Image-guided thermal ablation of benign thyroid nodules

Anna Pisani Mainini, Cristian Monaco, Lorenzo Carlo Pescatori, Chiara De Angelis, Francesco Sardanelli, Luca Maria Sconfienza, Giovanni Mauri

Research output: Contribution to journalArticlepeer-review

Abstract

Benign thyroid nodules are a common disease in the general population. Most often, they are completely asymptomatic and discovered occasionally during routine ultrasound examinations, and do not require any treatment. When thyroid nodules become symptomatic, surgical excision is still considered standard treatment. In the last few years, several experiences in the treatment of benign thyroid nodules through image-guided percutaneous thermal ablation have been reported with encouraging results, so that currently, these treatments are often proposed as first-choice options for patients with symptomatic benign thyroid nodules. In this paper, we discuss the present literature on the topic, focusing on different techniques available for image-guided percutaneous ablation, particularly radiofrequency (RFA), laser (LA), microwave (MWA), and high-intensity-focus ultrasound (HIFU). Little evidence about the efficacy of MWA and HIFU is now available. According to the literature, good results have been obtained with RFA and LA. Regarding RFA, volume reduction after ablative treatment has been found to range from 47 to 84 % at 3–6 months, and from 62 to 93 % at 1 year; LA also seems to be effective in achieving shrinkage of thyroid nodules, with volume reduction from 37 to 81 % at 3–6 months, and from 13 to 82 % at 1-year follow-up. Moreover, applications of advanced image-guidance modality, such as contrast-enhanced ultrasound and virtual navigation with fusion imaging, are discussed.

Original languageEnglish
Pages (from-to)11-22
Number of pages12
JournalJournal of Ultrasound
Volume20
Issue number1
DOIs
Publication statusPublished - Mar 1 2017

Keywords

  • High-intensity focused ultrasound
  • Laser
  • Microwave
  • Radiofrequency
  • Thyroid nodule

ASJC Scopus subject areas

  • Internal Medicine
  • Radiology Nuclear Medicine and imaging

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