Visualization of tissue alterations in thyroid nodules after microwave ablation

Klebe, Julia; Happel, Christian; Grünwald, Frank; Korkusuz, H.

doi:10.1097/mnm.0000000000000242

Cited by 14 publications

(5 citation statements)

References 25 publications

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“…It has been shown that tracer uptake after MWA ablation and during the follow-up was significantly reduced in the ablated tissue. Further research is necessary to establish the real role of scintigraphic imaging in follow-ups after MWA is used in the treatment of benign thyroid nodules [83,84].…”

Section: Clinical Resultsmentioning

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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Section: Clinical Resultsmentioning

confidence: 99%

Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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“…The magnetron in the microwave generator produces microwaves, which can raise the local temperature to 60 to 100 °C and leads to protein denaturation. [ 4 ] In 2000 and 2001, Pacella [ 5 ] and Dupuy [ 6 ] first applied laser ablation and radiofrequency ablation (RFA), respectively, to treat recurrent thyroid carcinoma. Currently, RFA and MWA are mainly used to treat benign thyroid nodules in China.…”

Section: Introductionmentioning

confidence: 99%

Horner syndrome as a complication after thyroid microwave ablation

Zhang

Ren

et al. 2018

Medicine

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Rationale:Horner's syndrome (HS) can present as a complication of thyroid surgery, particularly after thyroid microwave ablation (MWA). HS presents clinically with eyelid ptosis, miosis, enophthalmos, anhidrosis, and vascular dilatation, all of which result from a damaged oculosympathetic chain. We aimed to try to avoid such devastating symptoms in future cases by exploring reasons for the destruction of the cervical sympathetic trunk.Patient concerns:HS has previously been reported in the literature as a complication of thyroid surgery. Here, we report the case of a 44-year-old female patient who presented with miosis and eyelid ptosis following thyroid MWA.Diagnoses:This patient was subsequently diagnosed with HS.Interventions:Mecobalamin was administered immediately.Outcomes:After 5 months of follow up, the patient's miosis and ptosis was incompletely relieved.Lessons:Although HS is a rare complication of thyroid MWA, surgeons must be aware of the anatomic relationship of the cervical sympathetic trunk and thyroid gland with adjacent structures. Moreover, we hope this case presentation enables surgeons to take measures to minimize the possibility of oculosympathetic damage. Long-term follow up and comprehensive assessments are important for the patient's prognosis.

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“…The MOA technique is a good alternative in the case of MWA or bipolar RFA for TNs ( 20 ). In our experience of treating nodules with a maximum diameter of 2 cm, we only needed four to five overlapping ablations of no more than 2 min for each one to cover >80% of the nodule ( Fig.…”

Section: Discussionmentioning

confidence: 99%

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

Vallejo

Hermosín

Gargallo

et al. 2023

European Thyroid Journal

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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.

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Visualization of tissue alterations in thyroid nodules after microwave ablation

Cited by 14 publications

References 25 publications

Image-guided thermal ablation of benign thyroid nodules

Image-guided thermal ablation of benign thyroid nodules

Horner syndrome as a complication after thyroid microwave ablation

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

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