a Department of Radiology and Thyroid Center , Chung-Ang University Hospital, Chung-Ang University College of Medicine , Seoul , Korea.
b Department of Radiology and Thyroid Center , Daerim St. Mary's Hospital , Seoul , Korea.
Int J Hyperthermia. 2017 Dec;33(8):931-937. doi: 10.1080/02656736.2017.1331268. Epub 2017 May 25.
In thyroid gland, radiofrequency ablation (RFA) has been applied to both recurrent cancers and benign nodules, although, according to the American Thyroid Association (ATA) and the Korean Society of Thyroid Radiology (KSThR) guidelines, surgery is the first-line treatment for follicular neoplasm. However, it has been argued that follicular neoplasm with lower risk of malignancy can be managed by close follow-up. In this study, we evaluated the effectiveness of RFA of small follicular neoplasms, examining reductions in volume and related clinical problems, and making observations over long-term follow-up.
We evaluated 10 follicular neoplasms in 10 patients who were treated with RF ablation between 2009 and 2011. A RF generator and an 18-gauge internally cooled electrode were used to perform complete ablation of the whole nodules. Changes in nodules or ablated zones on follow-up ultrasound, and complications during and after RF ablation were evaluated.
The mean follow-up period was 66.4 ± 5.1 months (range: 60-76 months). In eight patients, single session of RF ablation was sufficient, while two patients required two sessions. There was a significant reduction in the mean volume (99.5 ± 1.0%) of lesions, with eight ablated lesions (8/10, 80%) disappearing completely on follow-up. No recurrences were found in any ablated zones at last follow-up. Transient mild neck pain (n = 6) occurred during the procedure without requiring any medication.
In addition to active surveillance, RF ablation may be an effective and safe alternative for the management of patients with small (<2 cm) follicular neoplasm suspected on thyroid biopsy and who strongly refuse surgery.
在甲状腺中，射频消融 (RFA) 已被应用于复发性癌症和良性结节，尽管根据美国甲状腺协会 (ATA) 和韩国甲状腺放射学会 (KSThR) 指南，手术是滤泡性肿瘤的首选治疗方法。然而，有人认为，恶性程度较低的滤泡性肿瘤可以通过密切随访来管理。在这项研究中，我们评估了 RFA 治疗小滤泡性肿瘤的有效性，检查了体积减少和相关临床问题，并进行了长期随访观察。
我们评估了 2009 年至 2011 年间接受 RF 消融治疗的 10 例 10 个滤泡性肿瘤患者。使用 RF 发生器和 18 号内部冷却电极对整个结节进行完全消融。评估随访超声上结节或消融区的变化以及 RF 消融过程中和之后的并发症。
平均随访时间为 66.4±5.1 个月（范围：60-76 个月）。8 例患者单次 RF 消融即可，2 例患者需要 2 次。病变的平均体积（99.5±1.0%）显著减少，8 个消融病变（8/10，80%）在随访中完全消失。最后一次随访时，任何消融区均未发现复发。术中均出现短暂的轻度颈痛（n=6），无需用药。
除了主动监测外，RF 消融可能是一种有效且安全的替代方法，适用于经甲状腺活检怀疑有小（<2cm）滤泡性肿瘤且强烈拒绝手术的患者。
