Low-energy interstitial laser photocoagulation for treatment of nonfunctioning thyroid nodules

Therapeutic outcome in relation to pretreatment and treatment parameters

Gerardo Amabile, Mario Rotondi, Giovanni De Chiara, Antonio Silvestri, Bruno Di Filippo, Antonio Bellastella, Luca Chiovato

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objective: Interstitial laser photocoagulation (ILP) is a recently proposed therapeutic procedure lor the ablation of benign thyroid nodules, which has already proven to be safe and effective. However, results supporting the routine use of ILP are still limited. Design: The aim of the study was to evaluate the efficacy and safety of ILP treatment in benign nonfunctioning thyroid nodules and to establish whether the therapeutic outcome may be predicted by any clinical parameter at baseline. Twenty-three patients with either a solitary nodule or a dominant nodule within a multinodular goiter underwent ILP and were evaluated 1 and 3 months later. In order to assess the efficacy of low-energy ILP, the procedure was performed with an output power of 3 W, delivering a mean energy of 33.4 ± 12.7 Joule/mL of nodule volume, which is much lower than previously reported. Main outcome: Nodule volume significantly decreased after ILP as assessed after 1 and 3 months (analysis of variance; F = 5.37; p = 0.007). Patients with multinodular goiter showed a greater reduction at 3 months compared with patients bearing a solitary thyroid nodule (38.6 ± 5.3 vs. 30.9 ± 6.5%; p <0.01). Age, sex, ultrasound pattern (isoechogenous/hypoechogenous), pretreatment volume, number of ILP treatments, and total energy delivered did not show any significant correlation with treatment outcome. Conclusions: Our results demonstrate that ILP can produce a significant reduction of thyroid nodule volume even when a much lower energy than previously reported is delivered. ILP constitutes a minimally invasive technique, which can be carried out on an outpatient basis and could represent a valid nonsurgical alternative for thyroid nodule management. Dominant nodules within a multinodular goiter appear to be more responsive to ILP compared with solitary thyroid nodules.

Original languageEnglish
Pages (from-to)749-755
Number of pages7
JournalThyroid
Volume16
Issue number8
DOIs
Publication statusPublished - Aug 2006

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Thyroid Nodule
Light Coagulation
Lasers
Goiter
Therapeutics
Analysis of Variance
Outpatients
Safety

ASJC Scopus subject areas

  • Endocrinology

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Low-energy interstitial laser photocoagulation for treatment of nonfunctioning thyroid nodules : Therapeutic outcome in relation to pretreatment and treatment parameters. / Amabile, Gerardo; Rotondi, Mario; De Chiara, Giovanni; Silvestri, Antonio; Di Filippo, Bruno; Bellastella, Antonio; Chiovato, Luca.

In: Thyroid, Vol. 16, No. 8, 08.2006, p. 749-755.

Research output: Contribution to journalArticle

Amabile, Gerardo ; Rotondi, Mario ; De Chiara, Giovanni ; Silvestri, Antonio ; Di Filippo, Bruno ; Bellastella, Antonio ; Chiovato, Luca. / Low-energy interstitial laser photocoagulation for treatment of nonfunctioning thyroid nodules : Therapeutic outcome in relation to pretreatment and treatment parameters. In: Thyroid. 2006 ; Vol. 16, No. 8. pp. 749-755.
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abstract = "Objective: Interstitial laser photocoagulation (ILP) is a recently proposed therapeutic procedure lor the ablation of benign thyroid nodules, which has already proven to be safe and effective. However, results supporting the routine use of ILP are still limited. Design: The aim of the study was to evaluate the efficacy and safety of ILP treatment in benign nonfunctioning thyroid nodules and to establish whether the therapeutic outcome may be predicted by any clinical parameter at baseline. Twenty-three patients with either a solitary nodule or a dominant nodule within a multinodular goiter underwent ILP and were evaluated 1 and 3 months later. In order to assess the efficacy of low-energy ILP, the procedure was performed with an output power of 3 W, delivering a mean energy of 33.4 ± 12.7 Joule/mL of nodule volume, which is much lower than previously reported. Main outcome: Nodule volume significantly decreased after ILP as assessed after 1 and 3 months (analysis of variance; F = 5.37; p = 0.007). Patients with multinodular goiter showed a greater reduction at 3 months compared with patients bearing a solitary thyroid nodule (38.6 ± 5.3 vs. 30.9 ± 6.5{\%}; p <0.01). Age, sex, ultrasound pattern (isoechogenous/hypoechogenous), pretreatment volume, number of ILP treatments, and total energy delivered did not show any significant correlation with treatment outcome. Conclusions: Our results demonstrate that ILP can produce a significant reduction of thyroid nodule volume even when a much lower energy than previously reported is delivered. ILP constitutes a minimally invasive technique, which can be carried out on an outpatient basis and could represent a valid nonsurgical alternative for thyroid nodule management. Dominant nodules within a multinodular goiter appear to be more responsive to ILP compared with solitary thyroid nodules.",
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