Objective: To assess the predictors of successful inactivation of benign thyroid nodules using radiofrequency ablation (RFA) and the hormonal responses thereafter. Methods: A retrospective study conducted at Zhongnan Hospital of Wuhan University (January 2022 to January 2024) analysed thyroid tumor characteristics using B-mode ultrasound, colour Doppler imaging, and CEUS post-RFA. Thyroid hormone levels were also assessed before RFA and at 1, 3, and 6 months after the procedure. Results: The study involved 72 patients with benign thyroid nodules, comprising 13 males and 59 females, with a mean age of 45.8 ± 12.1 years. Complete inactivation was achieved in 70.8% of nodules, while 29.2% showed partial inactivation. Nodules with complete inactivation exhibited more calcification (p = 0.040), whereas those with partial inactivation demonstrated higher vascularity (p < 0.001). Hormonal levels remained within normal ranges, with no significant differences between the groups. Multivariate logistic regression identified nodular vascularity (p < 0.001) as an independent predictor of nodule inactivation after RFA. Conclusion: In conclusion, this study found that therapeutic RFA effectively achieves high rates of complete inactivation in benign thyroid nodules, with the degree of inactivation mainly influenced by nodule vascularity and calcifications.
References
[1]
Li, Y., Jin, C., Li, J., Tong, M., Wang, M., Huang, J., et al. (2021) Prevalence of Thyroid Nodules in China: A Health Examination Cohort-Based Study. FrontiersinEndocrinology, 12, Article 676144. https://doi.org/10.3389/fendo.2021.676144
[2]
Muhammad, H., Tehreem, A. and Russell, J.O. (2022) Radiofrequency Ablation and Thyroid Cancer: Review of the Current Literature. AmericanJournalofOtolaryngology, 43, Article ID: 103204. https://doi.org/10.1016/j.amjoto.2021.103204
[3]
Cesareo, R., Palermo, A., Pasqualini, V., Cianni, R., Gaspa, G., Manfrini, S., et al. (2017) Radiofrequency Ablation for the Management of Thyroid Nodules: A Critical Appraisal of the Literature. ClinicalEndocrinology, 87, 639-648. https://doi.org/10.1111/cen.13422
[4]
Guth, S., Theune, U., Aberle, J., Galach, A. and Bamberger, C.M. (2009) Very High Prevalence of Thyroid Nodules Detected by High Frequency (13 MHz) Ultrasound Examination. EuropeanJournalofClinicalInvestigation, 39, 699-706. https://doi.org/10.1111/j.1365-2362.2009.02162.x
[5]
Muhammad, H., Santhanam, P. and Russell, J.O. (2021) Radiofrequency Ablation and Thyroid Nodules: Updated Systematic Review. Endocrine, 72, 619-632. https://doi.org/10.1007/s12020-020-02598-6
[6]
Orloff, L.A., Noel, J.E., Stack, B.C., Russell, M.D., Angelos, P., Baek, J.H., et al. (2021) Radiofrequency Ablation and Related Ultrasound-Guided Ablation Technologies for Treatment of Benign and Malignant Thyroid Disease: An International Multidisciplinary Consensus Statement of the American Head and Neck Society Endocrine Surgery Section with the Asia Pacific Society of Thyroid Surgery, Associazione Medici Endocrinologi, British Association of Endocrine and Thyroid Surgeons, European Thyroid Association, Italian Society of Endocrine Surgery Units, Korean Society of Thyroid Radiology, Latin American Thyroid Society, and Thyroid Nodules Therapies Association. Head&Neck, 44, 633-660. https://doi.org/10.1002/hed.26960
[7]
Petrasova, H., Slaisova, R., Rohan, T., Stary, K., Kyclova, J., Pavlik, T., et al. (2022) Contrast‐enhanced Ultrasonography for Differential Diagnosis of Benign and Malignant Thyroid Lesions: Single-Institutional Prospective Study of Qualitative and Quantitative CEUS Characteristics. ContrastMedia&MolecularImaging, 2022, Article ID: 8229445. https://doi.org/10.1155/2022/8229445
[8]
Ma, X., Zhang, B., Ling, W., Liu, R., Jia, H., Zhu, F., et al. (2015) Contrast-Enhanced Sonography for the Identification of Benign and Malignant Thyroid Nodules: Systematic Review and Meta-Analysis. JournalofClinicalUltrasound, 44, 199-209. https://doi.org/10.1002/jcu.22311
[9]
Wang, Y., Dong, T., Nie, F., Wang, G., Liu, T. and Niu, Q. (2021) Contrast-Enhanced Ultrasound in the Differential Diagnosis and Risk Stratification of ACR TI-RADS Category 4 and 5 Thyroid Nodules with Non-Hypovascular. FrontiersinOncology, 11, Article 662273. https://doi.org/10.3389/fonc.2021.662273
[10]
Sengupta, S., Araujo, A.A., Shindo, M.L. and Park, B.J. (2024) Radiomic Texture Analysis for Classification of Radiofrequency Ablated Thyroid Nodules. Medical Imaging 2024: Imaging Informatics for Healthcare, Research, and Applications, San Diego, 18-23 February 2024, 160-166. https://doi.org/10.1117/12.3008536
[11]
Xu, D., et al. (2016) Radiofrequency Ablation for Postsurgical Thyroid Removal of Differentiated Thyroid Carcinoma. American Journal of Translational Research, 8, 1876-1885. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859916/
[12]
Lin, Y., Shi, Y., Tang, X., Ding, M., He, Y., Li, P., et al. (2022) Significance of Radiofrequency Ablation in Large Solid Benign Thyroid Nodules. FrontiersinEndocrinology, 13, Article 902484. https://doi.org/10.3389/fendo.2022.902484
[13]
Jung, S.L., Baek, J.H., Lee, J.H., Shong, Y.K., Sung, J.Y., Kim, K.S., et al. (2018) Efficacy and Safety of Radiofrequency Ablation for Benign Thyroid Nodules: A Prospective Multicenter Study. KoreanJournalofRadiology, 19, 167-174. https://doi.org/10.3348/kjr.2018.19.1.167
[14]
Xu, D., Wang, L., Yang, Y., Li, M., Zheng, C., Qiu, X., et al. (2019) Safety and Efficacy of Ultrasound-Guided Percutaneous Thermal Ablation in Treating Low-Risk Papillary Thyroid Microcarcinoma: A Pilot and Feasibility Study. JournalofCancerResearchandTherapeutics, 15, 1522-1529. https://doi.org/10.4103/jcrt.jcrt_214_19
[15]
Nguyen, V.B., Nguyen, T.X., Nguyen, V.V.H., Nguyen, H.T., Nguyen, D.T. and Le, C.V. (2021) Efficacy and Safety of Single-Session Radiofrequency Ablation in Treating Benign Thyroid Nodules: A Short-Term Prospective Cohort Study. InternationalJournalofEndocrinology, 2021, Article ID: 7556393. https://doi.org/10.1155/2021/7556393
[16]
Motaghed, Z., Chegeni, H., Mosadeghkhah, A., Azimi Aval, M., Gerami, R. and Ebrahiminik, H. (2023) Effect of Ultrasound Parameters of Benign Thyroid Nodules on Radiofrequency Ablation Efficacy. BMCMedicalImaging, 23, Article No. 85. https://doi.org/10.1186/s12880-023-01044-z
[17]
Deandrea, M., Trimboli, P., Mormile, A., Cont, A.T., Milan, L., Buffet, C., et al. (2021) Determining an Energy Threshold for Optimal Volume Reduction of Benign Thyroid Nodules Treated by Radiofrequency Ablation. EuropeanRadiology, 31, 5189-5197. https://doi.org/10.1007/s00330-020-07532-y
[18]
Lyung Jung, S. (2022) Advanced Techniques for Thyroid Nodule Radiofrequency Ablation. TechniquesinVascularandInterventionalRadiology, 25, Article ID: 100820. https://doi.org/10.1016/j.tvir.2022.100820
[19]
Navin, P.J., Thompson, S.M., Kurup, A.N., Lee, R.A., Callstrom, M.R., Castro, M.R., et al. (2022) Radiofrequency Ablation of Benign and Malignant Thyroid Nodules. RadioGraphics, 42, 1812-1828. https://doi.org/10.1148/rg.220021
[20]
Li, Y., He, H., Li, W., Zhao, J., Ge, N., Zhang, Y., et al. (2022) Efficacy and Safety of Radiofrequency Ablation for Calcified Benign Thyroid Nodules: Results of over 5 Years’ Follow-up. BMCMedicalImaging, 22, Article No. 75. https://doi.org/10.1186/s12880-022-00795-5
[21]
Chan, S.J., Betcher, M.C., Kuo, E.J., McManus, C.M., Lee, J.A. and Kuo, J.H. (2024) Trends in Thyroid Function Following Radiofrequency Ablation of Benign, Nonfunctioning Thyroid Nodules: A Single Institution Review. TheAmericanJournalofSurgery, 237, Article ID: 115793. https://doi.org/10.1016/j.amjsurg.2024.115793
[22]
Tang, X., Li, P., Zhai, B. and Zhu, X. (2021) Changes in Thyroid Antibody and T Lymphocyte Subsets after Radiofrequency Ablation of Thyroid Nodules in Patients with Autoimmune Thyroiditis. JournalofCancerResearchandTherapeutics, 17, 638-643. https://doi.org/10.4103/jcrt.jcrt_1421_20
[23]
Rodriguez Escobedo, R., Martinez Tames, G., Lanes Iglesias, S., Alonso Felgueroso, C., Montes Garcia, A.M., Prieto Fernandez, A., et al. (2022) Efficacy in Size and Symptom Reduction of Radiofrequency Ablation of Benign Non-Functioning Thyroid Nodules. Endocrinología, DiabetesyNutrición, 69, 194-200. https://doi.org/10.1016/j.endien.2022.02.018
[24]
Kim, C., Lee, J.H., Choi, Y.J., Kim, W.B., Sung, T.Y. and Baek, J.H. (2016) Complications Encountered in Ultrasonography-Guided Radiofrequency Ablation of Benign Thyroid Nodules and Recurrent Thyroid Cancers. EuropeanRadiology, 27, 3128-3137. https://doi.org/10.1007/s00330-016-4690-y
[25]
Wang, J., Wu, T., Hu, K., Xu, W., Zheng, B., Tong, G., et al. (2017) Complications Following Radiofrequency Ablation of Benign Thyroid Nodules: A Systematic Review. ChineseMedicalJournal, 130, 1361-1370. https://doi.org/10.4103/0366-6999.206347
[26]
Hussain, I., Zulfiqar, F., Li, X., Ahmad, S. and Aljammal, J. (2021) Safety and Efficacy of Radiofrequency Ablation of Thyroid Nodules—Expanding Treatment Options in the United States. JournaloftheEndocrineSociety, 5, bvab110. https://doi.org/10.1210/jendso/bvab110
[27]
Wang, N., Zheng, B., Wu, T., Tan, L., Lian, Y., Ma, Y., et al. (2021) Thyroid Dysfunction Following Radiofrequency Ablation for Benign Thyroid Nodules: More Likely to Occur within One-Week and in High-Risk Population. InternationalJournalofHyperthermia, 38, 1060-1068. https://doi.org/10.1080/02656736.2021.1950849
