Interstitial laser photocoagulation for benign thyroid nodules: Time to treat large nodules

Amabile, Gerardo; Rotondi, Mario; Pirali, Barbara; Dionisio, Rosa; Agozzino, L; Lanza, Michele; Buonanno, Luciano; Filippo, Bruno Di; Fonte, R.; Chiovato, Luca

doi:10.1002/lsm.21114

Cited by 44 publications

(40 citation statements)

References 20 publications

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“…After three cycles of LA, 87 % of the hyperthyroid patients achieved normal serum levels of TSH [62].…”

Section: Clinical Resultsmentioning

confidence: 97%

“…Some studies also analyze these outcomes in patients with hyperfunctioning nodules [57,62,66,71,73]. For the evaluation of symptoms and cosmetic scores, different methods are used, making the comparison between various studies difficult.…”

Section: Clinical Resultsmentioning

confidence: 99%

“…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%

“…from the inferior margin of the lesion [59,62,74], and to maintain the same distance between the needle tip and surrounding cervical structures [57,58,61,62,66,69,70,[72][73][74]. A laser source, a continuous-wave Nd-YAG laser operating at 1.064 lm, is used with an optical beam-splitting device with as many as four separate fibers that can be illuminated separately or concurrently [12].…”

Section: La Devices and Proceduresmentioning

confidence: 99%

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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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“…After three cycles of LA, 87 % of the hyperthyroid patients achieved normal serum levels of TSH [62].…”

Section: Clinical Resultsmentioning

confidence: 97%

Section: Clinical Resultsmentioning

confidence: 99%

Section: La Devices and Proceduresmentioning

confidence: 99%

Section: La Devices and Proceduresmentioning

confidence: 99%

See 2 more Smart Citations

Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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“…As both of the therapies involve drawbacks and complications, e. g. scar formation, nerve lesions, hypothyroidism or thyroiditis [1,18], and surgery is often contraindicated or refused by older patients due to high surgical risk because of cardiopulmonary diseases, attention is increasingly focused on non-surgical alternative treatments. In the last two decades several nonsurgical, image-guided, minimally invasive approaches including RFA [7,19], LAT [8,20], PEIT [21], HIFU [8,22] and MWA [1, 10,11,23] have been developed for the efficient treatment of thyroid nodules, without the risk of general anesthesia and while preserving normal thyroid function. Nevertheless, there is barely any research and results on thermal ablation of very large goiters as the treatment is quite time-consuming, needs more treatment sessions and is accompanied by increased discomfort [24].…”

mentioning

confidence: 99%

Combination of Ultrasound-Guided Percutaneous Microwave Ablation and Radioiodine Therapy in Benign Thyroid Disease: A 3-Month Follow-Up Study

Korkusuz

Happel²,

Gruenwald

2015

Fortschr Röntgenstr

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Purpose: Pilot studies of combined therapies treating benign nodular goiters reported promising results. The aim of this study was to investigate the effectiveness of combined microwave ablation (MWA) and radioiodine therapy (RIT) with a special focus on thyroid function at the 3-month follow-up. Materials and Methods: 15 patients (median age: 55 years) with a large goiter and benign thyroid nodules or Graves? disease were treated with the combined therapy. Serum levels of triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyroglobuline (Tg) and, additionally, antibody levels against thyroglobulin (TgAb), thyrotropin receptors (TRAb) and thyroid peroxidase (TPOAb) were measured at enrollment, post MWA and at the 3-month follow-up (3MFU). Furthermore, the goiter volume, I-131 dose and hospitalization time were analyzed to evaluate effectiveness. MWA was operated under local anesthesia with a system working in a wavelength field of 902 to 928?MHz. Results: TSH, T4, T3 and Tg did not change at 3MFU, except for in two patients in whom the initial TSH levels improved to normal thyroid functioning levels at follow-up.?One of the patients developed a high TRAb-level that receded back into the normal range. At 3MFU, the combined therapy showed a mean thyroid volume reduction of?26.4?ml ??7.9?ml (30.5?% ??4.6?% (p?

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Ultrasound‐guided percutaneous laser ablation in treating symptomatic solid benign thyroid nodules: Our experience in 45 patients

Achille¹,

Zizzi²,

Stasio

et al. 2015

Head & Neck

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Background Laser ablation may be useful in debulking of benign thyroid nodules. Methods In order to retrospectively evaluate the effectiveness and safety of laser ablation, 45 patients with benign solid thyroid nodules, with a fluid component ≤20%, were included in our series between October 2009 and January 2011. All reported pressure and/or cosmetic complaints. Nd:YAG laser at 1064 nm was used, with a fix‐power (3W), changing the application time. All patients were evaluated at baseline, 6 months, and 12 months and any complications were recorded. Results Mean nodule volume reduction decreased from 24.2 mL ± 19.4 to 4.5 ± 5.2 at 12 months (p < .001). Mean nodule volume reduction was 84% ± 13. Cosmetic signs were completely resolved in 87%, reduced in 9%, unchanged in 2%, and pressure symptoms were resolved in 88%. One patient experienced transient dysphonia. Conclusion Ultrasound‐guided laser ablation is an effective tool for treatment of symptomatic benign thyroid nodules in patients not eligible for surgery. © 2015 Wiley Periodicals, Inc. Head Neck 38: 677–682, 2016

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Interstitial laser photocoagulation for benign thyroid nodules: Time to treat large nodules

Cited by 44 publications

References 20 publications

Image-guided thermal ablation of benign thyroid nodules

Image-guided thermal ablation of benign thyroid nodules

Combination of Ultrasound-Guided Percutaneous Microwave Ablation and Radioiodine Therapy in Benign Thyroid Disease: A 3-Month Follow-Up Study

Ultrasound‐guided percutaneous laser ablation in treating symptomatic solid benign thyroid nodules: Our experience in 45 patients

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