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Perez AS, Inada NM, Mezzacappo NF, Vollet-Filho JD, Bagnato VS. Microwave radiation and thermal effects on the bioenergetics of isolated mitochondria. Int J Radiat Biol 2024; 100:1093-1103. [PMID: 38843455 DOI: 10.1080/09553002.2024.2348073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 04/22/2024] [Indexed: 07/02/2024]
Abstract
AIMS This study proposes to investigate the effects of microwave radiation and its thermal effects, compared to thermal effects alone, on the bioenergetics of mitochondria isolated from mouse liver. METHODS The main parameters investigated in this study are mitochondrial respiration (coupled states: S3 and S4; uncoupled state), using a high-resolution respirometer, and swelling, using a spectrophotometer. RESULTS Mitochondria irradiated at 2.45 GHz microwave with doses 0.085, 0.113 and 0.141 kJ/g, presented a decrease in S3 and uncoupled state, but an increase in S4. Conversely, mitochondria thermally treated at 40, 44 and 50 °C presented an increasing in S3 and S4, while uncoupled state was unaltered. Mitochondrial swelling increases as a function of the dose or temperature, indicating membrane damages in both cases. CONCLUSION Microwave radiation and thermal effect alone indicated different bioenergetics mitochondria response. These results imply that the effects due to microwave in medical treatment are not exclusively due to the increase in temperature, but a combination of electromagnetic and thermal effects.
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Affiliation(s)
- Aline S Perez
- Sao Carlos Institute of Physics, University of Sao Paulo, Sao Carlos, Brazil
- Institute of Physics, University of Sao Paulo, Sao Paulo, Brazil
| | - Natalia M Inada
- Sao Carlos Institute of Physics, University of Sao Paulo, Sao Carlos, Brazil
| | | | - Jose D Vollet-Filho
- Sao Carlos Institute of Physics, University of Sao Paulo, Sao Carlos, Brazil
| | - Vanderlei S Bagnato
- Sao Carlos Institute of Physics, University of Sao Paulo, Sao Carlos, Brazil
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
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Aliberti C, Impellizzeri H, Inama M, Moretto G, Vitali A, Balduzzi A, Toaiari M, Francia G, Casaril A. Microwave ablation for large benign thyroid nodules: a proposal for a new approach: "the fluid-motion technique". Updates Surg 2024; 76:239-244. [PMID: 37899391 DOI: 10.1007/s13304-023-01663-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/29/2023] [Indexed: 10/31/2023]
Abstract
INTRODUCTION Most thyroid nodules are benign, and treatment is primarily indicated for patients with symptoms or cosmetic concerns related to nodular volume. Recently, there has been growing interest in nonsurgical and minimally invasive techniques for the treatment of symptomatic benign thyroid nodules, including microwave ablation (MWA). AIMS This study aims to evaluate the effectiveness, efficacy, and safety of ultrasound-guided uncooled MWA in the treatment of benign symptomatic thyroid nodules, using a new ablation technique called the "fluid-motion technique." MATERIALS AND METHODS From April 2021 to February 2023, a total of 150 patients with benign thyroid nodules were treated using MWA at the Endocrine Surgery Unit of Pederzoli Hospital, Peschiera del Garda (Italy), with 102 of them being followed-up for at least 6 months. RESULTS Before treatment, the mean major diameter was 38.4 ± 10.0 mm, and the mean volume was 13.6 ± 10.5 mL. At 1 month, the mean volume was 6.8 ± 6.2 mL, and at 3 months, it was 4.6 ± 4.1 mL. The mean Volume Reduction Rate (VRR) at 3 months was 61.1 ± 22.0%. Of the nodules, 17 (17%), 65 (66%), and 20 (19%) had volumes ≤ 10, 10.1-20, and ≥ 20.1 mL, respectively. For these nodules, the mean VRR at 3 and 6 months was 55.3 ± 16%, 63.4 ± 24.8%, 72 ± 26.9% and 68.0 ± 11.2%, 73.5 ± 18.3%, and 81.6 ± 15.8%, respectively. CONCLUSION Our study shows that ultrasound-guided MWA is an effective and safe minimally invasive treatment for benign thyroid nodules. The goal is to achieve a VRR that can reduce symptoms and improve cosmetic appearance.
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Affiliation(s)
- C Aliberti
- Interventional Radiology, Pederzoli Hospital, Peschiera del Garda, Italy
| | - H Impellizzeri
- EndocrineSurgery Unit, Pederzoli Hospital, Peschiera del Garda, Italy.
| | - M Inama
- Minimal Invasive Surgery, Pederzoli Hospital, Peschiera del Garda, Italy
| | - G Moretto
- Minimal Invasive Surgery, Pederzoli Hospital, Peschiera del Garda, Italy
| | - A Vitali
- Minimal Invasive Surgery, Pederzoli Hospital, Peschiera del Garda, Italy
| | - A Balduzzi
- Minimal Invasive Surgery, Pederzoli Hospital, Peschiera del Garda, Italy
| | - M Toaiari
- Endocrinology Service, Pederzoli Hospital, Peschiera del Garda, Italy
| | - G Francia
- Endocrinology Service, Pederzoli Hospital, Peschiera del Garda, Italy
| | - A Casaril
- EndocrineSurgery Unit, Pederzoli Hospital, Peschiera del Garda, Italy
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3
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Meta-Analysis of the Application Effect of Different Modalities of Thermal Ablation and Surgical Treatment in Papillary Thyroid Microcarcinoma. DISEASE MARKERS 2022; 2022:9714140. [PMID: 36217504 PMCID: PMC9547687 DOI: 10.1155/2022/9714140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/12/2022] [Indexed: 12/07/2022]
Abstract
Background Papillary thyroid microcarcinoma (PTMC) refers to papillary thyroid carcinoma (PTC) with a maximum diameter of 10 mm. Thermal ablation, including radiofrequency ablation (RFA), microwave ablation (MWA), and laser ablation (LA), has been applied in the treatment of benign thyroid nodules and captured extensive attention. At present, the application of thermal ablation in PTMC has been extensively reported, but outcomes such as volume reduction rate (VRR), complete remission rate (CRR), and adverse reaction rate (ARR) vary considerably. Therefore, this meta-analysis was performed to evaluate the safety and efficacy of different treatment methods of PTMC. Methods We did a systematic review and network meta-analysis. We searched PubMed, EMBase, and Cochrane-Library from the date of inception to January 10, 2022, to retrieve the VRR, CRR, and ARR of MWA, RFA, LA and surgical treatment of PTMC, and a meta-analysis was performed using the R meta-package. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated, and sensitivity analyses, cumulative meta-analyses, and publication bias were also performed. Relevant literature was retrieved with keywords; the eligible cohort studies were screened based on the established inclusion and exclusion criteria. Results A total of 1515 patients were included in the 12-month follow-up. The overall VRR was 86.25% (95% CI: 77.89, 94.60), and the VRR was RFA > WMA > LA, but the differences were not significant. A total of 1483 patients were included in the last follow-up. The overall VRR was 99.41% (95% CI: 99.11, 99.72), and the VRR was RFA > WMA > LA, but the differences were not significant. A total of 1622 patients showed complete remission at the last follow-up, and the overall CRR was 0.63 (95% CI: 0.46, 0.79). The CRR was RFA > LA > WMA, but the differences were not significant. A total of 1883 patients had adverse reactions at the last follow-up, and the overall ARR was 0.06 (95% CI: 0.03, 0.08). The ARR at the last follow-up was RFA = Surg < LA < WMA. The ARR of the RFA and Surg subgroups was significantly lower than that of the WMA subgroup. Conclusions Similar good efficacy and safety profiles were observed in WMA, RFA, LA, and surgical treatment in PTMC, among which RFA showed the best volume reduction, complete remission rate, and adverse reaction reduction. However, there is a slight bias in the limited literature included in this study, and we did not conduct or refer to mechanistic studies to confirm its specific mechanism of action. Clinicians are advised to use their discretion in the choice of treatment.
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Baldwin CK, Natter MB, Patel KN, Hodak SP. Minimally Invasive Techniques for the Management of Thyroid Nodules. Endocrinol Metab Clin North Am 2022; 51:323-349. [PMID: 35662444 DOI: 10.1016/j.ecl.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
Image-guided interventional techniques have emerged as promising treatments for thyroid disease. Percutaneous ethanol ablation, radiofrequency ablation, laser ablation, high intensity focused ultrasound, and microwave ablation have shown efficacy in treating benign thyroid disease. There is increasing evidence that these techniques may effectively treat papillary thyroid microcarcinomas, recurrent and metastatic disease, follicular neoplasms, and parathyroid lesions. They are performed in an outpatient setting, well-tolerated, with negligible risk for thyroid hormone supplementation, making them a popular alternative to surgical resection. In this comprehensive review, we discuss the devices, techniques, advantages, and disadvantages of each intervention, and summarize the published outcomes.
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Affiliation(s)
- Chelsey K Baldwin
- Department of Medicine, Diabetes and Endocrinology Section, New York University School of Medicine, 222 East, 41st Street, Floor 23, NY 10016, USA.
| | - Michael B Natter
- Department of Medicine, Diabetes and Endocrinology Section, New York University School of Medicine, 222 East, 41st Street, Floor 23, NY 10016, USA
| | - Kepal N Patel
- Otolaryngology and Biochemistry, Division of Endocrine Surgery, Department of Surgery, Division of Endocrine Surgery, New York University School of Medicine, 530 1st Avenue, Floor 12, NY 10016, USA
| | - Steven P Hodak
- Department of Medicine, Diabetes and Endocrinology Section, New York University School of Medicine, 222 East, 41st Street, Floor 23, NY 10016, USA
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5
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Zhang M, Luo Y. The Use of Ultrasound-Guided Microwave Ablation for Benign Thyroid Nodules. VideoEndocrinology 2022. [DOI: 10.1089/ve.2022.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mingbo Zhang
- Department of Ultrasound, General Hospital of Chinese PLA, Haidian, Beijing, China
| | - Yukun Luo
- Department of Ultrasound, General Hospital of Chinese PLA, Haidian, Beijing, China
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Uncooled Microwave Ablation as a Treatment Option to Preserve Thyroid Function in Patients with Benign Thyroid Nodules. J Belg Soc Radiol 2022; 106:50. [PMID: 35651913 PMCID: PMC9138712 DOI: 10.5334/jbsr.2746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/12/2022] [Indexed: 11/20/2022] Open
Abstract
Objective: The objective is to evaluate the long-term efficacy and safety of uncooled MWA for the treatment of benign thyroid nodules and its long-term effect on thyroid functions. Material and Methods: The study was conducted on 40 patients with 40 nodules. They were treated between September 2019 and December 2020. Nodules’ volumes, thyroid functions (triiodothyronine, free thyroxine, thyrotropin) and anti-thyroid peroxidase and anti-thyroglobulin antibodies were measured before treatment and at 3rd, 6th and 12th month following the treatment. Volume reduction rates and changes in clinical findings were evaluated. Results: The mean volume reduction rate was 49.88, 65.3, and 79.06% at 3rd, 6th, and 12th month, respectively. Antibody levels and thyroid function tests have remained within normal limits and were not exhibited significant change during follow-ups (p > 0.05), except for a significant increase in free thyroxin level at 12th-month (p = 0.007). Subjective symptoms and cosmetic scores were significantly improved all follow-up (p < 0.0001). The only complication was a first-degree skin burn in a patient. Conclusion: In conclusion, uncooled microwave ablation is an effective and safe method for the treatment of benign thyroid nodules and preserves thyroid function.
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7
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Guo DM, Chen Z, Zhai YX, Su HH. Comparison of radiofrequency ablation and microwave ablation for benign thyroid nodules: A systematic review and meta-analysis. Clin Endocrinol (Oxf) 2021; 95:187-196. [PMID: 33556187 DOI: 10.1111/cen.14438] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/19/2021] [Accepted: 02/02/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE To compare the effectiveness and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) for the treatment of benign thyroid nodules (BTNs). METHODS PubMed, Embase and Cochrane databases were searched up to September 11, 2020. Volume reduction rate (VRR), symptomatic and cosmetic scores analysed by standardized mean difference (SMD), and complications analysed by risk difference (RD) were performed to evaluate the efficacy and safety of RFA and MWA for treating BTNs. RESULTS Five eligible studies were included. 899 patients with 956 BTNs and 869 patients with 938 BTNs received RFA and MWA, respectively. RFA and MWA have the similar pooled 3-month (56.0% vs. 53.9%, p = .668) and 6-month (80.8% vs. 74.9%, p = .080) VRRs. But RFA showed a significantly higher VRR than MWA after 12 months (86.2% vs. 80.0%, p = .036). The pooled symptomatic and cosmetic scores decreased significantly after 6 and 12 months in both RFA and MWA. The improvements of symptoms were equivalent between two groups at 6 (SMD: 1.17 vs. 1.12, p = .930) and 12 (SMD: 1.46 vs. 1.45, p = .930) months. No significant differences in cosmetic scores were found between two groups at 6 (SMD: 0.87 vs. 0.94, p = 0. 334) and 12 (SMD: 1.21 vs. 1.15, p = 0. 872) months. Major (RD = -0.02, P = .107) and minor (RD = 0.00, p = .661) complications did not significantly differ between RFA and MWA. CONCLUSIONS RFA and MWA are effective and safe treatment modalities for BTNs. But RFA showed a superior 12-month VRR. RFA may have a better long-term effect on volume reduction of nodules compared with MWA.
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Affiliation(s)
- Dong-Ming Guo
- Department of Interventional Ultrasound, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Zhe Chen
- Department of Interventional Ultrasound, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Yu-Xia Zhai
- Department of Interventional Ultrasound, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
- Department of Ultrasound, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Hong-Hui Su
- Department of Interventional Ultrasound, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
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Technique and Procedural Aspects of Radiofrequency Ablation of Thyroid Nodules. CURRENT OTORHINOLARYNGOLOGY REPORTS 2021. [DOI: 10.1007/s40136-020-00321-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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9
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Mo HS, Wei L, Ye H, Li ZX. Microwave Ablation of Visible Benign Thyroid Nodules with Different Internal Characteristics: A Comparative Study with Follow-up Results. J INVEST SURG 2020; 35:347-353. [PMID: 33292024 DOI: 10.1080/08941939.2020.1854903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To investigate the effects of microwave ablation (MWA) on visible benign thyroid nodules (BTN) with different internal characteristics. MATERIALS & METHODS A total of 51 cases with 53 visible BTN were treated by ultrasound-guided percutaneous MWA. The 53 nodules were classified into three categories according to the internal characteristics, which were simple solid, mainly solid and mainly cystic nodules. Ultrasound examinations were performed to evaluate the volume shrinkage rations during follow-up. The thyroid functions and the cervical cosmetic scores were evaluated. The complications were observed during and after ablation. RESULTS A total of 53 symptomatic BTN were treated by MWA completely. The average volume of the nodules was 11.68 ± 10.16 ml, the volume reduction rates (VRR) at 1st, 3rd, 6th, 12th, and 18th months after ablation were 0.29 ± 0.27, 0.46 ± 0.25, 0.67 ± 0.19, 0.83 ± 0.10, and 0.92 ± 0.10, respectively. The VRR was significantly different among the three categories of lesions (p < 0.05). The symptoms of all patients were improved. Thyroid function indicators were fluctuated in normal range. There were no serious complications during and after the procedure. CONCLUSION MWA of visible BTN is safe and effective, and the short-time ablation effect is significantly different due to the internal characteristics of the nodule.
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Affiliation(s)
- Hai She Mo
- Ultrasound Center, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Li Wei
- Department of Ultrasound, The Peoplés Hospital of QIANNAN, Duyun, Guizhou, China
| | - Hui Ye
- Department of Thyroid Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Zhi Xian Li
- Department of Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Efficacy of Ultrasound-guided Radiofrequency Ablation of Parathyroid Hyperplasia: Single Session vs. Two-Session for Effect on Hypocalcemia. Sci Rep 2020; 10:6206. [PMID: 32277134 PMCID: PMC7148367 DOI: 10.1038/s41598-020-63299-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 03/28/2020] [Indexed: 12/18/2022] Open
Abstract
To evaluate safety and efficacy of one- vs. two-session radiofrequency ablation (RFA) of parathyroid hyperplasia for patients with secondary hyperparathyroidism (SHPT) and to compare the outcome of both methods on hypocalcemia. Patients with secondary hyperparathyroidism underwent ultrasound guided RFA of parathyroid hyperplasia. Patients were alternately assigned to either group 1 (n = 28) with RFA of all 4 glands in one session or group 2 (n = 28) with RFA of 2 glands in a first session and other 2 glands in a second session. Serum parathyroid hormone (PTH), calcium, phosphorus and alkaline phosphatase (ALP) values were measured at a series of time points after RFA. RFA parameters, including operation duration and ablation time and hospitalization length and cost, were compared between the two groups. Mean PTH decreased in group 1 from 1865.18 ± 828.93 pg/ml to 145.72 ± 119.27 pg/ml at 1 day after RFA and in group 2 from 2256.64 ± 1021.72 pg/ml to 1388.13 ± 890.15 pg/ml at 1 day after first RFA and to 137.26 ± 107.12 pg/ml at 1 day after second RFA. Group 1's calcium level decreased to 1.79 ± 0.31 mmol/L at day 1 after RFA and group 2 decreased to 1.89 ± 0.26 mmol/L at day 1 after second session RFA (P < 0.05). Multivariate analysis showed that hypocalcemia was related to serum ALP. Patients with ALP ≥ 566 U/L had lower calcium compared to patients with ALP < 566 U/L up to a month after RFA (P < 0.05). Group 1's RFA time and hospitalization were shorter and had lower cost compared with Group 2. US-guided RFA of parathyroid hyperplasia is a safe and effective method for treating secondary hyperparathyroidism. Single-session RFA was more cost-effective and resulted in a shorter hospital stay compared to two sessions. However, patients with two-session RFA had less hypocalcemia, especially those with high ALP.
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Zhu Y, Zhang M, Jin Z, Tian X, Zhang Y, Xie F, Song Q, Yan L, Jiang B, Tang J, Luo Y. Solid benign thyroid nodules (>10 ml): a retrospective study on the efficacy and safety of sonographically guided ethanol ablation combined with radiofrequency ablation. Int J Hyperthermia 2020; 37:157-167. [PMID: 32024398 DOI: 10.1080/02656736.2020.1717647] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Yaqiong Zhu
- Medical College, Nankai University, Tianjin, China
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Mingbo Zhang
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhuang Jin
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
- Department of Ultrasound, General Hospital of Northern Military Area, China
| | - Xiaoqi Tian
- Medical College, Nankai University, Tianjin, China
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ying Zhang
- Medical College, Nankai University, Tianjin, China
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fang Xie
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Qing Song
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Lin Yan
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Bo Jiang
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jie Tang
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Yukun Luo
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
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Trimboli P, Castellana M, Sconfienza LM, Virili C, Pescatori LC, Cesareo R, Giorgino F, Negro R, Giovanella L, Mauri G. Efficacy of thermal ablation in benign non-functioning solid thyroid nodule: A systematic review and meta-analysis. Endocrine 2020; 67:35-43. [PMID: 31327158 DOI: 10.1007/s12020-019-02019-3] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Image-guided thermal ablations are commonly used in the treatment of thyroid nodules. Radiofrequency ablation (RFA) and laser ablation are the most commonly used. Here we aimed to obtain solid evidence of the long-term efficacy of RFA and laser ablation in benign non-functioning solid thyroid nodules (BNFSTN). METHODS PubMed, CENTRAL, Scopus, and Web of Science were searched until March 2019. Studies reporting the effectiveness of RFA or laser ablation in patients with BNFSTN in terms of volume reduction rate (VRR), compressive symptoms and cosmetic concerns were included. Complications were also assessed. RESULTS Out of 963 papers, 12 studies on RFA and 12 on laser ablation were included, assessing 1186 and 2009 BNFSTNs, respectively. Overall, VRR at 6, 12, 24, and 36 months was 60%, 66%, 62%, and 53%. VRR of RFA was 68%, 75%, and 87%, respectively. VRR of laser ablation was 48%, 52%, 45%, and 44%, respectively. Baseline volume of nodules undergone RFA was significantly smaller compared to laser ablation (20.1 ± 22.4 versus 24.6 ± 23.6 ml; p < 0.01). Nodules smaller than 30 ml obtained better outcomes than larger ones. A significant reduction in compressive symptoms and cosmetic concerns was found after RFA. CONCLUSIONS This meta-analysis showed that both RFA and laser ablation are able to obtain a significant volume reduction in BNFSTNs. A significant volume reduction is already evident at 6 months after thermal ablation and results are stable over the time.
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Affiliation(s)
- Pierpaolo Trimboli
- Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Marco Castellana
- Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Luca Maria Sconfienza
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy.
- IRCCS Istituto Ortopedico Galeazzi, Unit of Diagnostic and Interventional Radiology, Milano, Italy.
| | - Camilla Virili
- Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | | | - Roberto Cesareo
- Unit of Metabolic Diseases, S.M.Goretti, Latina Hospital, Latina, Italy
| | - Francesco Giorgino
- Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Roberto Negro
- Division of Endocrinology, "V. Fazzi" Hospital, Lecce, Italy
| | - Luca Giovanella
- Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Clinic for Nuclear Medicine, University Hospital and University of Zurich, Zurich, Switzerland
| | - Giovanni Mauri
- Division of Interventional Radiology, European Institute of Oncology IRCCS, Milan, Italy
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Liu SY, Guo WH, Yang B, Li YF, Huang XY, Wang XQ, Chen J, Xue D, Zhou XH. Comparison of stress response following microwave ablation and surgical resection of benign thyroid nodules. Endocrine 2019; 65:138-143. [PMID: 30904997 DOI: 10.1007/s12020-019-01900-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 03/12/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE To compare the effects and safety of using microwave ablation (MWA) and surgical resection for the treatment of benign thyroid nodules (BTNs) under ultrasonic guidance and investigate the effects of this treatment on stress response. METHODS Patients with BTNs were divided into the MWA and operation groups (72 cases each). Interleukin (IL)-6, IL-8, serum tumor necrosis factor (TNF-α), and hydrostatic visual analog scale (VAS) prior to the operation, at 6 h, 24 h, and 72 h post-operation were compared between the two groups. Operation times, hospitalization times, hospitalization expenses, and postoperative complications in the two groups were also compared. All patients underwent routine ultrasound and thyroid function testing at 3 and 6 months post-operation for assessment of nodule changes and thyroid hormone levels. RESULTS Compared to the MWA group, the operation group had longer average operation times, longer hospital stays, a higher rate of neck pain after surgery, and a higher rate of fever (P < 0.05). Body temperature, as well as VAS, IL-6, IL-8, and TNF-α levels in the operation group were higher than those in the MWA group at 6 h, 24 h, and 72 h post-operation (P < 0.05). The levels of free thyroxine and free triiodothyronine in the operation group were lower than those in the MWA group (P < 0.05). CONCLUSION MWA is a safe and effective treatment for patients with BTNs. The effects of MWA are more tolerable than those of surgical resection and the physiological function of the thyroid is preserved, which has high clinical value.
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Affiliation(s)
- Shu-Yan Liu
- Department of Endocrinology, The First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People's Hospital), 454000, Jiaozuo, China
| | - Wei-Hong Guo
- Department of Ultrasound Medicine, The First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People's Hospital), 454000, Jiaozuo, China
| | - Bo Yang
- Department of Neurology, The First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People's Hospital), 454000, Jiaozuo, China
| | - Yong-Feng Li
- Department of Endocrinology, The First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People's Hospital), 454000, Jiaozuo, China
| | - Xiao-Yun Huang
- Department of Ultrasound Medicine, The First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People's Hospital), 454000, Jiaozuo, China
| | - Xiao-Qing Wang
- Department of Endocrinology, The First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People's Hospital), 454000, Jiaozuo, China
| | - Jie Chen
- Department of Endocrinology, The First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People's Hospital), 454000, Jiaozuo, China
| | - Dan Xue
- Department of Ultrasound Medicine, The First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People's Hospital), 454000, Jiaozuo, China
| | - Xue-Hong Zhou
- Department of Endocrinology, The First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People's Hospital), 454000, Jiaozuo, China.
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Ding M, Tang X, Cui D, Chi J, Shi Y, Wang T, Zhai B, Li P. Clinical outcomes of ultrasound-guided radiofrequency ablation for the treatment of primary papillary thyroid microcarcinoma. Clin Radiol 2019; 74:712-717. [PMID: 31253420 DOI: 10.1016/j.crad.2019.05.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 05/20/2019] [Indexed: 01/04/2023]
Abstract
AIM To evaluate the safety, efficacy, and long-term outcomes of ultrasound-guided radiofrequency ablation (RFA) for the treatment of primary papillary thyroid microcarcinoma (PTMC). MATERIALS AND METHODS A total of 37 patients with 38 PTMC nodules underwent RFA at a power of 20 W between September 2014 and December 2017. The clinical data of these patients were reviewed retrospectively and analysed. Imaging studies of the nodules were conducted, and the patients' thyroid function was assessed before RFA; 1, 3, 6, and 12 months after RFA; and every 6 months thereafter. The volumes and volume reduction rate (VRR) of the nodules were also calculated. RESULTS RFA with a low power of 20 W was used in the treatment of 37 patients with 38 PTMC nodules. All nodules achieved complete ablation, no complications occurred, and thyroid function was not affected. During follow-up, the volume of the nodules gradually decreased. Twelve months after ablation, the mean volumes of the nodules significantly decreased to 0.01±0.03 ml with a VRR of 99.34±3.49%. At a median follow-up of 6 (range: 1-18) months, 37 of the 38 nodules were completely absorbed, and no recurrence was observed in all 37 patients. CONCLUSIONS Low-power RFA showed good safety and promising efficacy outcomes for the treatment of PTMC. In addition to surgery and active surveillance, RFA may be an alternative treatment option for patients with PTMC.
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Affiliation(s)
- M Ding
- Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160# Pujian Road, Shanghai, 200127, China
| | - X Tang
- Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160# Pujian Road, Shanghai, 200127, China
| | - D Cui
- Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160# Pujian Road, Shanghai, 200127, China
| | - J Chi
- Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160# Pujian Road, Shanghai, 200127, China
| | - Y Shi
- Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160# Pujian Road, Shanghai, 200127, China
| | - T Wang
- Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160# Pujian Road, Shanghai, 200127, China
| | - B Zhai
- Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160# Pujian Road, Shanghai, 200127, China.
| | - P Li
- Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160# Pujian Road, Shanghai, 200127, China.
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Shi YF, Zhou P, Zhao YF, Liu WG, Tian SM, Liang YP. Microwave Ablation Compared With Laser Ablation for Treating Benign Thyroid Nodules in a Propensity-Score Matching Study. Front Endocrinol (Lausanne) 2019; 10:874. [PMID: 31920983 PMCID: PMC6923173 DOI: 10.3389/fendo.2019.00874] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 11/28/2019] [Indexed: 12/30/2022] Open
Abstract
Objective: The efficacy and safety of percutaneous ultrasound-guided microwave and laser ablation (MWA and LA, respectively), for treating benign thyroid nodules (BTNs), were retrospectively compared. Methods: Patients (n = 318) underwent ablation of 328 BTNs. Confounding bias was reduced by propensity-score matching, and finally the MWA and LA groups each comprised 160 nodules. At baseline (before ablation), 3, 6, and 12 months, and every 6 months thereafter, the following were recorded: nodule volume reduction rate (VRR), neck symptom scores, cosmetic scores, complications, and side effects. Results: The baseline characteristics of the MWA and LA groups were comparable. The volumes of all nodules were less at all follow-ups relative to the baseline, as were the symptom and cosmetic scores at postoperative 6 months and thereafter (P < 0.01). At each follow-up, the overall VRRs of the MWA and LA groups were comparable. However, for nodules ≥13 mL, the VRR associated with LA at ≥6 months was significantly greater than that of MWA. The average ablation time for MWA was less than that of LA (P < 0.01). The overall incidences of major complications, minor complications, and side effects were 1.6, 2.2, and 18.4%, respectively, and there were no significant differences between the MWA and LA groups. Conclusion: Percutaneous ultrasound-guided MWA and LA are both safe and effective for the treatment of BTNs. Each can significantly reduce the nodule volume and improve the neck symptoms and appearance of patients, with a low incidence of adverse side effects. The efficiency of MWA is higher than that of LA. For nodules ≥13 mL, MWA may be preferred, but at 6 months and subsequent follow-ups the reduction in volume was greater in patients receiving LA.
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Zheng BW, Wang JF, Ju JX, Wu T, Tong G, Ren J. Efficacy and safety of cooled and uncooled microwave ablation for the treatment of benign thyroid nodules: a systematic review and meta-analysis. Endocrine 2018; 62:307-317. [PMID: 30073455 DOI: 10.1007/s12020-018-1693-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate the effectiveness and safety of microwave ablation (MWA), including cooled MWA (cMWA) and uncooled MWA (uMWA), for the treatment of benign thyroid nodules (BTNs). METHODS The databases of MEDLINE, EMBASE and Cochrane library were searched up to 3 Jun, 2018. In this meta-analysis, data of volume reduction rates (VRRs) at the 3-, 6- and 12-month follow-up, and complications are obtained to evaluate the effectiveness and safety of cMWA and uMWA for the treatment of BTNs. RESULTS Nine studies involving 1461 patients with 1845 BTNs were included. The pooled VRR at the 3-month follow-up after MWA therapy reached 54.3% (95% CI: 45.3-63.3%, I2 = 97.6%), 73.5% (95% CI: 66.7-80.3%, I2 = 94.9%) at the 6-month follow-up, and 88.6% (95% CI: 84.9-92.4%, I2 = 92.7%) at the 12-month follow-up. The pooled proportions of overall, major and minor complications were 52.4% (95% CI: 29.8-74.9%; I2 = 99.5%), 4.8% (95% CI: 2.7-7.0%; I2 = 55.9%) and 48.3% (95% CI: 31.2-65.4%; I2 = 99.7%). Both cMWA and uMWA achieved similar pooled VRR at the 3-month follow-up (58.4 vs 45.3%, P = 0.07) and pooled proportion of major complications (4.9 vs 5.0%, P = 0.49), while uMWA had higher pooled proportions of overall and minor complications than cMWA (97.8 vs 29.7%, P < 0.01; 97.8 vs 21.0%, P < 0.01), with more patients suffering pain and skin burn after uMWA (100 vs 5.5%, P < 0.01; 47.2 vs 0.2%, P < 0.01). CONCLUSION MWA is an effective treatment modality for BTNs. When considering the patient's comfort, cMWA would be a more preferable procedure with less complications.
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Affiliation(s)
- Bo-Wen Zheng
- Department of Medical Ultrasonics, Guangdong Province Key Laboratory of Hepatology Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Jin-Fen Wang
- Department of Medical Ultrasonics, Guangdong Province Key Laboratory of Hepatology Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Jin-Xiu Ju
- Department of Medical Ultrasonics, Guangdong Province Key Laboratory of Hepatology Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Tao Wu
- Department of Medical Ultrasonics, Guangdong Province Key Laboratory of Hepatology Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Ge Tong
- Department of Medical Ultrasonics, Guangdong Province Key Laboratory of Hepatology Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Jie Ren
- Department of Medical Ultrasonics, Guangdong Province Key Laboratory of Hepatology Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
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Trimboli P, Bini F, Marinozzi F, Baek JH, Giovanella L. High-intensity focused ultrasound (HIFU) therapy for benign thyroid nodules without anesthesia or sedation. Endocrine 2018; 61:210-215. [PMID: 29453658 DOI: 10.1007/s12020-018-1560-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 02/04/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Thermal ablation of thyroid nodules has gained momentum due to the possibility to avoid surgery. High-intensity focused ultrasound (HIFU) allows thermal treatment by energy ultrasound beam inside the targeted zone. Aim of our study was to evaluate the effects of HIFU treatment using Beamotion mode without anesthesia. METHODS Since 2016, patients with normal thyroid function, benign thyroid nodules with diameter no larger than 4 cm, and presenting local discomfort and/or compressive symptoms were treated by HIFU. We performed Beamotion HIFU and did not use anesthesia. Nodule size and thyroid function were evaluated before HIFU and 6 and 12 months later. Complications to therapy and tolerability of patients were also recorded. According to local ethical committee, for this retrospective study formal consent was not required. RESULTS The final series included 26 nodules from 26 patients with estimated volume of 2.81 ± 2.04 mL, treated by a power of 33.3 ± 10.3 W/site and energy of 2.1 ± 1.1 kJ. Nodules volume was significantly (p < 0.0001) reduced at 6 months of follow-up (1.83 ± 1.63 mL), and further at 1 year (1.57 ± 1.47 mL). Mean percentage of reduction over time of nodules was 48%. A 73% of patients described good comfort during treatment, 100% experienced good comfort just after therapy, and tolerability was high. No complications were recorded. At one 1 year of follow-up, 85% of subjects reported a reduction of local symptoms. CONCLUSIONS HIFU therapy is effective in reducing size of thyroid nodules with major diameter below 4 cm and can be performed without anesthesia.
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Affiliation(s)
- Pierpaolo Trimboli
- Department of Nuclear Medicine and Thyroid Centre, Oncology Institute of Southern Switzerland, Bellinzona, 6500, Switzerland.
| | - Fabiano Bini
- Department of Mechanical and Aerospace Engineering, "Sapienza" University of Rome, Rome, 00184, Italy
| | - Franco Marinozzi
- Department of Mechanical and Aerospace Engineering, "Sapienza" University of Rome, Rome, 00184, Italy
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, Korea
| | - Luca Giovanella
- Department of Nuclear Medicine and Thyroid Centre, Oncology Institute of Southern Switzerland, Bellinzona, 6500, Switzerland
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Yan J, Qiu T, Lu J, Wu Y, Yang Y. Microwave ablation induces a lower systemic stress response in patients than open surgery for treatment of benign thyroid nodules. Int J Hyperthermia 2018; 34:606-610. [PMID: 29366346 DOI: 10.1080/02656736.2018.1427286] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE In this study, we compared the systemic stress response induced by microwave ablation with that induced by conventional open surgery for treatment of benign thyroid nodules. METHODS A total of 108 patients with benign thyroid nodules were randomly assigned to receive ultrasound-guided thyroid microwave ablation (microwave group, n = 57) and conventional open thyroid surgery (open group, n = 51). Body temperature, white blood cell (WBC) counts, visual analogue scale (VAS) scores for pain, and serum levels of high sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6) and cortisol were measured at 24 h before operation and at 8 h, 24 h and 48 h after operation. RESULTS No significant between-group differences were observed with respect to preoperative body temperature, VAS scores, WBC counts, serum hs-CRP, IL-6 and cortisol levels. Patients in the open group exhibited higher body temperature at 24 h after operation and higher WBC counts at both 24 h and 48 h after operation, as compared to those in the microwave group. As compared with microwave ablation, open surgery was associated with significantly higher VAS scores, and significantly higher serum levels of hs-CRP, IL-6 and cortisol at all postoperative time-points (8 h, 24 h and 48 h). CONCLUSION Microwave ablation induces a lower systemic stress response than open surgery for treatment of benign thyroid nodules.
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Affiliation(s)
- Jing Yan
- a Department of General Surgery , Panzhihua Central Hospital , Panzhihua , China
| | - Tihong Qiu
- a Department of General Surgery , Panzhihua Central Hospital , Panzhihua , China
| | - Jing Lu
- a Department of General Surgery , Panzhihua Central Hospital , Panzhihua , China
| | - Yanjun Wu
- a Department of General Surgery , Panzhihua Central Hospital , Panzhihua , China
| | - Yinghong Yang
- a Department of General Surgery , Panzhihua Central Hospital , Panzhihua , China
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Liu YJ, Qian LX, Liu D, Zhao JF. Ultrasound-guided microwave ablation in the treatment of benign thyroid nodules in 435 patients. Exp Biol Med (Maywood) 2017; 242:1515-1523. [PMID: 28847173 DOI: 10.1177/1535370217727477] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The objective of the present study was to investigate the effectiveness and safety of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules. A total of 474 benign thyroid nodules in 435 patients who underwent ultrasound-guided microwave ablation from September 2012 to August 2015 were included. Nodule volume and thyroid function were measured before treatment and at 1, 3, 6, and 12 months and subsequently after every 6 months. The nodule volume reduction rate and changes of thyroid function were evaluated. The volume of all thyroid nodules significantly decreased after ultrasound-guided microwave ablation. The average volume was 13.07 ± 0.95 ml before treatment, and 1.14 ± 0.26 ml at 12-months follow-up. The mean volume reduction rate was 90% and the final volume reduction rate was 94%. The volume reduction rate of mainly cystic nodules was significantly higher than that of simple solid and mainly solid nodules (all P < 0.05). The pretreatment volume of nodules was positively correlated with the final volume reduction rate at final follow-up ( P = 0.004). No serious complications were observed after treatment. In conclusion, ultrasound-guided microwave ablation is an effective and safe technique for treatment of benign thyroid nodules, and has the potential for clinical applications. Impact statement Ultrasound-guided MWA is an effective and safe technique for the treatment of benign thyroid nodules. It can significantly reduce the nodule volume, improve the patients' clinical symptoms, has less complication, guarantees quick recovery, meets patients' aesthetic needs, and shows less interference on the physiological and psychological aspects of the body. MWA should be a good complement to traditional open surgery and has potentials in clinical applications.
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Affiliation(s)
- Yu-Jiang Liu
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Lin-Xue Qian
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Dong Liu
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Jun-Feng Zhao
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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Pacella CM, Mauri G, Cesareo R, Paqualini V, Cianni R, De Feo P, Gambelunghe G, Raggiunti B, Tina D, Deandrea M, Limone PP, Mormile A, Giusti M, Oddo S, Achille G, Di Stasio E, Misischi I, Papini E. A comparison of laser with radiofrequency ablation for the treatment of benign thyroid nodules: a propensity score matching analysis. Int J Hyperthermia 2017; 33:911-919. [PMID: 28605944 DOI: 10.1080/02656736.2017.1332395] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To compare technique efficacy and safety of laser ablation (LA) and radiofrequency ablation (RFA) in treatment of benign thyroid nodules. MATERIALS AND METHODS Institutional review board approval was obtained, and patients' consent was waived. 601 nodules were treated from May 2009 to December 2014 at eight centres, 449 (309 females, age 57 ± 14 years) with LA and 152 (107 females, age 57 ± 14 years) with RFA. A matched cohort composed of 138 patients from each group was selected after adjustment with propensity score matching. Factors influencing volume reduction at 6 and 12 months and complications were evaluated. RESULTS No significant differences were observed in the baseline characteristics between groups after propensity score matching adjustment. Mean nodule reduction at 6 and 12 months was -67 ± 19% vs. -57 ± 21% (p < 0.001) - 70 ± 19% vs. -62 ± 22% (p = 0.001) in LA group and in RFA group, respectively. Nodules with volume >30 mL had significantly higher percentage volume reduction at 6 and 12 months (-69 ± 19 vs. -50 ± 21, p = 0.001) and (-73 ± 18 vs. -54 ± 23 8, p = 0.001) in the LA group than in the RFA group, respectively. In both groups, operator's skills affected the results. Major complications occurred in 4 cases in each group (p = 0.116) Conclusions: LA and RFA showed nearly similar outcome but LA was slightly more effective than RFA in large nodules. Operator's skills could be crucial in determining the extent of nodule volume reduction regardless of the used technique.
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Affiliation(s)
| | - Giovanni Mauri
- b Department of Interventional Radiology , European Institute of Oncology , Milan , Italy
| | - Roberto Cesareo
- c Thyroid Disease Center "S.M. Goretti" Hospital , Latina , Italy
| | | | - Roberto Cianni
- c Thyroid Disease Center "S.M. Goretti" Hospital , Latina , Italy
| | - Pierpaolo De Feo
- d Department of Internal Medicine , University of Perugia , Perugia , Italy
| | | | | | - Doris Tina
- e Endocrinology Unit, Atri Hospital , Atri , Italy
| | - Maurilio Deandrea
- f Thyroid Disease Center "A. Costa" Mauriziano Hospital , Turin , Italy
| | - Pier Paolo Limone
- f Thyroid Disease Center "A. Costa" Mauriziano Hospital , Turin , Italy
| | - Alberto Mormile
- f Thyroid Disease Center "A. Costa" Mauriziano Hospital , Turin , Italy
| | - Massimo Giusti
- g Endocrinology Department , AOU-IST IRCSS San Martino University of Genoa , Genoa , Italy
| | - Silvia Oddo
- g Endocrinology Department , AOU-IST IRCSS San Martino University of Genoa , Genoa , Italy
| | - Gaetano Achille
- h Cervico-Facial Ultrasound Diagnostic and Interventional Unit , Institute of Oncology of Bari , Bari , Italy
| | - Enrico Di Stasio
- i Institute of Biochemistry and Clinical Biochemistry , Rome Catholic University "Sacro Cuore" , Rome , Italy
| | - Irene Misischi
- j Department of Endocrinology , "Regina Apostolorum" Hospital , Albano Laziale , Italy
| | - Enrico Papini
- j Department of Endocrinology , "Regina Apostolorum" Hospital , Albano Laziale , Italy
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Zhuo L, Peng LL, Zhang YM, Xu ZH, Zou GM, Wang X, Li WG, Lu MD, Yu MA. US-guided Microwave Ablation of Hyperplastic Parathyroid Glands: Safety and Efficacy in Patients with End-Stage Renal Disease—A Pilot Study. Radiology 2017; 282:576-584. [DOI: 10.1148/radiol.2016151875] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Yu MA, Yao L, Zhang L, Peng L, Zhuo L, Zhang Y, Li W, Lv MD. Safety and efficiency of microwave ablation for recurrent and persistent secondary hyperparathyroidism after parathyroidectomy: A retrospective pilot study. Int J Hyperthermia 2015; 32:180-6. [PMID: 26606889 DOI: 10.3109/02656736.2015.1101788] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Recurrent and persistent secondary hyperparathyroidism (SHPT) nodules have an incidence of 10-70% after surgery. The treatment of recurrent and persistent SHPT nodules is a challenge, and surgical resection of difficult-to-reach or post-operative adhesions often fails. PURPOSE The aim of this research was to study the safety and effectiveness of microwave ablation (MWA) for recurrent and persistent SHPT. MATERIALS AND METHODS This was a retrospective study of 11 patients enrolled with a total of 16 nodules, and MWA was employed to manage SHPT. The laboratory test results, including the intact parathyroid hormone (iPTH), serum calcium, phosphorus and alkaline phosphatase (ALP) levels, improvement of SHPT-related symptoms after ablation, and complications during and after MWA were recorded and analysed. RESULTS After ablation the value of iPTH was markedly decreased from 1570 ± 1765 pg/mL to 287 ± 239 pg/mL 1 day after MWA (p < 0.05). The levels of serum calcium and phosphorus decreased from 2.51 ± 0.23 mmol/L to 2.06 ± 0.27 mmol/L (p < 0.001) and 1.80 ± 0.43 mmol/L to 1.48 ± 0.32 mmol/L (p < 0.05), respectively, 1 day after MWA. There was no significant difference in the ALP value before and after MWA (p > 0.05). The clinical symptoms, including ostalgia, pruritus, disability, and restless legs, improved after MWA. Minor complications and side effects encountered during or after MWA include haematoma (1/11, 9%), transient hoarseness (2/11, 18.2%), hypocalcemia (6/11, 54.5%). No major complication occurred. CONCLUSION MWA may be safe and effective to manage recurrent and persistent SHPT nodules; a definite conclusion needs to expand the sample size with a longer follow-up time.
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Affiliation(s)
- Ming-An Yu
- a Interventional Ultrasound Centre, China-Japan Friendship Hospital , Beijing
| | - Li Yao
- b Endoscopy Centre, China-Japan Friendship Hospital , Beijing
| | - Ling Zhang
- c Department of nephrology , China-Japan Friendship Hospital , Beijing , China
| | - Lili Peng
- a Interventional Ultrasound Centre, China-Japan Friendship Hospital , Beijing
| | - Li Zhuo
- c Department of nephrology , China-Japan Friendship Hospital , Beijing , China
| | - Yumei Zhang
- c Department of nephrology , China-Japan Friendship Hospital , Beijing , China
| | - Wenge Li
- c Department of nephrology , China-Japan Friendship Hospital , Beijing , China
| | - Ming-De Lv
- a Interventional Ultrasound Centre, China-Japan Friendship Hospital , Beijing
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Preliminary Results in Unresectable Head and Neck Cancer Treated by Radiofrequency and Microwave Ablation: Feasibility, Efficacy, and Safety. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2015.05.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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