Aims and objectives
Free-hand Ultrasound (US) plays an important role in thyroid diagnostics as a real-time examination,
not ionizing and non-invasive,
cost effective,
ideal also for repetitive follow-up and able to give information about anatomy (B-Mode modality),
hemodynamics (Color,
Power Doppler) [1,2] and tissue stiffness,
i.e.
Elastosonography [3].
Furthermore,
US is the most used imaging technology for guiding fine needle aspiration biopsy [4] and minimally invasive treatments of the thyroid,
for instance Radio Frequency Ablation (RFA), Ethanol injections [5] or Laser [6].
A recently published Consensus Statement and...
Methods and materials
A.
Subject Predisposition
Five patients (4 female,
1 male) with benign thyroid nodules (mean age = 57,
range = 42-70) underwent US examination and RFA ablation of the thyroid nodule,
after signing a written informed consent.
The RFA was performed using a RF Generator-M2004 (equipped with pump RFP 100 and jar for system cooling) with 6 cm and 10 cm radio frequency electrodes RFT-0710N (RF Medical Co.,
Ltd.,
Seoul,
Korea).
The subject was lying on the examination bed,
with the neck slightly hyper-extended and positioned...
Results
Virtual Biopsy guided RFA treatment (Fig.
2) was performed in all the five scheduled patients for thermal ablation of benign thyroid nodules.
One nodule was treated in each subject.
The Virtual Biopsy was used with the fusion between the real-time 2D scan and the already acquired 3D US volumes of the same patient.
In two patients the 3D US acquisition was performed using the 3D motorized probe BL433 while the 2D US guidance of the RFA electrode and the acquisitions of the 2D US scans...
Conclusion
In this preliminary study,
Virtual Biopsy technology facilitated the RFA electrodes insertion.
With its graphical representation of the electrode tip insertion point and the planning of the path within the area to be treated,
it represented a valuable tool for improved practical confidence.
The confidence is even increased by the possibility to monitor in real-time the tissue stiffness with elastosonography and the hemodynamics of the nodule and surrounding areas using Doppler technologies and CEUS.
Virtual Biopsy technology enabled a secure visualization of the RFA electrode...
Personal information
Roberto Garberoglio,
Centro Tiroide - Private Hospital Sede Sapientiae,
Torino,
Italy,
[email protected]
References
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C.
Frates,
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Benson,
P.
M.
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Cibas and E.
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“Can Color Doppler Sonography Aid in the Prediction of Malignancy of Thyroid Nodules?”,
JUM February 1,
2003 vol.
22 no.
2: 127-131.
[2] O.
Algin,
E.
Algin,
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Gokalp,
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Ocakoğlu,
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Erdoğan,
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Saraydaroglu and E.
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"Role of Duplex Power Doppler Ultrasound in Differentiation between Malignant and Benign Thyroid Nodules",
Korean J Radiol.
2010 Nov-Dec; 11(6): 594–602.
[3] F.
Ragazzoni et al.,
“High diagnostic accuracy and interobserver...