How to manage the patients with unsatisfactory results after ethanol ablation for thyroid nodules: role of radiofrequency ablation.

Jang, Seung Won; Baek, Jung Hwan; Kim, Jae Kyun; Sung, Jin Yong; Choi, Hoon; Lim, Hyun Kyung; Park, Jee Won; Lee, Ha Young; Park, Soonchan; Lee, Jeong Hyun
European journal of radiology
2012May ; 81 ( 5 ) :905-10.
저자 상세정보
Jang, Seung Won -
Baek, Jung Hwan -
Kim, Jae Kyun -
Sung, Jin Yong -
Choi, Hoon -
Lim, Hyun Kyung -
Park, Jee Won -
Lee, Ha Young -
Park, Soonchan -
Lee, Jeong Hyun -
PURPOSE: Although ethanol ablation (EA) is effective in the treatment of cystic thyroid nodules, it is less effective in nodules with solid component. Therefore refractory cases with solid component require another treatment modality such as radiofrequency ablation (RFA), which is effective in both solid and cystic thyroid nodules. We prospectively evaluated the efficacy of additional RFA and factors related to volume reduction in patients showing unsatisfactory results after a single session of EA. MATERIALS AND

METHODS: Of 94 patients with predominantly cystic thyroid nodules who underwent EA, 20 patients underwent additional RFA because of incompletely resolved clinical problems (symptomatic score reduction <50%) and presence of residual solid component at 1-month follow-up on ultrasonography. Improvement of clinical symptoms and nodule volume reduction were evaluated 6 month later. We evaluated factors related to nodule volume reduction after EA and RFA.

RESULTS: RFA after a single session of EA was effective in reducing mean symptom score from 4.8 to 1.1 (p<0.001), mean cosmetic score from 3.5 to 1.4 (p<0.001) and mean nodule volume from 11.3 to 0.9 mL (p<0.001). The only independent factor related to volume reduction after EA was the presence of a solid component (p<0.001), and EA was less effective in nodules when solid component >20% (p=0.001). We identified no factors related to volume reduction after RFA. CONCLUSION: RFA is effective in treatment of benign predominantly cystic thyroid nodules in patients whose clinical problems were incompletely resolved after EA. CI - Copyright ??2011 Elsevier Ireland Ltd. All rights reserved.
Adolescent, Adult, Aged, Catheter Ablation/*methods, Combined Modality Therapy, Cysts/diagnosis/*therapy, Ethanol/*therapeutic use, Female, Humans, Male, Middle Aged, Thyroid Nodule/diagnosis/*therapy, Treatment Failure, Treatment Outcome, Young Adult

주제명(Target field)
연구참여(Sample size)
질병특성(Condition Category)
연구설계(Study Design)
중재방법(Intervention Type)
중재명칭(Intervention Name)
EA seems to be an effective treatment modality in patients with predominantly cystic thyroid nodules. However, in 33% of such patients, EA was ineffective because a high proportion of the nodule was solid. In these patients, additional RFA was both effective and safe. .; Single session EA was effective in reducing nodule volume ( p < 0.001), improving cosmetic ( p < 0.001) and symptom scores ( p < 0.001). Volume reduction 1 month after EA ranged from 21% to 96% (mean ± SD, 65.0 ± 18.9%); RFA resulted in significant volume reduction ( p < 0.001) and improvements in cosmetic ( p < 0.001) and symptom ( p < 0.001) scores.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
ICD 03