Percutaneous Ethanol Injection Treatment in Benign Thyroid Lesions: Role and Efficacy

Guglielmi, Rinaldo; Pacella, Claudio Maurizio; Bianchini, A.; Bizzarri, Giancarlo; Rinaldi, Roberta; Graziano, Filomena; Petrucci, L.; Toscano, Vincenzo; Palma, Enzo; Poggi, Maurizio; Papini, Enrico

doi:10.1089/105072504322880364

Cited by 136 publications

(96 citation statements)

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“…Thyroid function is normalized after ethanol injection in approximately 60%-80% of pretoxic nodules and 35%-85% of toxic nodules. 3 Tarantino et al 4 reported complete cure (absent uptake in the nodule and recovery of normal uptake in the thyroid parenchyma) in 93% of patients with AFTNs. After laser ablation, cure rates of 61%-100% have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…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%

“…1,2 Locally ablative methods, such as percutaneous intranodular ethanol injection, 3,4 radio-frequency, 5 or laser ablation, 6,7 have also been suggested as treatments. HIFU is a new minimally invasive technique that allows elective thermal tissue destruction (coagulative necrosis and cavitation) within a few seconds by focusing a beam onto a given target.…”

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confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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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“…When nodules are cystic or predominantly cystic, percutaneous ethanol injection (PEI) represents a valuable minimally invasive treatment strategy [15][16][17][18][19], with a reported success rate of 82-85 % (volume reduction [85 % from baseline) after an average of two sessions [19][20][21][22]. However, there are several limitations to the use of this technique for solid nodules; these are related to the difficulty in predicting the diffusion of the ethanol within the nodule, the leakage-induced pain, and the possibility of extra-glandular fibrosis making subsequent surgery more complex [23,24].…”

Section: Introductionmentioning

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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“…US-guided percutaneous ethanol injection (PEI) therapy is currently considered one of the first-line treatment modality for cystic and predominantly cystic nodules (2,3). Laser ablation (LA) has been proposed as a safe outpatient procedure that effectively reduces the volume of solid nodules and the clinical outcomes in the majority of patients (4)(5)(6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of a single radiofrequency ablation of solid benign non-functioning thyroid nodules

Cesáreo

Palermo

Pasqualini

et al. 2017

Arch. Endocrinol. Metab.

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Objective: The objective of our study is to evaluate the clinical outcomes and safety of radiofrequency thermal ablation (RFA) for benign thyroid nodules (BTNs) over a 1-year follow-up. Subjects and methods: This is a monocentric retrospective study. Forty-eight patients with solid, non-functioning BTNs were treated by RFA using a 17G internally cooled electrode. We categorized thyroid nodules as small (≤ 12 mL), medium (12 to 30 mL), or large (over 30 mL). BTNs volume reduction, thyroid function, cosmetic and compressive score changes and side effect evaluation at 6 and 12 months were evaluated. Results: BTN volume decreased significantly from baseline to 6 (mean percentage decrease of BTN volume was 66.8 ± 13.6%, p < 0.001). At 12 months, the mean percentage reduction of BTN volume compared to six months was 13.7 ± 17.1% (p < 0.001). At 6-month, symptom score had improved significantly (p < 0.001) while it does not change significantly between 6 and 12 months. In particular, symptom score improved significantly in the medium (p < 0.001) and large (p < 0.01) subgroups. Cosmetic score improved significantly between baseline and 6 months (p < 0.001) and between 6 and 12 months (p < 0.01). In all the subgroups, cosmetic score improved significantly between baseline and 6 months, while between 6 and 12 months it improved significantly only in the large group (p < 0.05). RFA was well tolerated. Only one patient experienced permanent right paramedian vocal cord palsy. Conclusions: A single RFA treatment was effective in reducing BTNs volume, in particular small and medium nodules. Cosmetic score improved in all treated BTNs while symptom score only got better in the medium and large BTNs. Arch Endocrinol Metab. 2017;61(2):173-9.

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Percutaneous Ethanol Injection Treatment in Benign Thyroid Lesions: Role and Efficacy

Cited by 136 publications

References 39 publications

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

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

Image-guided thermal ablation of benign thyroid nodules

Efficacy and safety of a single radiofrequency ablation of solid benign non-functioning thyroid nodules

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