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Recurrence and additional treatment of cystic thyroid nodules after ethanol ablation: validation of three proposed criteria

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Abstract
Purpose: We evaluated the use of three criteria to determine the need for additional treatment of cystic thyroid nodules after their recurrence following ethanol ablation (EA).

Methods: In total, 154 patients (male:female=30:124; mean age, 53.4 years; range, 23 to 79 years) with 154 thyroid nodules (49 cystic and 105 predominantly cystic nodules) who presented between January 2014 and August 2017 were enrolled. All patients underwent follow-up ultrasonography (US) 1 month after EA, and were divided into therapeutic success and failure groups. Therapeutic success was defined as the absence of any residual fluid or sufficient volume reduction (>= 50%) with improvement of nodule-related symptoms. The therapeutic failure was defined according to three previously suggested criteria for recommending additional treatment: nodules with >= 1 mL of remnant fluid (criterion 1), volume reduction <50% (criterion 2), and demonstration of a solid component with vascularity (criterion 3).

Results: Thyroid nodules treated by EA showed significant volume reduction (18.4 +/- 21.6 mL to 4.2 +/- 6.5 mL [1-month follow-up] to 1.9 +/- 3.3 mL [final follow-up], P<0.001) and improvement in clinical problems. Therapeutic failure were 26 patients according to criteria 1, 14 patients according to criteria 2, and 35 patients according to criteria 3. Additional treatment was unnecessary in 81.3%, 70.0%, and 77.8% of patients deemed to need it according to criteria 1, 2, and 3, respectively.

Conclusion: The choice to perform additional treatment after EA should be made according to a combination of clinical problems and US features. Understanding this concept will be useful in planning further treatment following US-guided EA.
Author(s)
백정환이정현임영희정새롬최영준
Issued Date
2021
Type
Article
Keyword
Thyroid nodulesEthanolAblationRecurrence
DOI
10.14366/usg.20039
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8006
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9796794&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Recurrence%20and%20additional%20treatment%20of%20cystic%20thyroid%20nodules%20after%20ethanol%20ablation:%20validation%20of%20three%20proposed%20criteria&amp;offset=0&amp;pcAvailability=true
Publisher
ULTRASONOGRAPHY
Location
대한민국
Language
영어
ISSN
2288-5919
Citation Volume
40
Citation Number
3
Citation Start Page
378
Citation End Page
386
Appears in Collections:
Medicine > Medicine
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