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. 2024 Jun 3;17(1):10.
doi: 10.1186/s13044-024-00198-4.

Efficacy and safety of ultrasound-guided thermal ablation of graves' disease: a retrospective cohort study

Guangzhen Cai #  1 , Beilin Luo #  2 , Maolin Wang  1 , Jiqin Su  1 , Luping Lin  3 , Guibin Li  1 , Xiangru Chen  1 , Zhishu Huang  1 , Peiyi Lin  1 , Shengwei Liu  1 , Huidi Yan  1 , Lixin Zhou  4
Affiliations

Efficacy and safety of ultrasound-guided thermal ablation of graves' disease: a retrospective cohort study

Guangzhen Cai et al. Thyroid Res. .

Abstract

Background: Ultrasound-guided thermal ablation (TA) has emerged as a robust therapeutic approach for treating solid tumors in multiple organs, including the thyroid. Yet, its efficacy and safety profile in the management of Graves' Disease (GD) remains to be definitively established.

Methods: A retrospective study was conducted on 50 GD patients treated with TA between October 2017 and December 2021. Key metrics like thyroid volume, volume reduction rate (VRR), thyroid hormones, and basal metabolic rate (BMR) were evaluated using paired Wilcoxon tests.

Results: The intervention of ultrasound-guided TA yielded a statistically significant diminution in total thyroid volume across all postoperative follow-up intervals-1, 3, 6, and 12 months-relative to pre-intervention baselines (p < 0.001). The median VRR observed at these time points were 17.5%, 26.5%, 34.4%, and 39.8%, respectively. Euthyroid status was corroborated in 96% of patients at the one-year follow-up milestone. Transient tachycardia and dysphonia were observed in three patients, while a solitary case of skin numbness was noted. Crucially, no instances of enduring injury to the recurrent laryngeal nerve (RLN) were documented.

Conclusions: Our investigation substantiates ultrasound-guided TA as a pragmatic, well-tolerated, and safe therapeutic modality for GD. It effectively improves symptoms of hyperthyroidism, engenders a substantial reduction in thyroid volume, and restores thyroid hormone and BMR to physiological levels. Given its favorable safety profile, enhanced cosmetic outcomes, and minimally invasive nature, ultrasound-guided TA is a compelling alternative to thyroidectomy for GD patients.

Keywords: Efficacy assessment; Graves' disease; Retrospective study; Thermal ablation; Thyroid.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Volumetric reduction after thyroid thermal ablation. Box plots showing the variation of thyroid volume (A) and VRR (B) over pre-procedure and follow-up as medians ± one quartile, with the whiskers extending from the hinge to the smallest or largest value within 1.5 IQR from the box boundaries. The sample sizes of TA are 50, 50, 41, and 33, respectively. Differences between the two groups are tested using paired Wilcoxon test
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