Learning objectives
To show the state of art of thermoablative treatments of benign nodular thyroid pathology,
to compare RFA vs LA outcomes in this operating field,
and to point out the role of CEUS during benign nodules ablative session.
Background
Benign thyroid nodules account for 85-95% of the thyroid disease.
Asymptomatic hyperplastic nodules need only periodic follow-up ; while symptomaticones require treatment,
both for the appearance of compressive symptoms (dyspnoea and dysphonia) and aesthetic problems (due to the volumetric increase in glandular tissue), and for the potential risk of malignant transformation .
Despite the surgical excision representing the gold standard,
the associated risks (hypothyroidism,
hypoparathyroidism,
damage to n.recurrent,
general anesthesia,
bleeding and ematoma) have led to an increase of the demand for minimally invasive treatments,...
Findings and procedure details
In the last years,
the experiences gained in the treatment of benign thyroid nodules through image-guided percutaneous thermal ablation have been reported with encouraging results,
so that currently,
these treatments (such as microwave ablation,
laser ablation or radiofrequency ablation),
are often proposed as first-choice for patients with symptomatic benign thyroid nodules.
Good results have been obtained with radiofrequency (RFA) and laser ablation (LA).
Volumetric reduction is obteined both after ablative procedure,
with similar results:
RFA (47-84% at 3-6 months / 93% at 1 year),
LA...
Conclusion
The percutaneous eco-guided thermal ablation is effective in obtaining the reduction of benign solid nodules’ volume and in providing a significant improvement of the symptoms,
thus proposing itself as a valid alternative to surgical excision.
For this reason it is often proposed as first choice treatment.
Similar results had been obtained both with RFA and with LA treatment.
Furthermore the use of CEUS,
during benign thyroid nodules treatment,
is an important tool for its high sensitivity,
specificity and accuracy in assessing ablative effects after thermal...
References
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Valcavi,
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Riganti,
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Bertani,
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Formisano,
and C.
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Pacella,
“Percutaneous laser ablation of cold benign thyroid nodules:a 3-yearfollow-upstudyin122patients,”Thyroid,vol.
20,no.11,pp.1253–1261,2010;
Ji Hong M,
Baek JH,
Choi YJ et al (2015) Radiofrequency ablation is a thyroid function-preserving treatment for patients with bilateral benign thyroid nodules.
J Vasc Interv Radiol 26:55–61 44;
Che Y,
Jin S,
Shi C et al (2015) Treatment of benign thyroid nodules: comparison of surgery with radiofrequency ablation.
AJNR AmJ Neuroradiol 36:1321–1325 45;
Ugurlu MU,
Uprak K,
Akpinar IN,
Attaallah W,...