소 경부 재발암에 고주파 절제술이 시행되었으며, 일부 폐, 뼈 등의 원격 전이에 대해서도 시도되었고, 전반적으로 양호한 결과가 보고되었다. 최근 들어, 한국, 미국, 유럽 등 각지에서 갑상선암의 고주파 절제술에 대해 옹호하는 움직임이 있다. 하지만, 미국 국립 종합 암 네트워크(National Comprehensive Cancer Network) 등의 중립적인 임상지침에는 고주파 절제술이 아직 인정되지는 않은 상태이다. 지금까지의 노력들과 미래의 연구를 바탕으로 향후 가까운 미래에 갑상선암의 치료에 있어 고주파 절제술이 적절한 자리매김을 할 것으로 전망한다.

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Section: 갑상선암의 고주파 절제술에 대한 진료지침unclassified

Application of Radiofrequency Ablation to Thyroid Cancer: Past, Present, and Future

Kim

2023

J Korean Soc Radiol

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“…According to international guidelines, Bethesda III thyroid nodules are not considered an indication of radiofrequency ablation (RFA) ( 6 , 7 , 8 ). Patients with Bethesda III thyroid nodules or those undergoing regular follow-up, or even those undergoing repeated FNAC or core needle biopsy (CNB) examinations, may experience psychological stress and burden.…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency ablation for thyroid Bethesda III nodules: preliminary results

Chiang,

Luo,

Chang

et al. 2023

European Thyroid Journal

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Purpose: The purpose of this study was to evaluate the feasibility of radiofrequency ablation (RFA) for thyroid nodules with cytological atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS, Bethesda III). Materials and Methods: A total of 28 adults presenting with 30 initial Bethesda III nodules underwent thyroid RFA at a single medical center. Thyroid nodules with Bethesda IV or V according to the second aspiration were excluded. All RFA procedures were performed using the free-hand, “moving-shot’’ technique under local anesthesia. Clinical features and demographics, RFA details, nodule volume reduction rate (VRR), and complications were analyzed. Results: The mean age of patients was 47.6 years, 82.1% of whom were females. Mean nodule volumes at pre-RFA, and at 6 months and 12 months post-RFA were 7.92, 2.42, and 1.25 mL, respectively, with a VRR of 77.9% at 6 months, and 87.4% at 12 months. Post-RFA complications were noted in two patients, one with transient vocal cord palsy and another with isthmus minor rupture. Conclusion: RFA may be another safe alternative except for active surveillance or surgical excision for AUS/FLUS nodules with low-suspicion TI-RADS features for patients who are unsuitable or strongly refuse surgery. Long-term results remain uncertain, thus further follow-up study is necessary.

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Thyroid Radiofrequency Ablation‐Thermal Effects on Recurrent Laryngeal Nerve Using Continuous Intraoperative Neuromonitoring Animal Model

Huang,

Wang,

Tseng

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveWhen performing radiofrequency ablation for thyroid nodules, it is essential to avoid thermal injury to the recurrent laryngeal nerve. This porcine animal model study used continuous intraoperative neuromonitoring to investigate the thermal safety parameters of thyroid radiofrequency ablation.Study DesignPorcine animal study.SettingUniversity animal laboratory.MethodsTwelve piglets were tested at different radiofrequency power levels, and the real‐time electromyography signal changes were recorded under continuous intraoperative neuromonitoring. The spread heat study (8 piglets) included spontaneous recovery tests and cold water irrigation tests to investigate the safety distance from the recurrent laryngeal nerve to the active tip during 5‐second activation with standard stimulation patterns. The residual heat study (4 piglets) investigated the safety cooling durations by touching the recurrent laryngeal nerve with the tip after a 5‐second activation.ResultsIn the spread heat study, substantial signal attenuation events were observed at an spread heat distance of 2, 3, 5, and 5 mm when the power was set as 10, 20, 30, and 50 W, respectively. No signal recovery could be observed in 20 minutes with or without cold water irrigation in the injured recurrent laryngeal nerve area. The residual heat study shows the residual thermal effect of the tip is minimal, and no substantial signal attenuation event was observed at all experiments.ConclusionsThis innovative study established the thermal safety parameters for radiofrequency ablation in a porcine model at various power levels, which can potentially assist operators in delineating a precise ablation field and providing effective thyroid ablation treatment safely.

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2022 Taiwan clinical multicenter expert consensus and recommendations for thyroid radiofrequency ablation

Cited by 12 publications

References 187 publications

Application of Radiofrequency Ablation to Thyroid Cancer: Past, Present, and Future

Application of Radiofrequency Ablation to Thyroid Cancer: Past, Present, and Future

Radiofrequency ablation for thyroid Bethesda III nodules: preliminary results

Thyroid Radiofrequency Ablation‐Thermal Effects on Recurrent Laryngeal Nerve Using Continuous Intraoperative Neuromonitoring Animal Model

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