Thyroid Radiofrequency Ablation: Updates on Innovative Devices and Techniques

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Abstract

Radiofrequency ablation (RFA) is a well-known, effective, and safe method for treating benign thyroid nodules and recurrent thyroid cancers. Thyroid-dedicated devices and basic techniques for thyroid RFA were introduced by the Korean Society of Thyroid Radiology (KSThR) in 2012. Thyroid RFA has now been adopted worldwide, with subsequent advances in devices and techniques. To optimize the treatment efficacy and patient safety, understanding the basic and advanced RFA techniques and selecting the optimal treatment strategy are critical. The goal of this review is to therefore provide updates and analysis of current devices and advanced techniques for RFA treatment of benign thyroid nodules and recurrent thyroid cancers.

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Most cited references 52

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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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Radiofrequency ablation of benign non-functioning thyroid nodules: 4-year follow-up results for 111 patients.

Joseph Sung, Wun-Jae Kim, E Ha … (2013)

To evaluate the clinical outcomes and safety of radiofrequency (RF) ablation for benign non-functioning thyroid nodules over a 4-year follow-up. We evaluated 126 benign non-functioning thyroid nodules of 111 patients treated with RF ablation and followed-up more than 3 years. RF ablation was performed using the Cool-Tip RF system and an internally cooled electrode. Nodule volume and cosmetic and symptom scores were evaluated before treatment and during follow-up. Complications and factors related to efficacy were evaluated. The mean follow-up duration was 49.4 ± 13.6 months. Thyroid nodule volume decreased significantly, from 9.8 ± 8.5 ml before ablation to 0.9 ± 3.3 ml (P < 0.001) at final evaluation: a mean volume reduction of 93.4 ± 11.7 %. The mean cosmetic (P < 0.001) and symptom scores (P < 0.001) improved significantly. Factors related to efficacy were initial solidity and volume. The overall recurrence rate was 5.6 % (7/126). The overall complication rate was 3.6 % (4/111). RF ablation was effective in shrinking benign thyroid nodules and in controlling nodule-related problems over a 4-year follow-up. There were no life-threatening complications or sequelae. Therefore, RF ablation can be used as a non-surgical treatment for patients with benign non-functioning thyroid nodules.

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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 2017

Publication date (Electronic): 19 May 2017

Volume: 18

Issue: 4

Pages: 615-623

Affiliations

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

[2 ]Department of Radiology, Vascular & Interventional Radiology Section, University of Virginia Health System, Charlottesville, VA 22908-0170, USA.

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) 3010-4348, Fax: (822) 476-0090, radbaek@ 123456naver.com

Article

DOI: 10.3348/kjr.2017.18.4.615

PMC ID: 5447637

PubMed ID: 28670156

SO-VID: 12786344-1346-4a57-beec-d30afe8337df

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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.

Thyroid Radiofrequency Ablation: Updates on Innovative Devices and Techniques

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Most cited references 52

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.

Radiofrequency ablation of benign non-functioning thyroid nodules: 4-year follow-up results for 111 patients.

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