Korean J Radiol.  2018 Feb;19(1):167-174. 10.3348/kjr.2018.19.1.167.

Efficacy and Safety of Radiofrequency Ablation for Benign Thyroid Nodules: A Prospective Multicenter Study

Affiliations
  • 1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea. radbaek@naver.com
  • 2Department of Endocrinology and Metabolism, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.
  • 3Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
  • 4Department of Radiology, Thyroid Center, Daerim St. Mary's Hospital, Seoul 07442, Korea.
  • 5Department of Internal Medicine, Thyroid Center, Daerim St. Mary's Hospital, Seoul 07442, Korea.
  • 6Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea.
  • 7Department of Radiology, Sharing and Happiness Hospital, Busan 48101, Korea.
  • 8Department of Radiology, Withsim Clinic, Seongnam 13590, Korea.
  • 9Department of Radiology, Human Medical Imaging & Intervention Center, Seoul 06524, Korea.

Abstract


OBJECTIVE
To assess the efficacy and safety of thyroid radiofrequency (RF) ablation for benign thyroid nodules by trained radiologists according to a unified protocol in a multi-center study.
MATERIALS AND METHODS
From 2010 to 2011, 345 nodules from 345 patients (M:F = 43:302; mean age ± SD = 46.0 ± 12.7 years, range = 15-79) who met eligibility criteria were enrolled from five institutions. At pre-ablation, the mean volume was 14.2 ± 13.2 mL (1.1-80.8 mL). For 12 months or longer after treatment, 276 lesions, consisting of 248 solid and 28 predominantly cystic nodules, were followed. All operators performed RF ablation with a cool-tip RF system and two standard techniques (a transisthmic approach and the moving-shot technique). Volume reduction at 12 months after RF ablation (the primary outcome), therapeutic success, improvement of symptoms as well as of cosmetic problems, and complications were evaluated. Multiple linear regression analysis was applied to identify factors that were independently predictive of volume reduction.
RESULTS
The mean volume reduction at 12 months was 80.3% (n = 276) and at the 24-, 36-, 48-, and 60-month follow-ups 84.3% (n = 198), 89.2% (n = 128), 91.9% (n = 57), and 95.3% (n = 6), respectively. Our therapeutic success was 97.8%. Both mean symptom and cosmetic scores showed significant improvements (p < 0.001). The rate of major complications was 1.0% (3/276). Solidity and applied energy were independent factors that predicted volume reduction.
CONCLUSION
Radiofrequency ablation performed by trained radiologists from multiple institutions using a unified protocol and similar devices was effective and safe for treating benign thyroid nodules.

Keyword

Radiofrequency ablation; Thyroid; Nodule; Tumor; Neoplasm; Ultrasound; Intervention; Prospective study
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