Radiofrequency Ablation Compared to Surgery for the Treatment of Benign Thyroid Nodules

Bernardi, Stella; Dobrinja, Chiara; Fabris, Bruno; Bazzocchi, Gabriele; Sabato, Nicoletta; Ulcigrai, Veronica; Giacca, Massimo; Barro, Enrica; Manzini, Nicoló de; Stacul, Fulvio

doi:10.1155/2014/934595

Cited by 125 publications

(159 citation statements)

References 37 publications

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“…Thinner (18-G or 19-G) internally cooled multi-tined (0.5-1-1.5 cm) electrode needles were later developed specifically for thyroid lesions, to make control of the needle easier, minimizing normal tissue injury [41][42][43][44][45][46][47][48][49].…”

Section: Rfa Devices and Proceduresmentioning

confidence: 99%

“…Most procedures are performed with local anesthesia [33][34][35][36][37][38][40][41][42][43][44][45][46][47][48][49].…”

Section: Rfa Devices and Proceduresmentioning

confidence: 99%

“…The most common complication in all studies was pain [33,34,38,[45][46][47][48][49][50][51][52] (Table 1). In the order of frequency, authors also reported hematomas [33,47,52], vomiting [47,52], skin burn [33,52], fever [38], and thyrotoxicosis [46]. Hematomas can be controlled by neck compression and usually disappear within 2 weeks.…”

Section: Complicationsmentioning

confidence: 99%

“…Hematomas can be controlled by neck compression and usually disappear within 2 weeks. There was only one case of thyrotoxicosis, which spontaneously resolved within 30 days [46]. Major complications were, in the order of frequency, permanent voice change [33,34,44,46,47,52], rupture of the nodule [44,52], permanent hypothyroidism [41,52], and brachial plexus injury [47,52].…”

Section: Complicationsmentioning

confidence: 99%

“…Voice change may be caused by the involvement of the recurrent laryngeal or vagus nerve [34,37]. Voice changes are usually transient, with most patients recovering within 3 months [34,44,46,47,52].…”

Section: Complicationsmentioning

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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Section: Rfa Devices and Proceduresmentioning

confidence: 99%

“…Most procedures are performed with local anesthesia [33][34][35][36][37][38][40][41][42][43][44][45][46][47][48][49].…”

Section: Rfa Devices and Proceduresmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

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Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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Image‐guided chemical and thermal ablations for thyroid disease: Review of efficacy and complications

et al. 2018

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Image-guided ablation of thyroid disease is increasingly being commonly reported. Techniques including ethanol injection and thermal ablation using radio-frequency, laser, and microwave devices have been described. Minimally invasive approaches to the management of benign cystic, solid, and functional thyroid nodules as well as both primary and recurrent thyroid malignancy have been reported. The purpose of this article is to review the current evidence relating to image-guided ablation of thyroid disease with a focus on clinical outcomes and complication rates for patients treated with this minimally invasive approach.

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Radiofrequency ablation and related ultrasound‐guided ablation technologies for treatment of benign and malignant thyroid disease: An international multidisciplinary consensus statement of the American Head and Neck Society Endocrine Surgery Section with the Asia Pacific Society of Thyroid Surgery, Associazione Medici Endocrinologi, British Association of Endocrine and Thyroid Surgeons, European Thyroid Association, Italian Society of Endocrine Surgery Units, Korean Society of Thyroid Radiology,

et al. 2021

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Background The use of ultrasound‐guided ablation procedures to treat both benign and malignant thyroid conditions is gaining increasing interest. This document has been developed as an international interdisciplinary evidence‐based statement with a primary focus on radiofrequency ablation and is intended to serve as a manual for best practice application of ablation technologies. Methods A comprehensive literature review was conducted to guide statement development and generation of best practice recommendations. Modified Delphi method was applied to assess whether statements met consensus among the entire author panel. Results A review of the current state of ultrasound‐guided ablation procedures for the treatment of benign and malignant thyroid conditions is presented. Eighteen best practice recommendations in topic areas of preprocedural evaluation, technique, postprocedural management, efficacy, potential complications, and implementation are provided. Conclusions As ultrasound‐guided ablation procedures are increasingly utilized in benign and malignant thyroid disease, evidence‐based and thoughtful application of best practices is warranted.

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Radiofrequency Ablation Compared to Surgery for the Treatment of Benign Thyroid Nodules

Cited by 125 publications

References 37 publications

Image-guided thermal ablation of benign thyroid nodules

Image-guided thermal ablation of benign thyroid nodules

Image‐guided chemical and thermal ablations for thyroid disease: Review of efficacy and complications

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