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Volume reduction rate of radiofrequency ablation in ≤ 2 cm Bethesda IV thyroid nodules. | LitMetric

AI Article Synopsis

  • - This study investigated the effectiveness of radiofrequency ablation (RFA) for treating thyroid nodules that are ≤ 2 cm and classified as Bethesda IV cytology and C-TIRADS 4A, including assessment of factors affecting the success of treatment.
  • - A total of 62 nodules were treated with RFA, showing significant volume reduction at follow-ups, with over half achieving a 90% reduction after one year; 88.7% of nodules displayed complete absorption by the end of the study.
  • - Findings revealed that nodules with a grade 3 blood supply and chronic thyroiditis had delayed absorption of treatment, indicating these factors can impact RFA effectiveness.

Article Abstract

Objective: This prospective observational study aimed to evaluate the efficacy of radiofrequency ablation (RFA) in treating ≤ 2 cm thyroid nodules with Bethesda IV cytology and C-TIRADS 4A categorization. Additionally, the factors influencing the completed absorption of ablation (CAA) were examined.

Methods: A total of 62 cases with 62 nodules underwent ultrasound-guided RFA and were included in the study. The volume reduction rate (VRR), CAA, and incomplete absorption of ablation (IAA) were assessed at the 1st, 3rd, 6th, and subsequent 6-month follow-ups. Clinical and ultrasound features were compared between the CAA and IAA groups at the 12th month follow-up.

Results: The average VRR at the 1st, 3rd, 6th, 12th month, and last follow-up were -88.6%, 16.0%, 59.7%, 82.0%, and 98.2%, respectively. More than half of the nodules achieved a 90% VRR after 1 year of RFA, with 88.7% demonstrating CAA at the end of the study (follow-up duration of 14 to 63 months). Nodules with grade 3 vascularity and those associated with chronic thyroiditis showed delayed CAA at the 12th month follow-up (p = 0.036 and 0.003, respectively).

Conclusion: RFA is an effective technique for treating ≤ 2 cm thyroid nodules with Bethesda IV cytology and C-TIRADS 4A categorization. Nodules with grade 3 blood supply and patients with chronic thyroiditis exhibited an impact on the completed absorption following RFA.

Clinical Relevance Statement: Our study has shown that radiofrequency ablation is an effective treatment for ≤ 2 cm thyroid nodules classified as Bethesda IV cytology. However, we identified that high vascularity of the nodule and chronic thyroiditis are adverse factors affecting the completed absorption of the ablation.

Key Points: •Radiofrequency ablation (RFA) is an effective technique for treatment of ≤ 2 cm Bethesda IV category thyroid nodules. •Higher blood supply and chronic thyroiditis influence the completed absorption after RFA.

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Source
http://dx.doi.org/10.1007/s00330-023-10185-2DOI Listing

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