Minimally-invasive treatments for benign thyroid nodules: a Delphi-based consensus statement from the Italian minimally-invasive treatments of the thyroid (MITT) group

Enrico Papini, Claudio Maurizio Pacella, Luigi Alessandro Solbiati, Gaetano Achille, Daniele Barbaro, Stella Bernardi, Vito Cantisani, Roberto Cesareo, Arturo Chiti, Luca Cozzaglio, Anna Crescenzi, Francesco De Cobelli, Maurilio Deandrea, Laura Fugazzola, Giovanni Gambelunghe, Roberto Garberoglio, Gioacchino Giugliano, Livio Luzi, Roberto Negro, Luca PersaniBruno Raggiunti, Francesco Sardanelli, Ettore Seregni, Martina Sollini, Stefano Spiezia, Fulvio Stacul, Dominique Van Doorne, Luca Maria Sconfienza, Giovanni Mauri

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Benign thyroid nodules are a common clinical occurrence and usually do not require treatment unless symptomatic. During the last years, ultrasound-guided minimally invasive treatments (MIT) gained an increasing role in the management of nodules causing local symptoms. In February 2018, the Italian MIT Thyroid Group was founded to create a permanent cooperation between Italian and international physicians dedicated to clinical research and assistance on MIT for thyroid nodules. The group drafted this list of statements based on literature review and consensus opinion of interdisciplinary experts to facilitate the diffusion and the appropriate use of MIT of thyroid nodules in clinical practice. (#1) Predominantly cystic/cystic symptomatic nodules should first undergo US-guided aspiration; ethanol injection should be performed if relapsing (level of evidence [LoE]: ethanol is superior to simple aspiration = 2); (#2) In symptomatic cystic nodules, thermal ablation is an option when symptoms persist after ethanol ablation (LoE = 4); (#3) Double cytological benignity confirmation is needed before thermal ablation (LoE = 2); (#4) Single cytological sample is adequate in ultrasound low risk (EU-TIRADS ≤3) and in autonomously functioning nodules (LoE = 2); (#5) Thermal ablation may be proposed as first-line treatment for solid, symptomatic, nonfunctioning, benign nodules (LoE = 2); (#6) Thermal ablation may be used for dominant lesions in nonfunctioning multinodular goiter in patients refusing/not eligible for surgery (LoE = 5); (#7) Clinical and ultrasound follow-up is appropriate after thermal ablation (LoE = 2); (#8) Nodule re-treatment can be considered when symptoms relapse or partially resolve (LoE = 2); (#9) In case of nodule regrowth, a new cytological assessment is suggested before second ablation (LoE = 5); (#10) Thermal ablation is an option for autonomously functioning nodules in patients refusing/not eligible for radioiodine or surgery (LoE = 2); (#11) Small autonomously functioning nodules can be treated with thermal ablation when thyroid tissue sparing is a priority and ≥80% nodule volume ablation is expected (LoE = 3).

Original languageEnglish
JournalInternational Journal of Hyperthermia
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Thyroid Nodule
Thyroid Gland
Hot Temperature
Ethanol
Therapeutics
Goiter
Expert Testimony
Physicians
Recurrence
Injections
Research

Keywords

  • minimally invasive treatments
  • percutaneous thermal ablation
  • Statement
  • thyroid gland
  • thyroid nodule
  • ultrasonography

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)
  • Cancer Research

Cite this

Minimally-invasive treatments for benign thyroid nodules : a Delphi-based consensus statement from the Italian minimally-invasive treatments of the thyroid (MITT) group. / Papini, Enrico; Pacella, Claudio Maurizio; Solbiati, Luigi Alessandro; Achille, Gaetano; Barbaro, Daniele; Bernardi, Stella; Cantisani, Vito; Cesareo, Roberto; Chiti, Arturo; Cozzaglio, Luca; Crescenzi, Anna; De Cobelli, Francesco; Deandrea, Maurilio; Fugazzola, Laura; Gambelunghe, Giovanni; Garberoglio, Roberto; Giugliano, Gioacchino; Luzi, Livio; Negro, Roberto; Persani, Luca; Raggiunti, Bruno; Sardanelli, Francesco; Seregni, Ettore; Sollini, Martina; Spiezia, Stefano; Stacul, Fulvio; Van Doorne, Dominique; Sconfienza, Luca Maria; Mauri, Giovanni.

In: International Journal of Hyperthermia, 01.01.2019.

Research output: Contribution to journalArticle

Papini, Enrico ; Pacella, Claudio Maurizio ; Solbiati, Luigi Alessandro ; Achille, Gaetano ; Barbaro, Daniele ; Bernardi, Stella ; Cantisani, Vito ; Cesareo, Roberto ; Chiti, Arturo ; Cozzaglio, Luca ; Crescenzi, Anna ; De Cobelli, Francesco ; Deandrea, Maurilio ; Fugazzola, Laura ; Gambelunghe, Giovanni ; Garberoglio, Roberto ; Giugliano, Gioacchino ; Luzi, Livio ; Negro, Roberto ; Persani, Luca ; Raggiunti, Bruno ; Sardanelli, Francesco ; Seregni, Ettore ; Sollini, Martina ; Spiezia, Stefano ; Stacul, Fulvio ; Van Doorne, Dominique ; Sconfienza, Luca Maria ; Mauri, Giovanni. / Minimally-invasive treatments for benign thyroid nodules : a Delphi-based consensus statement from the Italian minimally-invasive treatments of the thyroid (MITT) group. In: International Journal of Hyperthermia. 2019.
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AU - Solbiati, Luigi Alessandro

AU - Achille, Gaetano

AU - Barbaro, Daniele

AU - Bernardi, Stella

AU - Cantisani, Vito

AU - Cesareo, Roberto

AU - Chiti, Arturo

AU - Cozzaglio, Luca

AU - Crescenzi, Anna

AU - De Cobelli, Francesco

AU - Deandrea, Maurilio

AU - Fugazzola, Laura

AU - Gambelunghe, Giovanni

AU - Garberoglio, Roberto

AU - Giugliano, Gioacchino

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AU - Negro, Roberto

AU - Persani, Luca

AU - Raggiunti, Bruno

AU - Sardanelli, Francesco

AU - Seregni, Ettore

AU - Sollini, Martina

AU - Spiezia, Stefano

AU - Stacul, Fulvio

AU - Van Doorne, Dominique

AU - Sconfienza, Luca Maria

AU - Mauri, Giovanni

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