Treating thyroid nodules by radiofrequency: is the delivered energy correlated with the volume reduction rate? A pilot s
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Treating thyroid nodules by radiofrequency: is the delivered energy correlated with the volume reduction rate? A pilot study Pierpaolo Trimboli
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Maurilio Deandrea
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Received: 20 January 2020 / Accepted: 16 March 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Objective Radiofrequency ablation (RFA) was proven as effective in reducing thyroid nodules’ volume. However, whether technical procedure aspects could influence the volume reduction rate (VRR) has not been clarified. This retrospective pilot study aimed to analyze the correlation of RFA power, duration, and energy with VRR. Methods During the period from June to December 2018 two primary-care centers treated benign thyroid nodules of adult outpatients according to the same RFA procedure. Technical parameters to be investigated were the following: median power (Pmedian), effective time of treatment (Teff), energy calculated as Pmedian × Teff (Ecalc), and energy delivered per mL as Kcal × 4184 × nodule’s volume (Edel). Continuous variables were analyzed by the Mann–Whitney test. Data of 1-year posttreatment follow-up were collected on December 2019 and the correlation of the above parameters with VRR was analyzed by linear regression. Results Forty-one nodules were included and their 1-year VRR was 66.6%. RFA was performed with a Pmedian of 55 W, Teff 10.24 min, Ecalc 31,380 J, and Edel 1473 J/mL. Edel was significantly correlated with VRR (p = 0.014) while Pmedian, Teff, and Ecalc not. A strong correlation of Edel with VRR was found in nodules 10 mL. Conclusions This study showed that the energy delivered with RFA is the only technical parameter significantly correlated with the VRR of thyroid nodules. Keywords Intervention Thyroid nodule Radiofrequency ablation Energy ●
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Introduction The prevalence of thyroid nodule in the general population approaches to 70% and only a minority of these patients has a thyroid cancer [1–3]. Among the vast number of patients with benign nodules, those with lesions responsible for neck compressive symptoms and/or cosmetic concerns can be considered for a treatment. While surgery has traditionally
* Pierpaolo Trimboli [email protected] 1
Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
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Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
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Endocrinology, Diabetes and Metabolism Department and Center for Thyroid Diseases, A.O. Ordine Mauriziano, Turin, Italy
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represented the main treatment choice, nonsurgical thermal therapies of benign thyroid nodules have been rapidly diffused due to their efficacy combined with poor procedurerelated risks/side effects [4, 5]. In particular, laser and radiofrequency ablation (RFA), as the most popular thermal options in the thyroid field, have been proven to be effective in shrinking ben
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