Jawad Susan, Morley Simon, Otero Sofia, Beale Timothy, Bandula Steven
1 Department of Imaging, University College London Hospitals , London , England.
2 Centre for Medical Imaging, University College London , England.
Br J Radiol. 2019 Jun;92(1098):20190026. doi: 10.1259/bjr.20190026. Epub 2019 May 14.
To report on the use of RFA for the treatment of symptomatic benign and autonomously functioning thyroid nodules (AFTNs) in the first reported UK cohort.
Patients treated over a 19-month period were retrospectively reviewed. Nodules were assessed pre-treatment and at 1 and 6 months post-treatment. Nodule volume was calculated and cosmetic assessment and thyroid-related quality of life (QoL) scores were recorded at each time point. Thyroid function tests (TFTs) were recorded at all three time points for patients with ATFNs.
46 patients with 50 nodules were treated with no complications. The mean volume reduction 1-month post-treatment was 53 +- 14.9 % ( < 0.0001). Six month data was available for 31 nodules and showed a mean 67 +- 17.6% vol reduction ( < 0.0001). Five of the six patients with ATFNs were euthyroid at 1-month post-procedure. 6-month data was available on three of these patients, and all remained euthyroid. The thyroid-related QoL and cosmetic scores also improved. Data from 23 patients was available pre-treatment and at 6 months post-treatment and there was a significant ( < 0.0001) reduction in QoL score. Pre-treatment, 82 % of nodules were readily visible at rest, decreasing to 12.5 % 6 months after treatment ( < 0.0001).
Results align with published data suggesting that RFA is effective at reducing nodule volume and at treating ATFNs and leads to improvement in thyroid-related QoL and cosmetic scores.
This early UK experience demonstrates that day-case radiofrequency ablation can provide safe and effective treatment of benign symptomatic thyroid nodules.
报告在英国首个报道队列中使用射频消融术(RFA)治疗有症状的良性自主功能性甲状腺结节(AFTNs)的情况。
对19个月期间接受治疗的患者进行回顾性分析。在治疗前、治疗后1个月和6个月对结节进行评估。计算结节体积,并在每个时间点记录美容评估和甲状腺相关生活质量(QoL)评分。对患有AFTNs的患者在所有三个时间点记录甲状腺功能测试(TFTs)。
46例患者的50个结节接受了治疗,无并发症发生。治疗后1个月平均体积缩小53±14.9%(P<0.0001)。31个结节有6个月的数据,显示平均体积缩小67±17.6%(P<0.0001)。6例AFTNs患者中有5例在术后1个月甲状腺功能正常。其中3例患者有6个月的数据,且均保持甲状腺功能正常。甲状腺相关QoL和美容评分也有所改善。23例患者有治疗前和治疗后6个月的数据,QoL评分显著降低(P<0.0001)。治疗前,82%的结节在静息时易于看到,治疗后6个月降至12.5%(P<0.0001)。
结果与已发表的数据一致,表明RFA在缩小结节体积和治疗AFTNs方面有效,并能改善甲状腺相关QoL和美容评分。
英国的这一早期经验表明,日间射频消融术可为有症状的良性甲状腺结节提供安全有效的治疗。