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Radiology. 2012 Jun;263(3):909-16. doi: 10.1148/radiol.12111300. Epub 2012 Mar 21.

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

Author information

1
Department of Radiology, Thyroid Center, Daerim St. Mary's Hospital, 978-13 Daerim-dong, Youngdeungpo-gu, Seoul 150-070, Korea.

Abstract

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 ± 12.9 (standard deviation) to 3.8 mL ± 4.4 in group 1 (P = .001), and from 13.0 mL ± 6.8 to 3.0 mL ± 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.

PMID:
22438360
DOI:
10.1148/radiol.12111300
[Indexed for MEDLINE]

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