Symptomatic benign thyroid nodules: efficacy of additional radiofrequency ablation treatment session--prospective randomized study.

Huh, Jung Yin; Baek, Jung Hwan; Choi, Hoon; Kim, Jae Kyun; Lee, Jeong Hyun
2012Jun ; 263 ( 3 ) :909-16.
저자 상세정보
Huh, Jung Yin -
Baek, Jung Hwan -
Choi, Hoon -
Kim, Jae Kyun -
Lee, Jeong Hyun -
PURPOSE: To prospectively evaluate the efficacy of additional radiofrequency (RF) ablation by comparing the results of one and two sessions. MATERIALS AND

METHODS: All patients gave written informed consent to participate in this institutional review board-approved prospective study. From September 2007 to February 2008, 30 patients with benign predominantly solid thyroid nodules causing pressure symptoms and/or cosmetic problems were randomly assigned to undergo single-session (group 1, n = 15) or two-session (group 2, n = 15) RF ablation. RF ablation was performed by using an 18-gauge internally cooled electrode with ultrasonographic guidance. Nodule volume and cosmetic and symptom scores were evaluated before ablation and at 1, 3, and 6 months after initial ablation, and quantitative comparisons of these were performed by using the Mann-Whitney and Wilcoxon signed rank tests; the Spearman rank test was used for correlation between nodule volume reduction and applied energy.

RESULTS: At 6-month follow-up, there was significant nodule volume reduction, from 13.3 mL 짹 12.9 (standard deviation) to 3.8 mL 짹 4.4 in group 1 (P = .001), and from 13.0 mL 짹 6.8 to 3.0 mL 짹 2.2 in group 2 (P = .001). Each group showed significant improvement in cosmetic (P < .0001) and symptom (P = .001) scores. However, there was no significant difference in volume reduction, cosmetic score, and symptom score between two groups (P = .078, P > .99, and P = .259, respectively). In group 1, three of four patients who had a pretreatment nodule volume larger than 20 mL underwent additional RF ablation because of unresolved clinical problems after the first session. CONCLUSION: Single-session RF ablation showed significant volume reduction and satisfactory clinical response in most patients. Therefore, additional RF ablation should be limited to patients with a large nodule (>20 mL) or unresolved clinical problems.
Adult, Aged, Catheter Ablation/*methods, Female, Humans, Male, Middle Aged, Prospective Studies, Retreatment, Statistics, Nonparametric, Thyroid Nodule/*surgery/ultrasonography, Treatment Outcome, Ultrasonography, Interventional

주제명(Target field)
연구참여(Sample size)
질병특성(Condition Category)
연구설계(Study Design)
중재방법(Intervention Type)
중재명칭(Intervention Name)
• Single-session radiofrequency (RF) ablation is effective in the majority (12 [80%] of 15) of patients with symptomatic thyroid nodules. • Additional RF ablation may be required for patients with a large thyroid nodule greater than 20 mL.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
ICD 03