Document Detail


Radiofrequency ablation for the treatment of autonomously functioning thyroid nodules.
MedLine Citation:
PMID:  19575141     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 nine patients (4 toxic and 5 pretoxic patients; male to female ratio = 1:8; mean age, 47 +/- 17 (range, 25-71) years) who were not eligible for surgery or radioiodine therapy. All of the patients showed hot nodule with suppression of normal thyroid gland in (99m)Tc pertechnetate scintigraphy. RFA was performed using a 17- and 18-gauge internally cooled electrode. Nodule volume, thyroid function, scintigraphy, symptom score (visual analogue scale, 0-10 cm), cosmetic grading score (4-point scale), and complications were evaluated before treatment and at 1, 3, and 6 months follow-up. RESULTS: Mean volume of the index nodule was 14.98 +/- 25.53 (range, 0.29-82.29) mL. After RFA it decreased at 1 month (12.01 +/- 25.97 mL, p = 0.015), 3 months (7.27 +/- 15.13 mL, p = 0.011), 6 months (8.27 +/- 21.29 mL, p = 0.008), and the last month (7.57 +/- 19.99 mL, p = 0.008). Initial mean T3, fT4, and TSH were 156.2 +/- 42.1 ng/dL, 1.73 +/- 0.40 ng/dL, and 0.052 +/- 0.087 mU/mL, respectively. A significant improvement of mean T3, fT4, and TSH were observed at last follow-up (T3: 116.8 +/- 20.7 ng/dL, p = 0.015; fT4: 1.37 +/- 0.26 ng/dL, p = 0.036; TSH: 1.454 +/- 1.756 mU/mL, p = 0.012). After ablation, four patients became a cold or normal scan and five remained as a hot nodule. The mean symptom and cosmetic grading score was reduced from 2.4 +/- 1.7 to 0.6 +/- 0.7 (p = 0.011) and from 3.1 +/- 1.2 to 1.4 +/- 1.0 (p = 0.017), respectively. No major complications were encountered. CONCLUSIONS: RFA seems to be effective and safe for the treatment of AFTN.
Authors:
Jung Hwan Baek; Won-Jin Moon; Yoon Suk Kim; Jeong Hyun Lee; Ducky Lee
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  33     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-17     Completed Date:  2009-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1971-7     Citation Subset:  IM    
Affiliation:
Department of Radiology, Thyroid Center, Daerim St. Mary's Hospital, #978-13 Daerim-dong, Youngdeunpo-gu, Seoul, 150-070, Korea. radbaek@naver.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Ambulatory Care
Biopsy, Fine-Needle
Catheter Ablation* / instrumentation
Female
Humans
Male
Middle Aged
Retrospective Studies
Statistics, Nonparametric
Thyroid Function Tests
Thyroid Nodule / pathology,  radionuclide imaging,  surgery*
Treatment Outcome

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