2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology

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Abstract

Thermal ablation using radiofrequency is a new, minimally invasive modality employed as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. The Task Force Committee of the Korean Society of Thyroid Radiology (KSThR) developed recommendations for the optimal use of radiofrequency ablation for thyroid tumors in 2012. As new meaningful evidences have accumulated, KSThR decided to revise the guidelines. The revised guideline is based on a comprehensive analysis of the current literature and expert consensus.

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Most cited references 130

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Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study.

M Meloni, Luigi Solbiati, Tito Livraghi … (2003)

To report complications encountered by members of a collaborative group who performed radio-frequency (RF) ablation in patients with focal liver cancer. Members of 41 Italian centers that were part of a collaborative group used a percutaneous internally cooled RF ablation technique and a standardized protocol for follow-up. They completed a questionnaire regarding number of deaths, presumed cause of death, and likelihood of its relationship to the RF procedure; number and types of major complications; and types of minor complications and side effects. Enrollment included 2,320 patients with 3,554 lesions (size, 3.1 cm +/- 1.1 [SD] in diameter): 1,610 had hepatocellular carcinoma with chronic liver disease; 693 had metastases, predominantly from colorectal cancer (n = 501); and 17 had cholangiocellular carcinoma. Number and characteristics of complications (ie, deaths and major and minor complications) attributed to the procedure were reported. Data were subsequently analyzed with analysis of variance to determine whether the major complication rate was related to tumor size, number of ablation sessions, or electrode type (single or cluster). In total, 3,554 lesions were treated. Six deaths (0.3%) were noted, including two caused by multiorgan failure following intestinal perforation; one case each of septic shock following Staphylococcus aureus-caused peritonitis, massive hemorrhage following tumor rupture, liver failure following stenosis of right bile duct; and one case of sudden death of unknown cause 3 days after the procedure. Fifty (2.2%) patients had additional major complications. The most frequent of these were peritoneal hemorrhage, neoplastic seeding, intrahepatic abscesses, and intestinal perforation. An increased number of RF sessions were related to a higher rate of major complications (P <.01), whereas the number of complications was not significantly different when tumor size or electrode type were compared. Minor complications were observed in less than 5% of patients. Results of this study confirm that RF ablation is a relatively low-risk procedure for the treatment of focal liver tumors.

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Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients.

Y. Kim, Jee Jeong, Woo Kyoung Jeong … (2008)

This study evaluated the safety and volume reduction of ultrasonography (US)-guided radiofrequency ablation (RFA) for benign thyroid nodules, and the factors affecting the results obtained. A total of 302 benign thyroid nodules in 236 euthyroid patients underwent RFA between June 2002 and January 2005. RFA was carried out using an internally cooled electrode under local anesthesia. The volume-reduction ratio (VRR) was assessed by US and safety was determined by observing the complications during the follow-up period (1-41 months). The correlation between the VRR and several factors (patient age, volume and composition of the index nodule) was evaluated. The volume of index nodules was 0.11-95.61 ml (mean, 6.13 +/- 9.59 ml). After ablation, the volume of index nodules decreased to 0.00-26.07 ml (mean, 1.12 +/- 2.92 ml) and the VRR was 12.52-100% (mean, 84.11 +/- 14.93%) at the last follow-up. A VRR greater than 50% was observed in 91.06% of nodules, and 27.81% of index nodules disappeared. The complications encountered were pain, hematoma and transient voice changes. In conclusion, RFA is a safe modality effective at reducing volume in benign thyroid nodules.

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Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study.

So-Lyung Jung, D. Kim, Sun I l Kim … (2011)

To evaluate clinical aspects and imaging features of complications encountered in the treatment of benign thyroid nodules with radiofrequency (RF) ablation. Institutional review board approval was obtained for this retrospective study, and informed consent was waived. From June 2002 to September 2009, 1459 patients underwent RF ablation of 1543 thyroid nodules with an RF system with internally cooled electrodes at 13 thyroid centers, which were members of Korean Society of Thyroid Radiology. Numbers and types of major and minor complications were assessed. The authors observed 48 complications (3.3%), 20 major and 28 minor. The major complications were voice changes (n = 15), brachial plexus injury (n = 1), tumor rupture (n = 3), and permanent hypothyroidism (n = 1). The minor complications were hematoma (n = 15), skin burn (n = 4), and vomiting (n = 9). All patients recovered spontaneously except for one with permanent hypothyroidism and one who underwent surgery. Although the complication rate of RF ablation is low, various complications may occur; comprehension of complications and suggested technical tips may prevent complications or properly manage those that occur. © RSNA, 2011.

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Author and article information

Journal

Journal ID (nlm-ta): Korean J Radiol

Journal ID (iso-abbrev): Korean J Radiol

Journal ID (publisher-id): KJR

Title: Korean Journal of Radiology

Publisher: The Korean Society of Radiology

ISSN (Print): 1229-6929

ISSN (Electronic): 2005-8330

Publication date (Print): Jul-Aug 2018

Publication date (Electronic): 14 June 2018

Volume: 19

Issue: 4

Pages: 632-655

Affiliations

[1 ]Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea.

[2 ]Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.

[3 ]Department of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul 04401, Korea.

[4 ]Department of Radiology and Thyroid Center, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Korea.

[5 ]Department of Radiology, Haeundae Sharing and Happiness Hospital, Busan 48101, Korea.

[6 ]Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul 03181, Korea.

[7 ]Department of Radiology, Ajou University School of Medicine, Suwon 16499, Korea.

[8 ]Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul 06351, Korea.

[9 ]Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.

[10 ]Department of Radiolgy, Incheon Medical Center, Incheon 22532, Korea.

[11 ]Department of Radiology, Human Medical Imaging and Intervention Center, Seoul 06524, Korea.

[12 ]Department of Radiology, New Korea Hospital, Kimpo 10086, Korea.

[13 ]Department of Radiology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.

[14 ]Department of Radiology, Research Institute and Hospital, National Cancer Center, Goyang 10408, Korea.

[15 ]Department of Radiology, Sheikh Khalifa Specialty Hospital, Ras al Khaimah, UAE.

[16 ]Department of Radiology, Ansan Hospital, Korea University College of Medicine, Ansan 15355, Korea.

[17 ]Department of Radiology, Hanyang University College of Medicine, Hanyang University Hospital, Seoul 04763, Korea.

[18 ]Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.

[19 ]Department of Radiology and Thyroid Center, Daerim St. Mary's Hospital, Seoul 07442, Korea.

[20 ]Department of Radiology, Withsim Clinic, Seongnam 13590, Korea.

[21 ]Division for Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul 04554, Korea.

[22 ]Department of Radiology, GangNeung Asan Hospital, Gangneung 25440, Korea.

Author notes

Corresponding author: Jung Hwan Baek, MD, PhD, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: (822) 3010-4352, Fax: (822) 476-0090, radbaek@ 123456naver.com

Article

DOI: 10.3348/kjr.2018.19.4.632

PMC ID: 6005940

PubMed ID: 29962870

SO-VID: 02f9fce8-5b3c-4bc4-880e-c3086aaa27d9

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 04 May 2018

Date accepted : 10 May 2018

Funding

Funded by: Ministry of Health and Welfare, CrossRef http://dx.doi.org/10.13039/501100003625;

2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology

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Most cited references 130

Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study.

Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients.

Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study.

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