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. 2023 Jan 25;12(1):e220175.
doi: 10.1530/ETJ-22-0175. Print 2023 Feb 1.

Multiple overlapping microwave ablation in benign thyroid nodule: a single-center 24-month study

Eduardo Crespo Vallejo  1 , Antonio Hermosin  1 , Manuel Gargallo  2 , Álvaro Villalba  1 , Eduardo Daguer  1 , José Flores  1 , Javier Periañez  1 , Joaquim Amorín  1 , Ernesto Santos  3
Affiliations

Multiple overlapping microwave ablation in benign thyroid nodule: a single-center 24-month study

Eduardo Crespo Vallejo et al. Eur Thyroid J. .

Abstract

Objective: This study aimed to evaluate the safety and long-term efficacy using the multiple overlapping ablation technique with a novel non-cooled microwave system in benign symptomatic thyroid nodules.

Methods: This prospective cohort single-center study collected complication data from the start of the procedure to 30 days postoperatively and evaluated the safety and effectiveness with a follow-up of 24 months. Ultrasound examinations were performed to determine the volume shrinkage during follow-up. Thyroid function cosmetic and symptoms scores and satisfaction degree were evaluated.

Results: A total of 30 symptomatic benign thyroid nodules were treated by microwave ablation using a power between 15 and 30 W depending on the size of the nodule to be treated. The volume reduction rates in months 1, 3, 6, 9, 12, and 24 after ablation were 32, 59, 67, 69, 73, and 81%, respectively. The mean symptom score and mean cosmetic score before treatment were 4 and 3, respectively, while after treatment they dropped to 3 and 1, respectively. Thyroid function indicators fluctuated in the normal range and those with hyperthyroidism recovered to normal parameters. One case of temporary laryngeal paralysis occurred postoperatively and fully recovered in less than 3 months.

Conclusions: The novel microwave ablation system presented herein can help achieve good clinical success rate in benign thyroid nodules with a satisfying safety profile. The microwave ablation performed with the multiple overlapping ablation technique could be a good alternative to surgery and radiofrequency ablation in the management of benign thyroid nodules.

Keywords: microwave; moving shot technique; multiple overlapping ablation; radiofrequency; thyroid nodule.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
In this graph, two types of multiple overlapping ablation techniques used with the MW TATO system are shown. The first line presents the classic trans-isthmic access with partial withdrawal of the needle once the ablation has stopped, to go to the next ablative area once the first one has been achieved. In the second line, with a direct access to the nodule, the needle was not withdrawn so much to go to the next selected area; therefore, the ablation was always kept active.
Figure 2
Figure 2
Use of ultrasound contrast before and immediately after ablation ensures treatment of at least 80% of the nodule.
Figure 3
Figure 3
Volume reduction rate over time after microwave ablation in thyroid nodules.
Figure 4
Figure 4
VRR in nodules of different compositions over time showing how all have comparable results and a desirable reduction in volume. E, spongiform; M, mixed; S, solid.
Figure 5
Figure 5
Usual reduction in the size of the nodule and alteration of the echogenicity in the ultrasound control at 12 months after ablation.
See this image and copyright information in PMC

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