Thyroid Nodule No Surgery 101: Early Signs of Regrowth after Radiofrequency Ablation (RFA).

Thyroid Nodule No Surgery 101: Early Signs of Regrowth after Radiofrequency Ablation (RFA).

Thyroid Nodule No Surgery 101: Early Signs of Regrowth after Radiofrequency Ablation (RFA).
Comments by Dr.G. on this article.
The use of increase in volume from one visit to the next was able to predict which nodule would recur at a latter date.
RFA is not available in the USA for clinical use until  2018-19.
Until then a fast 2-3 day visit to Korea or Italy you can be treated without surgery for your nodules,and cancer lymph nodes and primary micro-papillary cancers.
Referral evaluations obtained at Santa Monica Thyroid Center will allow you to go for just the treatment and not an extended stay for another evaluation.
Call me at 310-393-8860 or email thyroid.manager@protonmail.com
Richard Guttler MD,FACE,ECNU
interventional thyroidologist
thyroid.com
Radiofrequency ablation of benign thyroid nodules: depicting early sign of regrowth by calculating vital volume
1. Regrowth after RFA is a problem.
2. 54 patients had 3 volumes studies.
3. Total volume (total volume, ablated volume and vital volume) were measured and calculated using ultrasonography.
4. Regrowth was defined as a more than a 50% increase in the total volume.
5.Vital volume increase was defined as a more than 50% increase compared to the previously reported smallest volume on ultrasonography.
6.Vital volumes increased in 31/54 nodules at 27 months.
7. Regrowth occurred at 40 months.
8. Vital volume increase tended to precede regrowth.
9. Vital volume increase tended to occur earlier than regrowth and might be an early sign of regrowth in following-up after the radiofrequency ablation of benign thyroid nodules.
Figure
Figure 1. (A) Transverse image from a 29-year-old woman who received RFA for a benign thyroid nodule 4 months previously. The index nodule volume was 21.1 mL. At the centre of the nodule, the ablated area was seen as a hypoechoic area (Va, arrows). At the margin of the nodule, the incompletely treated viable portion showed an isoechoic area (Vv). The volumes at 4 months were Vt = 7.4 mL, Va = 2.1 mL and Vv = 5.3 mL. (B) Transverse image at the 7-month follow-up. The Vt decreased to 5.3 mL whereas the Vv increased to 5.2 mL. (C) Transverse image at the 21-month follow-up. The Va decreased and nearly disappeared. The Vt increased to 12.4 mL through an increase in the Vv (12.3 mL). (D) Colour Doppler US image showing increased vascularity in the viable area of the nodule.

Figure 3 of 3

Figure 3. Comparison of the amount of Vv increase and Vt increase. The peak timing of Vv increase was 1 year after RFA. Regrowth started to occur after 1 year and occurred most frequently at 2–4 years after RFA. The mean timing of regrowth was 39.9 ± 17.5 months after RFA.

 10. Our current study has demonstrated that RFA is effective for the volume reduction of a benign thyroid nodule for up to 7-year follow-up.

11.We also found a low complication rate without sequelae or procedure-related deaths during this follow-up period.

12. In conclusion, Vv increase occurred about 1 year earlier than regrowth.

13.Thus, tracing Vv can indicate regrowth of marginal vital tissue earlier than tracing Vt after RFA of benign symptomatic thyroid nodules.

 

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