Thyroid Tumor Ablation: 101: What are the causes of recurrence?

Thyroid Tumor Ablation: 101: What are the causes of recurrence?

Thyroid Tumor Ablation: 101: What are  the causes of recurrence?

Recurrence of benign thyroid nodules after thermal ablation.

Some major factors

  1. Larger Volume nodules
  2. Irregular blood vessels
  3. Low microwave energy
  4. Nodules near vital structures.
  5. Marginal regrowth with RFA and MWA.
  6. Standard techniques for thermal ablation of the thyroid.kjr-18-615-g002-l
  7. Local injection of the thyroid capsule with Lidocaine
  8. Hydrodissection (Dextrose Avoidance method) and the moving-shot.img_1423Dextrose infusion to split the nodule from the dangerous structure
  9. moving-shot
  10.  and the moving-shot method..
  11. Contrast-enhanced ultrasound (CEUS) or Doppler to detect the recurrent portion.
  12.  The majority of patients in the thyroid RFA groups have undergone colour Doppler US examination.
  13. The under-treated nodule margin is seen using combined US findings (echo change, usually decreased echo in the treated area) and positive colour Doppler US.
  14. The cost and invasiveness (IV injections) of CEUS should be the focus of future work.
  15. Well-known factors related to recurrence or incomplete treatment after thermal ablation of benign thyroid nodules.
  16. They are Initial nodule volume proportion of the solid component, number of treatment sessions and follow-up period.
  17. The initial volume is a well-known factor related to outcome and recurrence.evaluate recurrence.
  18. 2 year follow up is the best to see recurrecne.
  19. Experience of the operators is an important factor to minimize incomplete ablation or recurrence.
  20. Recently, the Korean Society of Thyroid Radiology suggested that 50–100 cases for an operators’ experience is necessary for both efficacy and safety of thyroid RFA.
  21. Comments: AACE and the thyroid tumor ablation taskforce will be planning to ensure that the operators have the training they need to be successful Thyroid ablation specialists.
  22. Richard Guttler MD,FACE,ECNU
  24. Spongiform nodules seen in the image attached have the best results with ablation methods.





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