Effects of percutaneous laser ablation treatment in benign solitary thyroid nodules on nodule volume, thyroglobulin and anti-thyroglobulin levels, and cytopathology of nodule in 1 yr follow-up

Çakır, Bekir; Topaloğlu, Oya; Gül, Kamile; Agac, Tuba; Aydın, Cevdet; Dirikoç, Ahmet; Gümüş, Mehmet; Yazıcıoğlu, Kemal Rıdvan; Ersoy, Reyhan; Uğraş, Serdar

doi:10.1007/bf03349190

Cited by 54 publications

(44 citation statements)

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“…During the last two decades, nonsurgical alternative treatments have been introduced for patients with symptomatic benign thyroid nodules (6,18,20,21,23,(25)(26)(27)(28). Both ethanol injection and thermal energy have proven effective in inducing necrosis and subsequent nodule shrinkage.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules

Døssing¹,

Bennedbæk²,

Hegedűs³

2011

European Journal of Endocrinology

120

103

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Aim: To evaluate the long-term efficacy of interstitial laser photocoagulation (ILP) in solitary benign thyroid nodules. Design and methods: A total of 78 euthyroid outpatients (45 participating in randomized trials) with a benign solitary solid and scintigraphically cold thyroid nodule causing local discomfort were assigned to ILP. ILP (using one laser fiber) was performed under continuous ultrasound (US) guidance and with an output power of 1.5-3.5 W. Thyroid nodule volume was assessed by US and thyroid function determined by routine assays, before and during follow-up. Pressure symptoms and cosmetic complaints were evaluated on a visual analogue scale (0-10 cm). Of the total patients, six had thyroid surgery 6 months after ILP and three were lost to follow-up. The median follow-up for the remaining 69 patients was 67 months (range 12-114). Results: The overall median nodule volume decreased from 8.2 ml (range 2.0-25.9) to 4.1 ml (range 0.6-33.0; P!0.001) at the final evaluation, corresponding to a median reduction of 51% (range: K194 to 95%). This correlated with a significant decrease in pressure as well as cosmetic complaints. After 12-96 months (median 38 months) of ILP, 21 patients (29%) had thyroid surgery because of an unsatisfactory result. All had benign histology. Thyroid function was unaltered throughout and side effects were restricted to mild local pain. Conclusion: US-guided ILP results in a satisfactory long-term clinical response in the majority of patients with a benign solitary solid cold thyroid nodule. Further large-scale studies should aim at optimizing selection criteria for ILP, preferably in randomized studies.

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Section: Discussionmentioning

confidence: 99%

Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules

Døssing¹,

Bennedbæk²,

Hegedűs³

2011

European Journal of Endocrinology

120

103

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“…Surgery was not indicated because of the small size of the nodule and the patient's reservation toward surgery. Alternative treatments, such as ethanol injection, 3,4 laser, 6,12,13 or radio-frequency ablation, 5 have been reported. Thyroid function is normalized after ethanol injection in approximately 60%-80% of pretoxic nodules and 35%-85% of toxic nodules.…”

Section: Discussionmentioning

confidence: 99%

“…After laser ablation, cure rates of 61%-100% have been reported. 6,13 Radio-frequency ablation has also been suggested as a potential nonsurgical therapeutic option. 5 These procedures are all minimally invasive, requiring, in the case of radio-frequency ablation, the insertion of electrodes into the thyroid nodule and at least 1.5-cm safety margins around the surrounding organs.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Ablation of a Toxic Thyroid Nodule by High-Intensity Focused Ultrasound

Esnault¹,

Rouxel²,

Nestour³

et al. 2010

AJNR Am J Neuroradiol

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SUMMARY: HIFU is used in the treatment of cancer (prostate, breast) and uterine fibroma but not yet in TNs. This case report describes the first successful ablation of a toxic TN with HIFU. TSH and radioiodine scan normalization were achieved without complications and maintained for 18 months. HIFU treatment is a minimally invasive technique that may be an effective safe alternative to radioiodine or surgery in patients with toxic TNs.ABBREVIATIONS: AFTN ϭ autonomously functioning thyroid nodule; ENT ϭ ears, nose, and throat; FT 3 ϭ triiodothyronine, free; FT 4 ϭ thyroxine, free; HIFU ϭ high-intensity focused ultrasound; 123 I ϭ iodine 123; TN ϭ thyroid nodule; TSH ϭ thyroid-stimulating hormone, thyrotropin P atients with AFTNs present with overt (toxic adenoma) or subclinical (pretoxic adenoma) hyperthyroidism. Standard definitive treatments are surgery or radioiodine.

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“…The patient is placed in a supine position with neck hyperextended. The procedure is performed under ultrasound system guidance [59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74]. In most studies, a 21-G needle is inserted into the lesion along its longest axis.…”

Section: La Devices and Proceduresmentioning

confidence: 99%

“…In two studies, the power increases more than 3.5 W [64,73]. The number of fibers, number of pullbacks, and total energy delivered are tailored to nodule volume and shape.…”

Section: La Devices and Proceduresmentioning

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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Effects of percutaneous laser ablation treatment in benign solitary thyroid nodules on nodule volume, thyroglobulin and anti-thyroglobulin levels, and cytopathology of nodule in 1 yr follow-up

Abstract: US-guided PLA is a new, successful treatment method which is reliable in the long term in benign solid thyroid nodules for selected patients who are inoperable or do not prefer surgery.

Cited by 54 publications

References 10 publications

Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules

Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules

Minimally Invasive Ablation of a Toxic Thyroid Nodule by High-Intensity Focused Ultrasound

Image-guided thermal ablation of benign thyroid nodules

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