Thyroid No More Surgery RFA 101: Other Uses: Combined use of radioiodine therapy and radiofrequency ablation in treating postsurgical excessive thyroid remnant of differentiated thyroid carcinoma

Thyroid No More Surgery RFA 101: Other Uses: Combined use of radioiodine therapy and radiofrequency ablation in treating postsurgical excessive thyroid remnant of differentiated thyroid carcinoma

Thyroid No More Surgery RFA 101: Other Uses: Combined use of radioiodine therapy and radiofrequency ablation in treating postsurgical excessive thyroid remnant of differentiated thyroid carcinoma

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Year : 2015  |  Volume : 11  |  Issue : 8  |  Page : 244-247

Thyroid RFA 101: Other Uses:

 

Combined use of radioiodine therapy

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and radiofrequency ablation

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in treating postsurgical excessive thyroid remnant of differentiated thyroid carcinoma.

1. 12 DTC patients (4 males, 8 females, age 20–78 years) who underwent thyroidectomy for RFA followed by 131 I ablation.

2.The pretreatment requires iodine-free diet and thyroid hormone withdrawal for 3–4 week. All the patients showed the level of serum thyroid-stimulating hormone (TSH) <30 mU/L, and obvious thyroid remnant in 99m Technetium (99m Tc) imaging.

3. Serum TSH level was determined 1 day before RFA and on days 1, 7, 14 after RFA, and 99m Tc imaging was performed on day 14 after RFA. Subsequently, the patients were given an oral dosage of 3700 MBq 131 I for remnant ablation, and posttreatment whole body scan was performed on day 5 after ablation.

4. Efficacy evaluation was done 4–6 months after treatment.

5. The changes of variants before and after RFA were analyzed using Wilcoxon signed rank sum test.
6.  The success rate of thyroid remnant ablation was 91.7% (11/12), which was assessed 4–6 months after treatment.

7.All patients reported neck discomfort and some are self-limiting, with no hoarseness, choking, or radiation thyroiditis symptoms.

8.Five patients had puncture area pain, among which one patient had neck edema, which was relieved after prednisone treatment.

9.Conclusion: Combined use of RAI therapy and radiofrequency ablation in treating excessive postsurgical thyroid remnant of DTC can be an effective approach and avoids re-operation. Long-term efficacy monitoring would further determine its feasibility.

Images below show the value of combined RFA/RAI/131 to treat excess remnant instead of another surgery.

A. Excessive remnant I/131 uptake

B.After RFA the uptake is less intense in Remnant.

C.I/131 uptake after after post treatment image with neck and lung uptake.

D.Remnant ablated with RFA and RAI/131.Another Repeat therapy post treatment image 4 months later shows no neck uptake  but only in the lungs.

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