Radiofrequency ablation (RFA) of benign thyroid nodules in patients with incompletely resolved clinical problems after ethanol ablation (EA)

Abstract

Background: Although ethanol ablation (EA) is effective, refractory cases have been reported in 5-25% of patients, with a marked decline in efficacy on subsequent reattempt. The aim of this study was to evaluate the role of radiofrequency ablation (RFA) after EA of benign thyroid nodules in patients with incompletely resolved initial clinical problems.

Methods: Among 137 patients with 137 benign thyroid nodules who underwent EA, 27 patients (M:F = 5:22; mean age = 38 years, range = 21-60 years) underwent additional RFA if all of the following criteria were fulfilled: (1) complaint of incompletely resolved clinical problems, (2) demonstration of remaining solid component with internal vascularity on 1-month follow-up power Doppler US, and (3) patient desire for additional treatment. After RFA, there was improvement of clinical symptoms and characteristics and volume reduction of the treated nodules as seen on US; complications were evaluated at each follow-up.

Results: The mean follow-up duration was 21.2 months (range = 6-38 months) after RFA. The mean symptom grading score of 10-cm visual analog scale, the mean cosmetic grading score on a 4-point scale, and the mean volume reduction of thyroid nodules were all significantly decreased from those seen before RFA (2.4-1.1, 3.7-1.5, and 4.2-1.1, respectively) (P < 0.05). There were no major complications.

Conclusions: RFA is an effective and safe method for treating benign thyroid nodules in patients with incompletely resolved clinical problems following EA.