Thyroid Ethanol Ablation PEI of Thyroid Cysts: What is the Recurrence Rate and what is the results of retreatment with a second PEI or RFA session?
Key points about PEI recurrence and the causes are listed here.
- Ethanol ablation PEI showed unsatisfactory results in 18.7% of patient at one month.
- •Delayed recurrence was observed in 24.1% of patients during the follow-up period.
- •Total recurrence rate was 38.3% after PEI.
- Study results revealed that although PEI seemed to be effective in the initial period, delayed recurrence should be considered during the longer follow-up period.
- The independent predictors of recurrence were initial volume (>20 mL) and vascularity.
- Patients with recurrence (n = 41) were treated using radiofrequency ablation (n = 28), second PEI (n = 4), and refused further treatment (n = 9).
- These patients responded well to repeat PEI and RFA.
- The initial nodule volume (>20 ml; p < 0.036) and vascularity (grade >1; p < 0.049) were independent predictors of volume reduction at last follow-up.
Comments by Dr.Guttler
The recurrence rate means some patients need a second PEI session. This is less expensive than a new RFA session after the failed PEI. Both were able to complete the ablation.
Massive cyst required multiple PEI sessions to complete ablation.
Vascular nodules are also prone to have recurrence after one session PEI.
C H Suh at al
January 2015 Volume 70, Issue 1, Pages 42–47