Efficacy and safety of single-session radiofrequency ablation for benign thyroid nodules of different sizes: a retrospective study

Abstract

Purpose: To compare the effectiveness of radiofrequency ablation (RFA) for benign thyroid nodules (BTNs) among groups presenting with different nodule volumes. Materials and methods: This retrospective study evaluated 186 patients with BTNs who underwent ultrasound guided RFA treatment. The BTNs were categorized into small (10 ml); medium (10-30 ml); and large (>30 ml) according to the initial volume of BTNs before ablation. The RFA procedures were performed using the moving shot technique. The volume reduction ratio (VRR) of each nodule, cosmetic score, symptomatic score, and complications were analyzed at 1, 3, and 6 months after RFA treatment and the three groups compared. Results: At 1-month follow-up, the large nodules group showed significantly greater VRR compared to the other two groups (small, 31.88% ± 37.91; medium, 38.9% ± 19.18; large, 48.7% ± 20.43, p ¼ .03). At 6-month follow-up, there was no significant difference of VRR among the three groups (small, 74.6% ± 20.92; medium, 68.1% ± 17.07; large, 75.0% ± 11.88). The most common presented complication was temporary vocal palsy (6 patients; small, n ¼ 1; medium, n ¼ 1; large, n ¼ 3). Additionally, one skin burn, one hematoma, and one nodular rupture of BTNs occurred after the procedures. The complication rate of the large nodules group was highest among the three groups and showed a considerable difference (8 patients; small, n ¼ 1, 2.1%; medium, n ¼ 2, 4.5%; large, n ¼ 5, 11.4%, p ¼ .061). Conclusions: RFA was confirmed as effective in patients with large thyroid nodule (>30ml), with therapeutic efficacy similar to patients with smaller thyroid nodules.

Comparison of radiofrequency ablation and microwave ablation for benign thyroid nodules: A systematic review and meta‐analysis

“…Currently, there is no consensus on the time points of follow-up evaluation after thermal ablation. However, most of previous articles 12,14,15 reported the volume reduction ratios and improvements of symptoms at 1, 3, 6, or 12 months after the ablation treatment of thyroid nodules. Additionally, some studies [16][17][18] suggested that ultrasound examinations and the clinical symptoms could be routinely evaluated at 1, 3, 6 and 12 months after the ablation.…”

Efficacy and safety of ultrasound-guided radiofrequency ablation for low-risk papillary thyroid microcarcinoma in patients aged 55 years or older: a retrospective study

“…The formula for the calculation of the tumor volume was V ¼ pabc/6 [22,23] (V was the volume; a was the longest diameter, and b and c were the other two diameters of the tumor). The tumor locations were recorded as left and right lobes and cephalocaudal part (upper, middle and lower) of the thyroid.…”

Radiofrequency ablation for treatment of thyroid follicular neoplasm with low SUV in PET/CT study

“…The symptom score recorded five clinical symptoms: compression, cough, difficulty swallowing, voice change, and pain. For each positive symptom, we scored one point, with symptom scores ranging from 0 to 5 [13,18].…”

“…A thermal ablation is a treatment option for application with benign, malignant thyroid diseases and neck metastasis [10][11][12][13][14][15][16][17]; although the use of Radiofrequency ablation (RFA) on Bethesda category III/IV nodules remains controversial. Current RFA guidelines from ATA [8] and Korea [18] do not recommend RFA for the treatment of follicular neoplasm, as there is no evidence of treatment benefit.…”