Uncooled Microwave Ablation as a Treatment Option to Preserve Thyroid Function in Patients with Benign Thyroid Nodules

Gulsah Yildirim; Hakki Muammer Karakas

doi:10.5334/jbsr.2746

Abstract

Objective: The objective is to evaluate the long-term efficacy and safety of uncooled MWA for the treatment of benign thyroid nodules and its long-term effect on thyroid functions.

Material and Methods: The study was conducted on 40 patients with 40 nodules. They were treated between September 2019 and December 2020. Nodules’ volumes, thyroid functions (triiodothyronine, free thyroxine, thyrotropin) and anti-thyroid peroxidase and anti-thyroglobulin antibodies were measured before treatment and at 3rd, 6th and 12th month following the treatment. Volume reduction rates and changes in clinical findings were evaluated.

Results: The mean volume reduction rate was 49.88, 65.3, and 79.06% at 3rd, 6th, and 12th month, respectively. Antibody levels and thyroid function tests have remained within normal limits and were not exhibited significant change during follow-ups (p > 0.05), except for a significant increase in free thyroxin level at 12th-month (p = 0.007). Subjective symptoms and cosmetic scores were significantly improved all follow-up (p < 0.0001). The only complication was a first-degree skin burn in a patient.

Conclusion: In conclusion, uncooled microwave ablation is an effective and safe method for the treatment of benign thyroid nodules and preserves thyroid function.

References

Gharib H, Papini E, Paschke R, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: Executive summary of recommendations. J Endocrinol Invest. 2010; 33(5 Suppl): 51–56. DOI: 10.4158/EP.16.3.468
Open DOI Search in Google Scholar Back to article
Eng OS, Potdevin L, Davidov T, Lu SE, Chen C, Trooskin SZ. Does nodule size predict compressive symptoms in patients with thyroid nodules? Gland Surg. 2014; 3(4): 232–236. DOI: 10.3978/j.issn.2227-684X.2014.08.03
Open DOI Search in Google Scholar Back to article
Rosato L, Avenia N, Bernante P, et al. Complications of thyroid surgery: Analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg. 2004; 28: 271–6. DOI: 10.1007/s00268-003-6903-1
Open DOI Search in Google Scholar Back to article
Cirocchi R, Trastulli S, Randolph J, et al. Total or near-total thyroidectomy versus subtotal thyroidectomy for multinodular non-toxic goitre in adults. Cochrane Database Syst Rev. 2015; 8: CD010370. DOI: 10.1002/14651858.CD010370.pub2
Open DOI Search in Google Scholar Back to article
Ji Hong M, Baek JH, Choi YJ, et al. Radiofrequency ablation is a thyroid function-preserving treatment for patients with bilateral benign thyroid nodules. J Vasc Interv Radiol. 2015; 26(1): 55–61. DOI: 10.1016/j.jvir.2014.09.015
Open DOI Search in Google Scholar Back to article
Park HS, Baek JH, Park AW, Chung SR, Choi YJ, Lee JH. Thyroid Radiofrequency Ablation: Updates on Innovative Devices and Techniques. Korean J Radiol. 2017; 18(4): 615–623. DOI: 10.3348/kjr.2017.18.4.615
Open DOI Search in Google Scholar Back to article
Jeong WK, Baek JH, Rhim H, et al. Radiofrequency ablation of benign thyroid nodules: Safety and imaging follow-up in 236 patients. Eur Radiol. 2008; 18(6): 1244–1250. DOI: 10.1007/s00330-008-0880-6
Open DOI Search in Google Scholar Back to article
Baek JH, Lee JH, Sung JY, et al. Korean Society of Thyroid Radiology. Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: A multicenter study. Radiology. 2012 Jan; 262(1): 335–42. DOI: 10.1148/radiol.11110416
Open DOI Search in Google Scholar Back to article
Liu YJ, Qian LX, Liu D, Zhao JF. Ultrasound-guided microwave ablation in the treatment of benign thyroid nodules in 435 patients. Exp Biol Med (Maywood). 2017; 242(15): 1515–1523. DOI: 10.1177/1535370217727477
Open DOI Search in Google Scholar Back to article
Wu W, Gong X, Zhou Q, Chen X, Chen X. Ultrasound-Guided Percutaneous Microwave Ablation for Solid Benign Thyroid Nodules: Comparison of MWA versus Control Group. Int J Endocrinol. 2017; 2017: 9724090. DOI: 10.1155/2017/9724090
Open DOI Search in Google Scholar Back to article
Erturk MS, Cekic B, Celik M, Ucar H. Microwave ablation of symptomatic benign thyroid nodules: Short- and long-term effects on thyroid function tests, thyroglobulin and thyroid autoantibodies. Clin Endocrinol (Oxf). 2021; 94(4): 677–683. DOI: 10.1111/cen.14348
Open DOI Search in Google Scholar Back to article
Heck K, Happel C, Grünwald F, Korkusuz H. Percutaneous microwave ablation of thyroid nodules: Effects on thyroid function and antibodies. Int J Hyperthermia. 2015; 31(5): 560–567. DOI: 10.3109/02656736.2015.1032371
Open DOI Search in Google Scholar Back to article
Liu SY, Guo WH, Yang B, et al. Comparison of stress response following microwave ablation and surgical resection of benign thyroid nodules. Endocrine. 2019; 65(1): 138–143. DOI: 10.1007/s12020-019-01900-5
Open DOI Search in Google Scholar Back to article
Cheng Z, Che Y, Yu S, et al. US-guided percutaneous radiofrequency versus microwave ablation for benign thyroid nodules: A prospective multicenter study. Sci Rep. 2017: 7: 9554. DOI: 10.1038/s41598-017-09930-7
Open DOI Search in Google Scholar Back to article
Vorlander C, David Kohlhase K, Korkusuz Y, et al. Comparison between microwave ablation and bipolar radiofrequency ablation in benign thyroid nodules: Differences in energy transmission, duration of application and applied shots. Int J Hyperth. 2018: 35: 216–225. DOI: 10.1080/02656736.2018.1489984
Open DOI Search in Google Scholar Back to article
Zheng BW, Wang JF, Ju JX, Wu T, Tong G, Ren J. Efficacy and safety of cooled and uncooled microwave ablation for the treatment of benign thyroid nodules: A systematic review and meta-analysis. Endocrine. 2018; 62(2): 307–317. DOI: 10.1007/s12020-018-1693-2
Open DOI Search in Google Scholar Back to article
Yang YL, Chen CZ, Zhang XH. Microwave ablation of benign thyroid nodules. Future Oncol. 2014; 10(6): 1007–1014. DOI: 10.2217/fon.13.260
Open DOI Search in Google Scholar Back to article
Ha EJ, Baek JH, Lee JH, et al. Radiofrequency ablation of benign thyroid nodules does not affect thyroid function in patients with previous lobectomy. Thyroid. 2013; 23(3): 289–293. DOI: 10.1089/thy.2012.0171
Open DOI Search in Google Scholar Back to article
Honglei G, Shahbaz M, Farhaj Z, et al. Ultrasound guided microwave ablation of thyroid nodular goiter and cystadenoma: A single center, large cohort study. Medicine (Baltimore). 2021; 100(34): e26943. DOI: 10.1097/MD.0000000000026943
Open DOI Search in Google Scholar Back to article
Cakir B, Topaloglu O, Gul K, et al. Effects of percutaneous laser ablation treatment in benign solitary thyroid nodules on nodule volume, thyroglobulin and anti-thyroglobulin levels, and cytopathology of nodule in 1 yr follow-up. J Endocrinol Invest. 2006; 29(10): 876–884. DOI: 10.1007/BF03349190
Open DOI Search in Google Scholar Back to article

Uncooled Microwave Ablation as a Treatment Option to Preserve Thyroid Function in Patients with Benign Thyroid Nodules

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