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open access

Vol 72, No 2 (2021)
Original paper
Submitted: 2020-10-05
Accepted: 2020-11-25
Published online: 2020-12-16
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Microwave ablation of autonomously functioning thyroid nodules: a comparative study with radioactive iodine therapy on the functional treatment success

Mehmet Sercan Ertürk12, Bulent Cekic3, Mehmet Celik4, Isil Demiray Uguz3
DOI: 10.5603/EP.a2020.0088
·
Pubmed: 33619707
·
Endokrynol Pol 2021;72(2):120-125.
Affiliations
  1. Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
  2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
  3. Department of Nuclear Medicine, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey, Türkiye
  4. Division of Endocrinology and Metabolism, Department of Internal Medicine, Trakya University Medical Faculty, Edirne, Türkiye

open access

Vol 72, No 2 (2021)
Original Paper
Submitted: 2020-10-05
Accepted: 2020-11-25
Published online: 2020-12-16

Abstract

Introduction: The objective of this study was to compare the efficiency of microwave ablation (MWA) and radioactive iodine (RAI) in the treatment of toxic adenoma (TA), and to investigate the functional treatment success of the used modalities for its remission.

Material and methods: Treatment outcomes — thyroid hormone levels and nodule characteristics — of 30 patients (23:7 F:M; 52.77 ± 11.13 years) treated by MWA were compared with the those of 35 patients (24:11 F:M; 61.43 ± 12.60 years) treated by RAI. The baseline characteristics of TAs, which are gender and pre volume, were analogous and did not show any statistical significance (p > 0.05). Thyroid hormone levels of patients treated with two different methods were measured after 9 months, and the obtained results were compared.

Results: Although there was no statistically significant difference in the nodule volume (p > 0.05), there was a greater volume reduction rate (VRR%) in the group treated with MWA rather than RAI (p < 0.05) at the end of the follow-up. In the MWA group, there was a higher increase in FT3 than in the RAI group (p < 0.05). Furthermore, no statistically significant difference in TSH (p = 0.124) and FT4 (p = 0.144) levels of the patients as treatment outcomes was observed. The therapeutic success was accomplished in 18/30 (60%) of the MWA group and in 24/35 (68.6%) of the RAI group.

Conclusions: Therapeutic success of MWA and RAI did not show any statistically significant difference (p = 0.471). However, the development of hypothyroidism in 7 of 35 patients treated with RAI was observed. On the other hand, no case of post‐treatment hypothyroidism was observed in patients treated with MWA. In this regard, MWA could be a great alternative to RAI due to its advantages in terms of non-exposure to radiation and lower risk of post-treatment hypothyroidism. 

Abstract

Introduction: The objective of this study was to compare the efficiency of microwave ablation (MWA) and radioactive iodine (RAI) in the treatment of toxic adenoma (TA), and to investigate the functional treatment success of the used modalities for its remission.

Material and methods: Treatment outcomes — thyroid hormone levels and nodule characteristics — of 30 patients (23:7 F:M; 52.77 ± 11.13 years) treated by MWA were compared with the those of 35 patients (24:11 F:M; 61.43 ± 12.60 years) treated by RAI. The baseline characteristics of TAs, which are gender and pre volume, were analogous and did not show any statistical significance (p > 0.05). Thyroid hormone levels of patients treated with two different methods were measured after 9 months, and the obtained results were compared.

Results: Although there was no statistically significant difference in the nodule volume (p > 0.05), there was a greater volume reduction rate (VRR%) in the group treated with MWA rather than RAI (p < 0.05) at the end of the follow-up. In the MWA group, there was a higher increase in FT3 than in the RAI group (p < 0.05). Furthermore, no statistically significant difference in TSH (p = 0.124) and FT4 (p = 0.144) levels of the patients as treatment outcomes was observed. The therapeutic success was accomplished in 18/30 (60%) of the MWA group and in 24/35 (68.6%) of the RAI group.

Conclusions: Therapeutic success of MWA and RAI did not show any statistically significant difference (p = 0.471). However, the development of hypothyroidism in 7 of 35 patients treated with RAI was observed. On the other hand, no case of post‐treatment hypothyroidism was observed in patients treated with MWA. In this regard, MWA could be a great alternative to RAI due to its advantages in terms of non-exposure to radiation and lower risk of post-treatment hypothyroidism. 

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Keywords

thyroid; nodule; toxic adenoma; microwave ablation; thyroid hormones

About this article
Title

Microwave ablation of autonomously functioning thyroid nodules: a comparative study with radioactive iodine therapy on the functional treatment success

Journal

Endokrynologia Polska

Issue

Vol 72, No 2 (2021)

Article type

Original paper

Pages

120-125

Published online

2020-12-16

Page views

1226

Article views/downloads

826

DOI

10.5603/EP.a2020.0088

Pubmed

33619707

Bibliographic record

Endokrynol Pol 2021;72(2):120-125.

Keywords

thyroid
nodule
toxic adenoma
microwave ablation
thyroid hormones

Authors

Mehmet Sercan Ertürk
Bulent Cekic
Mehmet Celik
Isil Demiray Uguz

References (37)
  1. Laurberg P, Pedersen KM, Vestergaard H, et al. High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves' disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland. J Intern Med. 1991; 229(5): 415–420.
    CrossRefPubMed
  2. Parma J, Duprez L, Van Sande J, et al. Diversity and prevalence of somatic mutations in the thyrotropin receptor and Gs alpha genes as a cause of toxic thyroid adenomas. J Clin Endocrinol Metab. 1997; 82(8): 2695–2701.
    CrossRefPubMed
  3. Treglia G, Trimboli P, Verburg FA, et al. Prevalence of normal TSH value among patients with autonomously functioning thyroid nodule. Eur J Clin Invest. 2015; 45(7): 739–744.
    CrossRefPubMed
  4. Singer PA, Cooper DS, Daniels GH, et al. Treatment guidelines for patients with hyperthyroidism and hypothyroidism. Standards of Care Committee, American Thyroid Association. JAMA. 1995; 273(10): 808–812.
    PubMed
  5. Elbers L, Mourits M, Wiersinga W. Outcome of very long-term treatment with antithyroid drugs in Graves' hyperthyroidism associated with Graves' orbitopathy. Thyroid. 2011; 21(3): 279–283.
    CrossRefPubMed
  6. Vidal-Trecan GM, Stahl JE, Eckman MH. Radioiodine or surgery for toxic thyroid adenoma: dissecting an important decision. A cost-effectiveness analysis. Thyroid. 2004; 14(11): 933–945.
    CrossRefPubMed
  7. Kang AS, Grant CS, Thompson GB, et al. Current treatment of nodular goiter with hyperthyroidism (Plummer's disease): surgery versus radioiodine. Surgery. 2002; 132(6): 916–23; discussion 923.
    CrossRefPubMed
  8. Lippi F, Ferrari C, Manetti L, et al. Treatment of solitary autonomous thyroid nodules by percutaneous ethanol injection: results of an Italian multicenter study. The Multicenter Study Group. J Clin Endocrinol Metab. 1996; 81(9): 3261–3264.
    CrossRefPubMed
  9. Mazzeo S, Toni MG, De Gaudio C, et al. Percutaneous injection of ethanol to treat autonomous thyroid nodules. AJR Am J Roentgenol. 1993; 161(4): 871–876.
    CrossRefPubMed
  10. Pacella CM, Bizzarri G, Spiezia S, et al. Thyroid tissue: US-guided percutaneous laser thermal ablation. Radiology. 2004; 232(1): 272–280.
    CrossRefPubMed
  11. Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016; 26(10): 1343–1421.
    CrossRefPubMed
  12. Chung SR, Suh CH, Baek JH, et al. Safety of radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: a systematic review and meta-analysis. Int J Hyperthermia. 2017; 33(8): 920–930.
    CrossRefPubMed
  13. Nixon IJ, Angelos P, Shaha AR, et al. Image-guided chemical and thermal ablations for thyroid disease: Review of efficacy and complications. Head Neck. 2018; 40(9): 2103–2115.
    CrossRefPubMed
  14. Yue W, Wang S, Wang B, et al. Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: safety and imaging follow-up in 222 patients. Eur J Radiol. 2013; 82(1): e11–e16.
    CrossRefPubMed
  15. Landerholm K, Wasner AM, Järhult J. Incidence and risk factors for injuries to the recurrent laryngeal nerve during neck surgery in the moderate-volume setting. Langenbecks Arch Surg. 2014; 399(4): 509–515.
    CrossRefPubMed
  16. Pacella CM, Mauri G. Is there a role for minimally invasive thermal ablations in the treatment of autonomously functioning thyroid nodules? Int J Hyperthermia. 2018; 34(5): 636–638.
    CrossRefPubMed
  17. Alexander EK, Pearce EN, Brent GA, et al. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 2017; 27(3): 315–389.
    CrossRefPubMed
  18. Li H, Zheng J, Luo J, et al. Congenital anomalies in children exposed to antithyroid drugs in-utero: a meta-analysis of cohort studies. PLoS One. 2015; 10(5): e0126610.
    CrossRefPubMed
  19. Ceccarelli C, Canale D, Battisti P, et al. Testicular function after 131I therapy for hyperthyroidism. Clin Endocrinol (Oxf). 2006; 65(4): 446–452.
    CrossRefPubMed
  20. Kohlhase KD, Korkusuz Y, Gröner D, et al. Bipolar radiofrequency ablation of benign thyroid nodules using a multiple overlapping shot technique in a 3-month follow-up. Int J Hyperthermia. 2016; 32(5): 511–516.
    CrossRefPubMed
  21. Zhang M, Luo Y, Zhang Y, et al. Efficacy and Safety of Ultrasound-Guided Radiofrequency Ablation for Treating Low-Risk Papillary Thyroid Microcarcinoma: A Prospective Study. Thyroid. 2016; 26(11): 1581–1587.
    CrossRefPubMed
  22. Valcavi R, Piana S, Bortolan GS, et al. Ultrasound-guided percutaneous laser ablation of papillary thyroid microcarcinoma: a feasibility study on three cases with pathological and immunohistochemical evaluation. Thyroid. 2013; 23(12): 1578–1582.
    CrossRefPubMed
  23. Shengnan H, Lin Y, Lili P, et al. Microwave Ablation of An Autonomous Functioning Thyroid Nodule in A Pregnant Patient: A Case Report. Adv Ultrasound DiagnTher. 2019; 3(3): 136.
    CrossRef
  24. Cervelli R, Mazzeo S, Boni G, et al. Comparison between radioiodine therapy and single-session radiofrequency ablation of autonomously functioning thyroid nodules: A retrospective study. Clin Endocrinol (Oxf). 2019; 90(4): 608–616.
    CrossRefPubMed
  25. Zingrillo M, Torlontano M, Ghiggi MR, et al. Radioiodine and percutaneous ethanol injection in the treatment of large toxic thyroid nodule: a long-term study. Thyroid. 2000; 10(11): 985–989.
    CrossRefPubMed
  26. Døssing H, Bennedbaek FN, Bonnema SJ, et al. Randomized prospective study comparing a single radioiodine dose and a single laser therapy session in autonomously functioning thyroid nodules. Eur J Endocrinol. 2007; 157(1): 95–100.
    CrossRefPubMed
  27. Nygaard B, Hegedüs L, Nielsen KG, et al. Long-term effect of radioactive iodine on thyroid function and size in patients with solitary autonomously functioning toxic thyroid nodules. Clin Endocrinol (Oxf). 1999; 50(2): 197–202.
    CrossRefPubMed
  28. Sung JY, Baek JH, Jung SoL, et al. Radiofrequency ablation for autonomously functioning thyroid nodules: a multicenter study. Thyroid. 2015; 25(1): 112–117.
    CrossRefPubMed
  29. Bernardi S, Stacul F, Michelli A, et al. 12-month efficacy of a single radiofrequency ablation on autonomously functioning thyroid nodules. Endocrine. 2017; 57(3): 402–408.
    CrossRefPubMed
  30. Cerbone G, Spiezia S, Colao A, et al. Percutaneous ethanol injection under Power Doppler ultrasound assistance in the treatment of autonomously functioning thyroid nodules. J Endocrinol Invest. 1999; 22(10): 752–759.
    CrossRefPubMed
  31. Yano Y, Sugino K, Akaishi J, et al. Treatment of autonomously functioning thyroid nodules at a single institution: radioiodine therapy, surgery, and ethanol injection therapy. Ann Nucl Med. 2011; 25(10): 749–754.
    CrossRefPubMed
  32. Ross DS, Ridgway EC, Daniels GH. Successful treatment of solitary toxic thyroid nodules with relatively low-dose iodine-131, with low prevalence of hypothyroidism. Ann Intern Med. 1984; 101(4): 488–490.
    CrossRefPubMed
  33. Goldstein R, Hart IR. Follow-up of solitary autonomous thyroid nodules treated with 131I. N Engl J Med. 1983; 309(24): 1473–1476.
    CrossRefPubMed
  34. Mariotti S, Martino E, Francesconi M, et al. Serum thyroid autoantibodies as a risk factor for development of hypothyroidism after radioactive iodine therapy for single thyroid 'hot' nodule. Acta Endocrinol (Copenh). 1986; 113(4): 500–507.
    CrossRefPubMed
  35. Rho MHo, Kim DW, Hong HP, et al. Diagnostic value of antithyroid peroxidase antibody for incidental autoimmune thyroiditis based on histopathologic results. Endocrine. 2012; 42(3): 647–652.
    CrossRefPubMed
  36. Takasu N, Yoshimura Noh J. Hashimoto's thyroiditis: TGAb, TPOAb, TRAb and recovery from hypothyroidism. Expert Rev Clin Immunol. 2008; 4(2): 221–237.
    CrossRefPubMed
  37. Ramanathan P, Patel RB, Subrahmanyam N, et al. Visualization of suppressed thyroid tissue by technetium-99m-tertiary butyl isonitrile: an alternative to post-TSH stimulation scanning. J Nucl Med. 1990; 31(7): 1163–1165.
    PubMed

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