Radiofrequency Ablation of Benign Thyroid Nodules and Recurrent Thyroid Cancers: Consensus Statement and Recommendations

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Abstract

Thermal ablation using radiofrequency is a new, minimally invasive modality employed as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. The Task Force Committee of the Korean Society of Thyroid Radiology has developed recommendations for the optimal use of radiofrequency ablation for thyroid nodules. These recommendations are based on a comprehensive analysis of the current literature, the results of multicenter studies, and expert consensus.

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Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study.

M Meloni, Luigi Solbiati, Tito Livraghi … (2003)

To report complications encountered by members of a collaborative group who performed radio-frequency (RF) ablation in patients with focal liver cancer. Members of 41 Italian centers that were part of a collaborative group used a percutaneous internally cooled RF ablation technique and a standardized protocol for follow-up. They completed a questionnaire regarding number of deaths, presumed cause of death, and likelihood of its relationship to the RF procedure; number and types of major complications; and types of minor complications and side effects. Enrollment included 2,320 patients with 3,554 lesions (size, 3.1 cm +/- 1.1 [SD] in diameter): 1,610 had hepatocellular carcinoma with chronic liver disease; 693 had metastases, predominantly from colorectal cancer (n = 501); and 17 had cholangiocellular carcinoma. Number and characteristics of complications (ie, deaths and major and minor complications) attributed to the procedure were reported. Data were subsequently analyzed with analysis of variance to determine whether the major complication rate was related to tumor size, number of ablation sessions, or electrode type (single or cluster). In total, 3,554 lesions were treated. Six deaths (0.3%) were noted, including two caused by multiorgan failure following intestinal perforation; one case each of septic shock following Staphylococcus aureus-caused peritonitis, massive hemorrhage following tumor rupture, liver failure following stenosis of right bile duct; and one case of sudden death of unknown cause 3 days after the procedure. Fifty (2.2%) patients had additional major complications. The most frequent of these were peritoneal hemorrhage, neoplastic seeding, intrahepatic abscesses, and intestinal perforation. An increased number of RF sessions were related to a higher rate of major complications (P <.01), whereas the number of complications was not significantly different when tumor size or electrode type were compared. Minor complications were observed in less than 5% of patients. Results of this study confirm that RF ablation is a relatively low-risk procedure for the treatment of focal liver tumors.

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Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients.

Y. Kim, Jee Jeong, Woo Kyoung Jeong … (2008)

This study evaluated the safety and volume reduction of ultrasonography (US)-guided radiofrequency ablation (RFA) for benign thyroid nodules, and the factors affecting the results obtained. A total of 302 benign thyroid nodules in 236 euthyroid patients underwent RFA between June 2002 and January 2005. RFA was carried out using an internally cooled electrode under local anesthesia. The volume-reduction ratio (VRR) was assessed by US and safety was determined by observing the complications during the follow-up period (1-41 months). The correlation between the VRR and several factors (patient age, volume and composition of the index nodule) was evaluated. The volume of index nodules was 0.11-95.61 ml (mean, 6.13 +/- 9.59 ml). After ablation, the volume of index nodules decreased to 0.00-26.07 ml (mean, 1.12 +/- 2.92 ml) and the VRR was 12.52-100% (mean, 84.11 +/- 14.93%) at the last follow-up. A VRR greater than 50% was observed in 91.06% of nodules, and 27.81% of index nodules disappeared. The complications encountered were pain, hematoma and transient voice changes. In conclusion, RFA is a safe modality effective at reducing volume in benign thyroid nodules.

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Ultrasonography and the Ultrasound-Based Management of Thyroid Nodules: Consensus Statement and Recommendations

Won-Jin Moon, Jung Hwan Baek, So-Lyung Jung … (2011)

The detection of thyroid nodules has become more common with the widespread use of ultrasonography (US). US is the mainstay for detecting and making the differential diagnosis of thyroid nodules as well as for providing guidance for a biopsy. The Task Force on Thyroid Nodules of the Korean Society of Thyroid Radiology has developed recommendations for the US diagnosis and US-based management of thyroid nodules. The review and recommendations in this report have been based on a comprehensive analysis of the current literature, the results of multicenter studies and from the consensus of experts.

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Author and article information

Journal

Journal ID (nlm-ta): Korean J Radiol

Journal ID (publisher-id): KJR

Title: Korean Journal of Radiology

Publisher: The Korean Society of Radiology

ISSN (Print): 1229-6929

ISSN (Electronic): 2005-8330

Publication date (Print): Mar-Apr 2012

Publication date (Electronic): 07 March 2012

Volume: 13

Issue: 2

Pages: 117-125

Affiliations

[1 ]Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, Korea.

[2 ]Department of Radiology, Human Medical Imaging & Intervention Center, Seoul 137-902, Korea.

[3 ]Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea.

[4 ]Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea.

[5 ]Department of Radiology and Thyroid Center, Daerim St. Mary's Hospital, Seoul 150-070, Korea.

[6 ]Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.

[7 ]Department of Radiology, Yonsei Univsersity College of Medicine, Seoul 120-752, Korea.

[8 ]Department of Radiology, Dong-A University Medical Center, Busan 602-713, Korea.

[9 ]Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan 633-165, Korea.

[10 ]Department of Radiology, Hanyang University College of Medicine, Hanyang University Hospital, Seoul 133-792, Korea.

[11 ]Department of Radiology, Haeundae Healings Hospital, Busan 613-101, Korea.

[12 ]Department of Radiology, Ansan Hospital, Korea University Medical College, Ansan 425-707, Korea.

[13 ]Department of Radiology and Thyroid Center, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 156-755, Korea.

[14 ]Department of Radiology, Mothers' Clinic, Seongnam 463-821, Korea.

[15 ]Department of Radiology, CHA University College of Medicine, Gangnam CHA Hospital, Seoul 135-081, Korea.

[16 ]Department of Radiology, Ajou University School of Medicine, Suwon 443-721, Korea.

[17 ]Department of Radiology, UNMEC Clinic, Daegu 704-910, Korea.

[18 ]Department of Radiology, Dr. Han's Breast Clinic, Seoul 135-892, Korea.

[19 ]Department of Radiology, Myung Jindan Health Care Center, Seoul 157-927, Korea.

[20 ]Department of Radiology, Thyroid Clinic, Philip Medical Center, Seoul 150-042, Korea.

Author notes

Corresponding author: Jung Hwan Baek, MD, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Oylimpic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea. Tel: (822) 3010-4352, Fax: (822) 476-0090, radbaek@ 123456naver.com

Article

DOI: 10.3348/kjr.2012.13.2.117

PMC ID: 3303894

PubMed ID: 22438678

SO-VID: 7224725e-88c8-4adf-9c45-0b6dae6ee241

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Radiofrequency Ablation of Benign Thyroid Nodules and Recurrent Thyroid Cancers: Consensus Statement and Recommendations

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Most cited references 70

Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study.

Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients.

Ultrasonography and the Ultrasound-Based Management of Thyroid Nodules: Consensus Statement and Recommendations

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