Thyroid No Surgery Benign Nodules 101: Ethanol Ablation Did Not Work? Try Radiofrequency ablation before you sign up for surgery!

Thyroid No Surgery Benign Nodules 101: Ethanol Ablation Did Not Work? Try Radiofrequency ablation before you sign up for surgery!

Thyroid No Surgery Benign Nodules 101:  Ethanol Ablation Did Not Work? Try Radiofrequency ablation before  you sign up for surgery!

Thyroid No Surgery Benign Nodules 101: Ethanol Ablation Did Not Work? Try Radiofrequency ablation before you sign up for surgery!

Mixed cyst solid nodule.

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If ethanol leaves you with continued compressive symptoms go for

Radiofrequency ablation before consenting to thyroid surgery.

DR.Guttler’s Comments:

  1. Ethanol ablation failure to treat cystic nodules with a larger portion of solid components is a problem.
  2. Do not go to surgery when radiofrequency ablation can cure your problem.
  3. (RFA) is effective in both solid and cystic thyroid nodules.
  4. 20/90 patients needed RF after initial ethanol ablation of the cysts.
  5. RFA after a single session of EA was effective in reducing mean symptom score from 4.8 to 1.1 ,mean cosmetic score from 3.5 to 1.4 and mean nodule volume from 11.3 to 0.9 mL .
  6. Ethanol was less effective in nodules when solid component >20%.
  7.  RFA is effective in treatment of benign predominantly cystic thyroid nodules in patients whose clinical problems were incompletely resolved after EA.
  8. CAll me before going for surgery if you have unresolved problems after ethanol ablation.
  9. 310-393-8860 or thyroid.manager@protonmail.com.
  10. Dr.G.
Volume 81, Issue 5, May 2012, Pages 905-910
European Journal of Radiology

How to manage the patients with unsatisfactory results after ethanol ablation for thyroid nodules: Role of radiofrequency ablation

Seung WonJang et al

Abstract

Purpose

Although ethanol ablation (EA) is effective in the treatment of cystic thyroid nodules, it is less effective in nodules with solid component. Therefore refractory cases with solid component require another treatment modality such as radiofrequency ablation (RFA), which is effective in both solid and cystic thyroid nodules. We prospectively evaluated the efficacy of additional RFA and factors related to volume reduction in patients showing unsatisfactory results after a single session of EA.

Materials and methods

Of 94 patients with predominantly cystic thyroid nodules who underwent EA, 20 patients underwent additional RFA because of incompletely resolved clinical problems (symptomatic score reduction <50%) and presence of residual solid component at 1-month follow-up on ultrasonography. Improvement of clinical symptoms and nodule volume reduction were evaluated 6 month later. We evaluated factors related to nodule volume reduction after EA and RFA.

Results

RFA after a single session of EA was effective in reducing mean symptom score from 4.8 to 1.1 (p < 0.001), mean cosmetic score from 3.5 to 1.4 (p < 0.001) and mean nodule volume from 11.3 to 0.9 mL (p < 0.001). The only independent factor related to volume reduction after EA was the presence of a solid component (p < 0.001), and EA was less effective in nodules when solid component >20% (p = 0.001). We identified no factors related to volume reduction after RFA.

Conclusion

RFA is effective in treatment of benign predominantly cystic thyroid nodules in patients whose clinical problems were incompletely resolved after EA

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