Radiofrequency Ablation Is a Thyroid Function–Preserving Treatment for Patients with Bilateral Benign Thyroid Nodules

• Published in: Journal of vascular and interventional radiology Vol. 26; no. 1; pp. 55 - 61
• Main Authors: Ji Hong, Min, MD, Baek, Jung Hwan, MD, Choi, Young Jun, MD, Lee, Jeong Hyun, MD, Lim, Hyun Kyung, MD, Shong, Young Kee, MD, Hong, Suck Joon, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2015
• Subjects: Adult; Aged; Aged, 80 and over; Catheter Ablation; Female; Humans; Male; Middle Aged; Radiology; Recovery of Function; Retrospective Studies; Thyroid Gland - diagnostic imaging; Thyroid Gland - surgery; Thyroid Nodule - diagnostic imaging; Thyroid Nodule - surgery; thyroid peroxidase; TPO; Treatment Outcome; Ultrasonography; thyroid peroxidase; TPO
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2014.09.015

Abstract Purpose To evaluate the efficacy and safety of radiofrequency (RF) ablation for treatment of bilateral thyroid nodules as well as preservation of thyroid function. Materials and Methods Between January 2007 and October 2012, 18 patients (16 women and 2 men; mean age, 49.9 y; median age, 44 y; age range, 27–81 y) with bilateral thyroid nodules treated by RF ablation were included in this study. The inclusion criteria included bilateral thyroid nodules, pressure symptoms or cosmetic problems, cytologic confirmation of benignancy without atypical cells, and patient refusal of surgery. We used an RF generator (Cool-tip RF system [Covidien, Boulder, Colorado] or SSP-2000, Taewoong Medical Co, Ltd [Gyeonggi-do, Republic of Korea]) and an 18-gauge internally cooled electrode with 1-cm active tips (Cool-tip [Covidien] or Well-Point RF electrode [Taewoong Medical Co, Ltd]). RF ablation was conducted using the moving shot technique and a trans-isthmic approach. RF ablation was performed in separate sessions for nodules in each lobe. Follow-up ultrasound examinations were performed at 1–6 months, 6–12 months, and during the last month of follow-up. The diameter and volume of the nodule and clinical problems including cosmetic and symptom scores were evaluated before and after the procedure. Results The mean initial nodule size was 4.1 cm ± 1.9, although there was a significant decrease by the time of the last follow-up examination (range, 1–48 mo; mean, 18.1 mo ± 12.8; P < .001, 2.5 cm ± 1.4). The initial nodule volume was 24.4 mL ± 32.2 and was decreased at the last follow-up (6.3 mL ± 19.0, P < .001), with a mean volume reduction of 75.9% ± 19.0. The symptom ( P < .001) and cosmetic ( P < .001) scores were decreased. Serum hormone levels did not differ significantly before treatment and at the last follow-up ( P > .05). Conclusions RF ablation improves cosmetic problems and symptoms and preserves thyroid function in patients with bilateral thyroid nodules.