Thyroid Nodule RFA 101: New research by Dr. J.S. Sim
Radiofrequency ablation of benign thyroid nodules: Depicting early sign of regrowth by calculating vital volume
OBJECTIVE: We evaluated long term follow-up results of RFA of benign thyroid nodules to analyze the role of marginal vital tissue on nodule regrowth. MATERIALS AND METHODS: We reviewed the medical records of 54 patients who underwent radiofrequency ablation between June 2008 and November 2013 with pressure symptoms, and/or cosmetic problems. All patients were followed up at least 12 months on three occasions. To evaluate an early sign of regrowth, three types of nodule volumes (total volume, ablated volume, and vital volume) were measured and calculated using ultrasonography. Regrowth was defined as a more than a 50% increase in the total volume and vital volume increase was defined as a more than 50% increase compared to the previously reported smallest volume on ultrasonography. RESULTS: The mean follow-up period was 39.4 ± 21.7 (range, 13–87) months. Vital volume increases occurred in 31 nodules (57.4%) and there was regrowth in 13 nodules (24.1%). The mean timing of the vital volume increase was 27.5 ± 18.5 months, and for regrowth it was 39.9 ± 17.5 months. Vital volume increase tended to precede regrowth. CONCLUSION: 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.
Comments: Increase in volume of 50% over last visit called vital volume occurred earlier in half of the 54 patients, and regrowth was 50% regrowth from initial volume occurred in 24% 13/54 patients. The increase in growth (vital growth) 0n two successive visits may be used as a possible early sign of regrowth. Of those 31 nodules 13/31 went on the regrowth.
Richard Guttler MD,FACE,ECNU
Image of DR.Sim and Dr.Guttler exchanging cards at the thyroid ablation society first meeting in Boston 2017.