Image-guided thermal ablation in autonomously functioning thyroid nodules. A retrospective multicenter three-year follow-up study from the Italian Minimally Invasive Treatment of the Thyroid (MITT) Group

Giovanni Mauri, Enrico Papini, Stella Bernardi, Daniele Barbaro, Roberto Cesareo, Pierpaolo De Feo, Maurilio Deandrea, Laura Fugazzola, Giovanni Gambelunghe, Gabriele Greco, Carmelo Messina, Salvatore Monti, Alberto Mormile, Roberto Negro, Chiara Offi, Andrea Palermo, Luca Persani, Federica Presciuttini, Luigi Alessandro Solbiati, Stefano SpieziaFulvio Stacul, Marco Viganò, Luca Maria Sconfienza

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To report the results of a multicenter retrospective evaluation of the clinical outcomes of thermal ablation (TA) in a large series of autonomously functioning thyroid nodules (AFTN) with a follow-up protracted up to 3 years. Methods: Patients treated with single TA for an AFTN in Italy were included. Changes in nodule volume, TSH values, and ongoing anti-thyroid therapy were assessed at the 2-, 6-, 12-, 24-, and 36-month follow-up controls. Complications and need of any additional therapy after TA were also registered. Results: A total of 361 patients (244 females, 117 males, median age 58 years, IQR 46–70 years) were included. Nodule volume was significantly reduced at all time points (p < 0.001) (median volume reduction 58% at 6-month and 60% at 12-month). Serum TSH values increased significantly at all time points. After TA, anti-thyroid therapy was withdrawn in 32.5% of patients at 2 months, in 38.9% at 6 months, and in 41.3% at 12 months. A significant difference in the rate of patients who withdrawn medical therapy at 12 months was registered between small (< 10 mL) (74%), medium (49%), or large (> 30 mL) nodules (19%). A single major complication occurred (0.25%). Additional treatments were needed in 34/361 (9.4%) of cases including 4 (1.1%) surgical treatment. Conclusions: Image-guided thermal ablation offers a further safe and effective therapeutic option in patients with AFTN. Clinical outcomes are significantly more favorable in small than in large size AFTN. Key Points: • Thermal ablations (TA) can be safely and effectively used in patients with autonomously functioning thyroid nodules (AFTN). • TA results in a clinically significant nodule volume reduction that is paralleled by TSH level normalization and anti-thyroid drug therapy discontinuation (after TA anti-thyroid therapy was withdrawn in 41.3% at 12 months). • Clinical outcomes after TA are more favorable in small nodules, and when a large amount of thyroid nodule tissue is ablated.

Original languageEnglish
JournalEuropean Radiology
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • Laser therapy
  • Nodular goiter
  • Radiofrequency ablation
  • Thyroid nodule

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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