Article Sidebar

PDF
Date Published: 10/01/2022
Online Published: 10/01/2022
Abstract Views: 231
Views PDF: 121
DOI: https://doi.org/10.55046/vjrnm.43.24.2021
Issue
No. 43 (2021)
Section
Scientific research
How to Cite
My, L. T. ., Thông, P. M. ., & Lưu, V. Đăng. (2022). The results description of Radiofrequency Ablation of the Autonomously Functioning Thyroid Nodules. Vietnamese Journal of Radiology and Nuclear Medicine, 43, 12-18. https://doi.org/10.55046/vjrnm.43.24.2021

The results description of Radiofrequency Ablation of the Autonomously Functioning Thyroid Nodules

Lê Thị My, Phạm Minh Thông, Vũ Đăng Lưu

Main Article Content

Abstract

Background: Some patients with autonomously functioning thyroid nodules (AFTN) are not suitable for surgery or radioiodine therapy. Therefore, minimally invasive alternative treatments, such as ethanol ablation or radiofrequency ablation (RFA), are necessary.
Methods: This study included seven patients (7 toxic and 10 pretoxic patients; male to female ratio = 1:7.5; mean age, 46.47 ± 13 (range, 22–66) years) who were not eligible for surgery or radioiodine therapy. All of the patients showed hot nodules with suppression of normal thyroid gland in 99mTc pertechnetate scintigraphy. RFA was performed using a 18 Gauge internally cooled electrode. Nodule volume, thyroid function, scintigraphy,
symptom score (visual analogue scale, 0–10cm), cosmetic grading score (4 point scale), and complications were evaluated before treatment and at 1, 3, 6 and 24 months follow-up.
Results: Mean volume of the index nodule was 13.07 ± 8.44 (range, 2.2–35.5) mL. After RFA, The volume reduction at 1month, 3 months, 6 months follow up was 42.77 % , 63. % và 78.3 % . Initial mean T3, FT4, and TSH were 2.59 ± 1.19nmol/L, 16.3 ± 5.78pmol/L, and 0.101 ± 0.178 mU/mL, respectively. A significant improvement of mean T3, FT4, and TSH were observed after 1month (T3: 2.18 ± 0.753 nmol/L, p = 0.001; FT4: 14.78 ± 2.86 pmol/L, p = 0.001; TSH: 1.464 ± 0.844 mU/mL, p = 0.001), after 6 months (T3: 2.07 ± 0.614 nmol/L, p = 0.012; FT4: 15.12 ± 2.0 pmol/L, p = 0.001; TSH: 1.269 ± 0.398 mU/mL, p < 0.001), after 24 months ( T3: 2.05 ± 0.523 nmol/L, p = 0.016; FT4: 16.43 ± 1.39 pmol/L, p = 0.001; TSH: 1.69 ± 0.654 mU/mL, (p <0.001). After ablation, 17 patients became a cold nodule after 3 months. After 24 months, the mean symptom was reduced from 3.47 ± 1.9 to 0.06 ± 0.25 (p = 0.001) and cosmetic grading score was reduced from từ 3.59 ± 1.1 tới 1.19 ± 0.403 (p <0.001). No major complications were encountered.
Conclusions: RFA was effective and safe for treating autonomously functioning benign thyroid nodules.

Article Details

Keywords

Đốt sóng cao tần, nhân nóng tuyến giáp, nhân độc tuyến giáp

References

1. Gharib, H., E. Papini, J.R. Garber, D.S. Duick, R.M. Harrell, et al., American association of clinical endocrinologists, american college of endocrinology and associazione medici endocrinology medical guidelines for clinical practice for the diagnosis and management of thyroid nodule – 2016 update. Endocrine Practice, 2016. 22 (Supplement 1): p. 1-60.
2. Tamhane, S. and H. Gharib, Thyroid nodule update on diagnosis and {Tamhane, 2016 #31}management. Clinical Diabetes and Endocrinology, 2016. 2: p. 17.
3. Corvilain, B., The natural history of thyroid autonomy and hot nodules. Ann Endocrinol (Paris), 2003. 64 (1): p. 17-22.
4. Baek, J.H., A Guidebook on radiofrequency ablation for thyroid and neck tumors. 2017.
5. Kim, J.-H., J.H. Baek, H.K. Lim, H.S. Ahn, S.M. Baek, et al., 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology. Korean journal of radiology, 2018. 19 (4): p. 632-655.
6. Sung, J.Y., J.H. Baek, S.L. Jung, J.H. Kim, K.S. Kim, et al., Radiofrequency ablation for autonomously functioning thyroid nodules: a multicenter study. Thyroid, 2015. 25 (1): p. 112-7.
7. Solovov, V., Radiofrequency ablation of the autonomously functioning benign thyroid nodules: 5-years follow-up. 2018.
8. Spiezia, S., G. Vitale, C. Di Somma, A. Pio Assanti, A. Ciccarelli, et al., Ultrasound-guided laser thermal ablation in the treatment of autonomous hyperfunctioning thyroid nodules and compressive nontoxic nodular goiter. Thyroid, 2003. 13 (10): p. 941-7.
9. Baek, J.H., W.J. Moon, Y.S. Kim, J.H. Lee, and D. Lee, Radiofrequency ablation for the treatment of autonomously functioning thyroid nodules. World J Surg, 2009. 33(9): p. 1971-7.
10. Jung, S.L., J.H. Baek, J.H. Lee, Y.K. Shong, J.Y. Sung, et al., Efficacy and Safety of Radiofrequency Ablation for Benign Thyroid Nodules: A Prospective Multicenter Study. Korean journal of radiology, 2018. 19 (1): p. 167-174.
11. Cesareo, R., A. Palermo, D. Benvenuto, E. Cella, V. Pasqualini, et al., Efficacy of radiofrequency ablation in autonomous functioning thyroid nodules. A systematic review and meta-analysis. Rev Endocr Metab Disord, 2019. 20 (1): p. 37-44.
12. Bernardi, S., F. Stacul, A. Michelli, F. Giudici, G. Zuolo, et al., 12-month efficacy of a single radiofrequency ablation on autonomously functioning thyroid nodules. Endocrine, 2017. 57 (3): p. 402-408.
13. Ronga, G., M. Filesi, R. D’Apollo, M. Toteda, A.D. Di Nicola, et al., Autonomous Functioning Thyroid Nodules and 131I in Diagnosis and Therapy After 50 Years of Experience: What is Still Open to Debate? Clinical Nuclear Medicine, 2013. 38 (5): p. 349-353.
14. Park, H.S., J.H. Baek, A.W. Park, S.R. Chung, Y.J. Choi, et al., Thyroid Radiofrequency Ablation: Updates on Innovative Devices and Techniques. Korean Journal of Radiology, 2017. 18 (4): p. 615-623.