Abstract
Objectives Aim: of the study was to define the effectiveness and safety of US-guided percutaneous radiofrequency (RF) thermal ablation in the treatment of compressive solid benign thyroid nodules.
Methods: 31 patients, not liable to surgery or radioiodine (131I) treatment, underwent RF ablation for benign nodules; a total of 33 nodules were treated (two patients had two nodules treated in the same session): 10 cold nodules and 23 hyperfunctioning. Fourteen
patients complained of compressive symptoms. Nodule volume, thyroid function and compressive symptoms were evaluated before treatment and at 1, 3, and 6 months. US-guided RF ablation was performed using Starbust RITA© needle, with 9 expandable prongs; total exposure time was 6-10 minutes at 95 °C in one area or more of the nodule.
Results: Baseline volume (measured at the time of RF ablation) was 27.7 ? 21.5 ml (mean ? SD) but significantly decreased during follow-up: 19.2 ? 16.2 at 1 month (-32.7% p<0.001), 15.9 ? 14.1 ml at 3 months (-46.4 % p<0.001), 14.6 ? 12.6 ml at 6 months (-50.7% p<0.001). After treatment, all patients with cold nodules remained euthyroid; five patients with hot nodules normalized thyroid function, while the remaining sixteen showed a partial remission of hyperthyroidism. Besides a sensation of heat and a mild swelling of the neck, no major complications were observed. Improvement in compressive symptoms was reported by thirteen patients, with a reduction on severity scale from 6.1 ? 1.4 to 2.2 ? 1.9 (p<0.0001). Hyperfunction was fully controlled in 24% of patients and partially reduced in the others.
Conclusions: RF is an effective and safe tecnique in reducing volume of large benign nodules by about 50% and therefore in reducing compressive symptoms.