Diagnostic Accuracy of Elastography and Scintigraphic Imaging After Thermal Microwave Ablation of Thyroid Nodules

Korkusuz, H.; Happel, Christian; Klebe, Julia; Ackermann, Hanns; Grünwald, Frank

doi:10.1055/s-0034-1385827

Cited by 14 publications

(9 citation statements)

References 31 publications

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“…It has been shown that tracer uptake after MWA ablation and during the follow-up was significantly reduced in the ablated tissue. Further research is necessary to establish the real role of scintigraphic imaging in follow-ups after MWA is used in the treatment of benign thyroid nodules [83,84].…”

Section: Clinical Resultsmentioning

confidence: 99%

Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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Benign thyroid nodules are a common disease in the general population. Most often, they are completely asymptomatic and discovered occasionally during routine ultrasound examinations, and do not require any treatment. When thyroid nodules become symptomatic, surgical excision is still considered standard treatment. In the last few years, several experiences in the treatment of benign thyroid nodules through image-guided percutaneous thermal ablation have been reported with encouraging results, so that currently, these treatments are often proposed as first-choice options for patients with symptomatic benign thyroid nodules. In this paper, we discuss the present literature on the topic, focusing on different techniques available for image-guided percutaneous ablation, particularly radiofrequency (RFA), laser (LA), microwave (MWA), and high-intensity-focus ultrasound (HIFU). Little evidence about the efficacy of MWA and HIFU is now available. According to the literature, good results have been obtained with RFA and LA. Regarding RFA, volume reduction after ablative treatment has been found to range from 47 to 84 % at 3-6 months, and from 62 to 93 % at 1 year; LA also seems to be effective in achieving shrinkage of thyroid nodules, with volume reduction from 37 to 81 % at 3-6 months, and from 13 to 82 % at 1-year follow-up. Moreover, applications of advanced image-guidance modality, such as contrast-enhanced ultrasound and virtual navigation with fusion imaging, are discussed.Keywords Laser Á Radiofrequency Á Microwave Á Highintensity focused ultrasound Á Thyroid nodule SOMMARIO I noduli benigni della tiroide sono una evenienza comune nella popolazione generale. Più spesso vengono scoperti occasionalmente durante un esame ecografico fatto per altri motivi, sono asintomatici e non richiedono alcun trattamento. Qualora i noduli diventino sintomatici, l'escissione chirurgica è ancora considerato il trattamento standard. Tuttavia, negli ultimi anni, è cresciuta l'esperienza circa il trattamento di tali noduli tramite ablazione percutanea sotto guida ecografica tanto che, attualmente, questo viene spesso proposto come trattamento di scelta. Lo scopo del nostro lavoro è fare una revisione della letteratura riguardante l'argomento, con un particolare focus sulle differenti tecniche attualmente a disposizione, in particolare radiofrequenza (RFA), laser (LA), microonde (MWA) e high-intensity-focus ultrasound (HIFU). Al momento ci sono ancora poche evidenze sull'efficacia di MWA e HIFU. Secondo quanto riportato in letteratura, buoni risultati sono stati ottenuti con RFA e LA. Riguardo la radiofrequenza, la riduzione volumetrica dopo la procedura ablativa va da 47 a 84 % a 3-6 mesi e da 62 a 93 % a 1 anno; anche il laser sembra essere efficace nel causare la riduzione del nodulo, con percentuali che vanno da 37 a 81 % a 3-6-mesi a da 13 a 82 % a 1 anno di follow-up Abbiamo poi discusso brevemente le

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Section: Clinical Resultsmentioning

confidence: 99%

Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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“…It is not known to what extent this technology may aid in the management of positron emission tomography/computed tomography (PET/CT)-positive thyroid incidentalomas [104,105]. The value of US elastography for treatment monitoring of TN during and after radiofrequency, microwave, or laser ablation has not been studied sufficiently [106-108]. The value of US elastography-guided FNA biopsy of TNs in reducing nondiagnostic results needs to be further evaluated [109].…”

Section: Summary and Future Directionsmentioning

confidence: 99%

Ultrasound elastography of the thyroid: principles and current status

Zhao

2019

Ultrasonography

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Ultrasound (US) elastography has been introduced as a non-invasive technique for evaluating thyroid diseases. This paper presents a detailed description of the technical principles, peculiarities, and limitations of US elastography techniques, including strain elastography and shear-wave elastography. This review was conducted from a clinical perspective, and aimed to assess the usefulness of US elastography for thyroid diseases in specific clinical scenarios. Although its main focus is on thyroid nodules, the applications of US elastography for other thyroid diseases, such as diffuse thyroid diseases and thyroiditis, are also presented. Furthermore, unresolved questions and directions for future research are also discussed.

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“…No significant differences between the changes of elasticity, echogenicity and vascularization after cMWA and uMWA were observed. Thermal ablation procedure leads to elevated tissue stiffness (elasticity change) due to protein denaturation and dehydration [15] , [23] . Feng et.…”

Section: Discussionmentioning

confidence: 99%

“…Depending on the target area and the volume of the nodule (14–16 G; small, medium or large), different probes can be used to achieve the target temperature of 60–80 °C (max. 140 °C) with an ablation field of 1–4 cm [14] , [15] , [16] . The frequency is automatically controlled with real-time temperature and reverse-power feedback during ablation to optimize ablation safety, efficiency, energy transfer, and predictability.…”

Section: Methodsmentioning

confidence: 99%