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Efficacy and Safety of Radiofrequency Ablation for Benign Thyroid Nodules: A Prospective Multicenter Study

Korean Journal of Radiology
2018년 19권 1호 p.167 ~ p.174
정소령 ( Jung So-Lyung ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiology

백정환 ( Baek Jung-Hwan ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
이정현 ( Lee Jeong-Hyun ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
송영기 ( Shong Young-Kee ) - University of Ulsan College of Medicine Asan Medical Center Department of Endocrinology and Metabolism
성진용 ( Sung Jin-Yong ) - Daerim St. Mary’s Hospital Thyroid Center Department of Radiology
김규선 ( Kim Kyu-Sun ) - Daerim St. Mary’s Hospital Thyroid Center Department of Radiology
이덕기 ( Lee Duc-Ky ) - Daerim St. Mary’s Hospital Thyroid Center Department of Internal Medicine
김지훈 ( Kim Ji-Hoon ) - Seoul National University College of Medicine Department of Radiology
백선미 ( Baek Seon-Mi ) - Sharing and Happiness Hospital Department of Radiology
심정석 ( Sim Jung-Suk ) - Withsim Clinic Department of Radiology
나동규 ( Na Dong-Gyu ) - Human Medical Imaging and Intervention Center Department of Radiology

Abstract

Objective: To assess the efficacy and safety of thyroid radiofrequency (RF) ablation for benign thyroid nodules by trained radiologists according to a unified protocol in a multi-center study.

Materials and Methods: From 2010 to 2011, 345 nodules from 345 patients (M:F = 43:302; mean age ± SD = 46.0 ± 12.7 years, range = 15?79) who met eligibility criteria were enrolled from five institutions. At pre-ablation, the mean volume was 14.2 ± 13.2 mL (1.1?80.8 mL). For 12 months or longer after treatment, 276 lesions, consisting of 248 solid and 28 predominantly cystic nodules, were followed. All operators performed RF ablation with a cool-tip RF system and two standard techniques (a transisthmic approach and the moving-shot technique). Volume reduction at 12 months after RF ablation (the primary outcome), therapeutic success, improvement of symptoms as well as of cosmetic problems, and complications were evaluated. Multiple linear regression analysis was applied to identify factors that were independently predictive of volume reduction.

Results: The mean volume reduction at 12 months was 80.3% (n = 276) and at the 24-, 36-, 48-, and 60-month follow-ups 84.3% (n = 198), 89.2% (n = 128), 91.9% (n = 57), and 95.3% (n = 6), respectively. Our therapeutic success was 97.8%. Both mean symptom and cosmetic scores showed significant improvements (p < 0.001). The rate of major complications was 1.0% (3/276). Solidity and applied energy were independent factors that predicted volume reduction.

Conclusion: Radiofrequency ablation performed by trained radiologists from multiple institutions using a unified protocol and similar devices was effective and safe for treating benign thyroid nodules.

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