Thermal ablation of thyroid nodules: are radiofrequency ablation, microwave ablation and high intensity focused ultrasound equally safe and effective methods?
Yücel Korkusuz, Daniel Gröner, Natascha Raczynski, Oleg Relin, Yasmina Kingeter, Frank Grünwald, Christian Happel
Author Information
Yücel Korkusuz: Department of Nuclear Medicine, University Hospital Frankfurt, Theodor-Stern-Kai 7, D-60590, Frankfurt/Main, Germany.
Daniel Gröner: Department of Nuclear Medicine, University Hospital Frankfurt, Theodor-Stern-Kai 7, D-60590, Frankfurt/Main, Germany.
Natascha Raczynski: Department of Nuclear Medicine, University Hospital Frankfurt, Theodor-Stern-Kai 7, D-60590, Frankfurt/Main, Germany. s9351593@rz.uni-frankfurt.de.
Oleg Relin: Department of Nuclear Medicine, University Hospital Frankfurt, Theodor-Stern-Kai 7, D-60590, Frankfurt/Main, Germany.
Yasmina Kingeter: Department of Nuclear Medicine, University Hospital Frankfurt, Theodor-Stern-Kai 7, D-60590, Frankfurt/Main, Germany.
Frank Grünwald: Department of Nuclear Medicine, University Hospital Frankfurt, Theodor-Stern-Kai 7, D-60590, Frankfurt/Main, Germany.
Christian Happel: Department of Nuclear Medicine, University Hospital Frankfurt, Theodor-Stern-Kai 7, D-60590, Frankfurt/Main, Germany.
OBJECTIVES: This study compares volume reduction of benign thyroid nodules three months after Radiofrequency Ablation (RFA), Microwave Ablation (MWA) or High Intensity Focused Ultrasound (HIFU) to evaluate which of these methods is the most effective and safe alternative to thyroidectomy or radioiodine therapy. MATERIAL AND METHODS: Ninety-four patients (39 male, 55 female) with a total of 118 benign, symptomatic thyroid nodules were divided into three subgroups. HIFU was applied to 14 patients with small nodules. The other 80 patients were divided up into two groups of 40 patients each for RFA and MWA in the assumption that both methods are comparable effective. The pre-ablative and post-ablative volume was measured by ultrasound. RESULTS: RFA showed a significant volume reduction of nodules of 50 % (p<0.05), MWA of 44 % (p<0.05) and HIFU of 48 % (p<0.05) three months after ablation. None of the examined ablation techniques caused serious or permanent complications. CONCLUSION: RFA, MWA and HIFU showed comparable results considering volume reduction. All methods are safe and effective treatments of benign thyroid nodules. KEY POINTS: • Thermal Ablation can be used to treat benign thyroid nodules • Thermal Ablation can be an alternative to thyroidectomy or radioiodine therapy • Radiofrequency Ablation, Microwave Ablation, High Intensity Focused Ultrasound are safe and effective.
