Multiple overlapping microwave ablation in benign thyroid nodule: a single-center 24-month study

Abstract

Objective: This study aimed to evaluate the safety and long-term efficacy using the multiple overlapping ablation technique with a novel non-cooled microwave system in benign symptomatic thyroid nodules. Methods: This prospective cohort single-center study collected complication data from the start of the procedure to 30 days postoperatively and evaluated the safety and effectiveness with a follow-up of 24 months. Ultrasound examinations were performed to determine the volume shrinkage during follow-up. Thyroid function, cosmetic and symptoms scores, and satisfaction degree were evaluated. Results: A total of 30 symptomatic benign thyroid nodules were treated by microwave ablation using a power between 15 and 30 watts depending on the size of the nodule to be treated. The volume reduction rates in months 1, 3, 6, 9, 12, and 24 after ablation were 32%, 59%, 67%, 69%, 73%, and 81%, respectively. The mean symptom score and mean cosmetic score before treatment were 4 and 3 respectively, while after treatment they dropped to 3 and 1 respectively. Thyroid function indicators fluctuated in the normal range, and those with hyperthyroidism recovered to normal parameters. One case of temporary laryngeal paralysis occurred postoperatively and fully recovered in less than 3 months. Conclusions: The novel microwave ablation system presented herein can help achieve good clinical success rate in benign thyroid nodules, with a satisfying safety profile. The microwave ablation performed with the multiple overlapping ablation technique could be a good alternative to surgery and radiofrequency ablation in the management of benign thyroid nodules.

Modern Surgical Techniques of Thyroidectomy and Advances in the Prevention and Treatment of Perioperative Complications

“…There were no cases of major complications during the study, although one patient (3.3%) suffered from transient aphonia, which resolved after three months. MWA also does not cause the heat theft that is present with RFA [97].…”

Microwave ablation for benign thyroid nodules with cosmetic problems and related factors for post-ablative complete relief: a two-center retrospective study

“…Among them, MWA can potentially eradicate larger benign thyroid nodules with larger coagulation areas and is less affected by the heat sink effect caused by vessels around the nodule [8,9]. In recent years, multiple studies have shown that MWA is effective and safe for benign thyroid nodules [10][11][12]. However, due to the degree and speed of nodule volume reduction, which varies from individual to individual, the appropriate treatment options for benign thyroid nodules that cause cosmetic problems remain controversial.…”

Advances in influence factors of ultrasound-guided percutaneous thermal ablations for benign thyroid nodules: A review

“…Ultrasound-guided percutaneous thermal ablation of thyroid nodules has been widely used in clinical practice because of its obvious advantages and because it is highly effective. [13][14][15] This treatment mainly includes radiofrequency ablation (RFA), microwave ablation (MWA), and laser ablation (LA). The principle of radiofrequency ablation treatment is to use the high-frequency electromagnetic wave generated by the radiofrequency instrument inserted into the thyroid nodule to make the positive and negative ions in the cell move rapidly, causing frictional heating so that the thyroid nodule will produce coagulative necrosis due to high temperature, and then be absorbed and cleared by the body's immune system.…”