Safety and Efficacy of Radiofrequency Ablation for Nonfunctioning Benign Thyroid Nodules in Children and Adolescents in 14 Patients over a 10-Year Period.

Hong, Min Ji; Sung, Jin Yong; Baek, Jung Hwan; Je, Mi Su; Choi, Dong Whan; Yoo, Hyunju; Yang, Sae Jeong; Nam, Sang Yu; Yoo, Eun Young
Journal of vascular and interventional radiology : JVIR
2019Apr ; 18 ( 4 ) :.
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Hong, Min Ji - Department of Radiology, Gil Medical Center, Gachon University School of Medicine, Incheon, 21565, Korea.
Sung, Jin Yong - Department of Radiology, Thyroid Center, Daerim Saint Mary's Hospital, 657, Siheung-daero, Yeongdeungpo-gu, Seoul, 07442, Korea. Electronic address: jysrad68@empas.com.
Baek, Jung Hwan - Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Je, Mi Su - Department of Pediatrics, Thyroid Center, Daerim Saint Mary's Hospital, Seoul, 07442, Korea.
Choi, Dong Whan - Department of Surgery, Thyroid Center, Daerim Saint Mary's Hospital, Seoul, 07442, Korea.
Yoo, Hyunju - Department of Pathology, Thyroid Center, Daerim Saint Mary's Hospital, Seoul, 07442, Korea.
Yang, Sae Jeong - Department of Internal Medicine, Thyroid Center, Daerim Saint Mary's Hospital, Seoul, 07442, Korea.
Nam, Sang Yu - Department of Radiology, Gil Medical Center, Gachon University School of Medicine, Incheon, 21565, Korea.
Yoo, Eun Young - Department of Radiology, Gil Medical Center, Gachon University School of Medicine, Incheon, 21565, Korea.
ABSTRACT
PURPOSE: To evaluate the efficacy and safety of radiofrequency (RF) ablation for nonfunctioning benign thyroid nodules in children and adolescents. MATERIALS AND

METHODS: Fourteen pediatric patients (10 female, 4 male; mean age 15.7 ± 2.3 years, range 12-19 years) with nonfunctioning benign thyroid nodules (mean longest diameter 3.7 ± 1.1 cm, range 2.0-5.6 cm) treated with the use of RF ablation from 2005 to 2015 were evaluated. The inclusion criteria for RF ablation therapy were (i) age <20 years, (ii) benign cytological confirmation by ?? separate fine-needle aspiration or core needle biopsies, (iii) pressure symptoms or cosmetic problems caused by thyroid nodules, (iv) absence of any suspicious feature as determined with the use of ultrasound (US), (v) normal serum levels of thyroid hormone and thyrotropin, and (vi) follow-up of >6 months. RF ablation was performed with the use of an RF generator and an 18-gauge internally cooled electrode. RF ablation was performed under local anesthesia without conscious sedation or general anesthesia. Changes in nodules on follow-up US, changes in symptomatic and cosmetic scores, and complications arising during or after RF ablation were evaluated.

RESULTS: Mean follow-up period was 36.9 ± 21.7 months (range 6-69 months). At last follow-up visits, mean longest nodule diameter and volume had decreased significantly (3.7 ± 1.1 cm vs 1.4 ± 0.9 cm and 14.6 ± 13.3 mL vs 1.7 ± 4.4 mL; P < 0.001). Both cosmetic and compressive symptoms significantly improved (3.8 ± 0.6 vs 1.4 ± 0.6 and 3.4 ± 1.0 vs 0.1 ± 0.4; P < 0.001). The mean number of ablation sessions was 2.1 ± 1.2 (range 1-5 sessions) and no major complication was encountered during or after RF ablation.

CONCLUSIONS: RF ablation might be a safe and effective treatment modality for nonfunctioning benign thyroid nodules in children and adolescents. CI - Copyright ??2018 SIR. Published by Elsevier Inc. All rights reserved.
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During the mean follow-up period of 36.9 months, significant decrease in mean nodule volume was observed (from the initial average size of 3.7 ¡¾ 1.1 cm to 1.7 ¡¾ 4.4 mL at last follow-up ( P < .001), and the mean symptom and cosmetic scores were significantly reduced from baseline to final follow-up: from 3.4 ¡¾ 1.0 to 0.1 ¡¾ 0.4 ( P < .001) and from 3.8 ¡¾ 0.6 to 1.4 ¡¾ 0.6 ( P < .001), respectively; RFA might be a safe and effective treatment modality for nonfunctioning benign thyroid nodules in children and adolescents.
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DOI
10.1016/j.jvir.2018.10.034
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ICD 03
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