Ultrasound-guided radiofrequency ablation for papillary thyroid microcarcinoma: a retrospective analysis of 198 patients

Abstract

Purpose: To evaluate the safety and efficacy of ultrasound-guided RFA for the treatment of papillary thyroid microcarcinoma (PTMC). Materials and methods: The data of 204 nodules from 198 PTMC patients who were treated using RFA were retrospectively reviewed in this study. Demographic variables, complication details and CEUS results in different time points were collected. The volumes and volume reduction rate (VRR) of the ablated area under CEUS at different follow-up time points were calculated and compared. Results: All the patients were successfully treated without major complication. Mild complications included cervical discomfort in three cases, postoperative cervical pain in one case, and transient hoarse voice in five cases. The volume of the ablated area in the 1st, 3rd, 6th, 12th, 18th and 24th month postoperatively were 241.7 ± 298.3mm 3 , 89.8 ± 147.2 mm 3 , 37.6 ± 87.2 mm 3 , 13.6 ± 59.8 mm 3 , 2.4 ± 14.4 mm 3 , and 0.2 ± 2.0 mm 3 respectively, with a statistically significant decrease (F ¼ 138.1, p ¼ .000), and the VRR in those time points were 73.9 ± 13.7%, 90.5 ± 8.2%, 96.1 ± 5.9%, 98.8 ± 3.2%, 99.6 ± 1.9% and 99.8 ± 1.0% respectively, with a statistically significant decrease (F ¼ 695.3, p ¼ .000). Conclusions: US-guided RFA is safe and effective for PTMC, with a good oncological outcome and VRR. Further randomized controlled prospective trials are still needed to compare the value of RFA and surgery.

Intracystic Hemorrhage and Its Management During Ultrasound-Guided Percutaneous Microwave Ablation for Cystic Thyroid Nodules

“…Large blood vessels should be avoided in advance. (4) Operators should be proficient in basic techniques of ablation, such as the moving shot technique, the multiple overlapping shot technique, the hydrodissection technique, and leveraged pry-off method ( 14 – 17 ). Insufficient experience or unskilled operation can easily lead to failure of treatment, and even the risk of uncontrollable bleeding that requires conversion to open surgery.…”

Roles of contrast-enhanced ultrasonography in identifying volume change of benign thyroid nodule and optical time of secondary radiofrequency ablation

“…All the procedures, including ultrasonography-guided cytology/biopsy and ultrasonography guided radiofrequency ablation were performed by the same radiologist who have performed with more than 20 years' experience of thyroid ultrasonography and intervention ultrasound, and ultrasonography-guided cytology/biopsy were performed in accordance of previously published technical concensus and recommendations [12][13][14]. Similar procedure were also reported in our previous studies [2,15].…”

Radiofrequency for benign and malign thyroid lesions

“…Type of energy used, follow-up, reduction and recurrences. Ref Technique Patients (N) Nodules (N) Initial vol (mm 3 ) Reduction (%) FU (m) Recurrence (N) New foci (N) Zhang, M et al 2020 22 RFA 94 94 175.9 ± 228.3 – 72 1 0 Wu, R et al 2020 21 RFA 198 204 99.4 ± 82 99.8 ± 1 25.9 – – Cho, SJ et al 2020 20 RFA 74 84 20 (1–234) 100 60 0 4 Yue, W et al 2014 33 MWA 18 18 89.5 ± 20.1 90 12 0 0 Cui, T et al 2019 34 MWA 185 206 100.1 ± 92.9 98.6 ± 3.6 36 0 1 Zhang et al 2018 LA 64 64 41 ± 40 100 25.7 0 0 RFA: radiofrequency ablation; MWA: microwave ablation; LA: laser ablation. …”

“…During the follow-up no recurrences, no progression, no lymph nodes or distant metastasis were identified nor delayed surgery was necessary. Wu et al 21 described a retrospective analysis of 198 patients without major complications, four local pain and five temporary hoarseness. The reduction rate achieved with the procedure was (99.8 ± 1.0) % within 24 months ( P = 0.005).…”