Treatment of autonomous thyroid nodules with percutaneous ethanol injection: 4-year experience

Abstract

Purpose: To evaluate the long-term efficacy of treatment of autonomous thyroid nodules with percutaneous ethanol injection under ultrasound guidance.

Materials and methods: Treatment was performed in 101 patients. The mean ratio of injected ethanol volume to nodule volume was approximately 1.5; ethanol was usually administered in four to eight sessions.

Results: Complete cure was achieved in 59 patients. Partial cure was achieved in 34 patients. Eight patients had remission of thyrotoxicosis but persistence of thyroid-stimulating hormone level suppression and radionuclide uptake only in the nodule. The extent of the response was inversely proportional to the nodule volume. Marked nodule shrinkage was observed in all groups. No recurrences were observed. Transient vocal cord paresis occurred in four patients, with full recovery in all cases.

Conclusion: This method compares favorably with both surgery and radioiodine treatment, especially when the very low prevalence of posttreatment hypothyroidism is considered.