Image-guided thermal ablation in autonomously functioning thyroid nodules. A retrospective multicenter three-year follow-up study from the Italian Minimally Invasive Treatment of the Thyroid (MITT) Group.
Eur Radiol
; 32(3): 1738-1746, 2022 Mar.
Article
de En
| MEDLINE
| ID: mdl-34751793
ABSTRACT
OBJECTIVES:
To report the results of a multicenter retrospective evaluation of the clinical outcomes of thermal ablation (TA) in a large series of autonomously functioning thyroid nodules (AFTN) with a follow-up protracted up to 3 years.METHODS:
Patients treated with single TA for an AFTN in Italy were included. Changes in nodule volume, TSH values, and ongoing anti-thyroid therapy were assessed at the 2-, 6-, 12-, 24-, and 36-month follow-up controls. Complications and need of any additional therapy after TA were also registered.RESULTS:
A total of 361 patients (244 females, 117 males, median age 58 years, IQR 46-70 years) were included. Nodule volume was significantly reduced at all time points (p < 0.001) (median volume reduction 58% at 6-month and 60% at 12-month). Serum TSH values increased significantly at all time points. After TA, anti-thyroid therapy was withdrawn in 32.5% of patients at 2 months, in 38.9% at 6 months, and in 41.3% at 12 months. A significant difference in the rate of patients who withdrawn medical therapy at 12 months was registered between small (< 10 mL) (74%), medium (49%), or large (> 30 mL) nodules (19%). A single major complication occurred (0.25%). Additional treatments were needed in 34/361 (9.4%) of cases including 4 (1.1%) surgical treatment.CONCLUSIONS:
Image-guided thermal ablation offers a further safe and effective therapeutic option in patients with AFTN. Clinical outcomes are significantly more favorable in small than in large size AFTN. KEY POINTS ⢠Thermal ablations (TA) can be safely and effectively used in patients with autonomously functioning thyroid nodules (AFTN). ⢠TA results in a clinically significant nodule volume reduction that is paralleled by TSH level normalization and anti-thyroid drug therapy discontinuation (after TA anti-thyroid therapy was withdrawn in 41.3% at 12 months). ⢠Clinical outcomes after TA are more favorable in small nodules, and when a large amount of thyroid nodule tissue is ablated.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Nodule thyroïdien
/
Hyperthermie provoquée
Type d'étude:
Observational_studies
/
Prognostic_studies
Limites:
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Eur Radiol
Sujet du journal:
RADIOLOGIA
Année:
2022
Type de document:
Article
Pays d'affiliation:
Italie