Thyroid Nodules: Microwave Ablation 101
Another study looking at MWA for thyroid nodules. This one saw increases in thyroglobulin and increased stiffness 24 hours after MWA, but too much post MWA bleeding.
Cooled microwave ablation of thyroid nodules: Initial experience
Yücel Korkusuza et al
E J. Radiology Oct 2016
To evaluate if internally cooled microwave ablation (cMWA) is a safe and effective method for treatment of benign and malign thyroid nodules.
9 patients with 11 symptomatic cold benign thyroid nodules and 1 recurrent thyroid carcinoma ranging in volume from 9.1 to 197 ml (mean size 52 ± 57 ml) were treated with cMWA. The mean age of the patients was 59 years. Pain during the treatment was measured on a 10-point scale. Side effects revealed by ultrasound or patients’ complaints were documented. Periablative efficacy was measured 24 h after cMWA as change (Δ) in serum thyroglobulin (Tg). Nodule elasticity was measured on a 4-point scale, blood circulation and echogenicity on a 3-point scale.
All patients tolerated cMWA well. Median pain intensity averaged 2.1 ± 0.8 (range: 1–3). Postablative hematoma was observed in all cases. In no cases ablation led to hoarseness, superficial burns, nodule ruptures, vagal reactions or dysphagia. cMWA lead to a significant decrease of blood circulation, nodule echogenicity and a significant increase of elasticity (Δ = 1.1 ± 0.33; 0.8 ± 0.4 and 1.1 ± 0.6 points)(p < 0.05). An average increase of 4495 ng/ml Tg was measured (p < 0.05).
View of antenna probe in the nodule.
Before and after MWA treatment
Medtronic MWA system
MWA is an effective and secure method for treatment of thyroid nodules.
Ultrasound imaging allows guidance during microwave ablation.
Comment: The antenna probe is thick and can be one of the causes of bleeding with all 11 cases.
Richard Guttler MD,FACE,ECNU
Below os the antenna probe from MWA system.It is #16. Neck work is better with a smaller probe. #18 or less.