Percutaneous ethanol injection of autonomous thyroid nodules with a volume larger than 40 ml: Three years of follow-up

Salvatore Del Prete, Domenico Russo, Michele Caraglia, Gaia Giuberti, Monica Marra, Giovanni Vitale, Giovanni Lupoli, Alberto Abbruzzese, Elena Capasso

Research output: Contribution to journalArticlepeer-review


Aim: Autonomous thyroid nodules are conventionally treated by surgery or radioiodine. Percutaneous ethanol injection is a recognized alternative approach. An assessment of the long-term success and safety was conducted. Material and Methods: Thirty-four patients (seven men and 27 women; age range: 32-80 years; mean: 56 ± 13 years) with an autonomous thyroid nodule (ATN) > 40 ml (volume range 41-180 ml; mean: 63.6 ± 34.5 ml) were treated with ultrasound-guided percutancous ethanol injection (PEI). All patients were hyperthyroid with increased radionuclide uptake in the nodule at scintigraphy. Serial serum (free T3, free T4 and thyroid-stimulating hormone (TSH)) and ultrasound studies were performed at 3, 6, 12, 18, 24 and 36 months after the first PEI session. Scintigraphy was performed before treatment and 1 month after the serum TSH became detectable or alternatively after 6 months, even if the TSH was still undetectable. Results: Each patient had 1-11 sessions of PEI, with an injection of 3-14 ml of ethanol per session (total amount of ethanol per patient: 20-125 ml). Within 3 months from the end of the treatment, the recovery of extranodular uptake on isotope scan and the normalization of TSH levels were observed in 30/34 patients. A reduction (average: 62.9%) of nodule volume was recorded in all patients and only 4/34 patients were refractory to PEI. The responsiveness of ATN to PEI appeared to be dependent on the initial nodule volume (3/4 failures in patients had nodule volumes > 60 ml). Side-effects were always self-limiting. During follow-up (6-36 months) no recurrence was observed. Conclusion: In conclusion, the treatment of ATN > 40 ml with PEI would appear to be a valid alternative approach to traditional methods of treatment. It is safe, well tolerated and inexpensive. Its acceptability when compared with surgery and radiodioine has still to be assessed.

Original languageEnglish
Pages (from-to)895-901
Number of pages7
JournalClinical Radiology
Issue number11
Publication statusPublished - Nov 2001


  • Ethonal injection
  • Thyroid
  • Treatment
  • Ultrasound

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging


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