Comparison of Sonographically Guided Percutaneous Sodium Tetradecyl Sulfate Injection with Ethanol Injection in the Treatment of Benign Nonfunctioning Thyroid Nodules

Kalra, Naveen; Ahuja, Chirag Kamal; Dutta, Pinaki; Rajwanshi, Arwind; Mittal, Bhagwant Rai; Bhansali, Anil; Khandelwal, Niranjan

doi:10.1016/j.jvir.2014.04.026

Cited by 13 publications

(2 citation statements)

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“…However, only one of the included studies compared EA with another form of sclerotherapy [9]. In fact, a variety of sclerosants in addition to ethanol have been adopted for the treatment of thyroid nodules, including tetracycline, sodium tetradecyl sulfate, N-butyl cyanoacrylate, and polidocanol [46][47][48][49]. Among them, polidocanol and sodium tetradecyl sulfate were compared with EA and were shown to have similar VRRs, but higher costs [9,47].…”

Section: Discussionmentioning

confidence: 99%

“…In fact, a variety of sclerosants in addition to ethanol have been adopted for the treatment of thyroid nodules, including tetracycline, sodium tetradecyl sulfate, N-butyl cyanoacrylate, and polidocanol [46][47][48][49]. Among them, polidocanol and sodium tetradecyl sulfate were compared with EA and were shown to have similar VRRs, but higher costs [9,47]. Several factors are known to compromise the efficacy of EA, particularly for PCTNs, including a relatively large initial nodule volume (>20 mL), increased vascularity, a solid portion >20% of the total nodule, and a relatively low degree of cystic fluid aspiration prior to ethanol instillation [35,45,50,51].…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Ethanol Ablation for Benign Thyroid Cysts and Predominantly Cystic Nodules: A Systematic Review and Meta-Analysis

2021

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Background: Ultrasound-guided minimally invasive procedures are widely used to treat thyroid diseases. The objective of this study was to assess the efficacy and safety of ethanol ablation (EA) in comparison with other non-surgical options in the treatment of benign thyroid cystic nodules. Methods: We conducted a systematic search of studies on EA for thyroid cystic nodules, mainly in the Ovid-MEDLINE and Embase, Web of Science, and Cochrane databases. The standardized mean difference (SMD) of the volume reduction ratio (VRR) after EA versus other non-surgical treatments comprised the primary outcome, whereas the odds ratio (OR) of therapeutic success rates between the two groups comprised the secondary outcome. Results: The meta-analysis included 19 studies (four randomized controlled trials and 15 non-randomized studies) with 1,514 participants. The cumulative VRR of EA was 83.908% (95% confidence interval [CI], 79.358% to 88.457%). EA had a significantly higher pooled VRR (SMD, 0.381; 95% CI, 0.028 to 0.734; P=0.030), but not a significantly higher pooled therapeutic success rate (OR, 0.867; 95% CI, 0.132 to 5.689; P=0.880), than other forms of non-surgical management including radiofrequency ablation (RFA), polidocanol sclerotherapy, and simple aspiration with or without saline flush. However, the VRR and therapeutic success rate were not significantly different between EA and RFA. Major complications were recorded only in six patients (0.53%) with self-limiting dysphonia. Conclusion: The role of EA as the first-line treatment for benign thyroid cysts and predominantly cystic nodules is supported by its high effectiveness and good safety profile compared to other currently available non-surgical options.

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