From the Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing 100029, China (X.J.C., Y.W., Z.L.Z., L.L.P., Y.L., M.A.Y.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (S.R.W., L.Q.); Department of Ultrasound, the First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C., Y.L.Z.); Department of Thyroid, Beijing Beicheng Chinese Medicine Hospital, Beijing, China (J.L.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, China (J.F.H., G.Z.Y.); Department of Breast and Thyroid Surgery, People's Hospital of Xinjiang Uygur Autonomous, Wulumuqi, China (H.L.W., A.S.); Department of Ultrasound, Wuhai People's Hospital, Wuhai, China (G.L.); Department of Interventional Ultrasound, Qinghai Provincial People's Hospital, Xining, China (J.Q.G.); Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H., X.F.L.); Special Inspection Section, Wendeng District People's Hospital, Wendeng, China (Z.H.W.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Y.Z.); Department of Ultrasound, Bayannur Hospital, Bayannur China (M.J.); and Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.).
Radiology. 2021 Jul;300(1):209-216. doi: 10.1148/radiol.2021202735. Epub 2021 Apr 27.
Background Microwave ablation (MWA) and radiofrequency ablation (RFA) have recently attracted interest as minimally invasive treatment modalities for papillary thyroid carcinoma (PTC). However, the ablation outcomes of T1N0M0 PTC are not well characterized. Purpose To evaluate the efficacy and safety of thermal ablation (MWA or RFA) of solitary T1N0M0 PTC in patients who were ineligible for (due to presence of comorbid cardiovascular disease, renal failure, other malignancy, etc) or who refused surgery. Materials and Methods This was a retrospective multicenter study of 847 patients (660 women) who underwent thermal ablation for PTC (673 T1a, 174 T1b) between March 2015 and March 2020; of these patients, 645 underwent MWA and 202 underwent RFA. The mean age of patients was 46 years ± 11 (standard deviation) (age range, 18-81 years); the mean follow-up time was 22 months ± 13 (range, 6-60 months). Changes in tumor size and volume and the rates of technical success, tumor disappearance, disease progression, and complications were assessed. Results The technical success rate was 100%. Relative to preablation measurements, the maximum diameter and volume of the ablation zone increased during the 1st month after ablation ( < .001), whereas there was no difference by the 3rd month; subsequently, the tumors showed reduction in size at 6, 9, and 12 months (all < .001). Complete disappearance of tumors occurred in 68% of patients (577 of 847; 69% [466 of 673] in the T1a group vs 64% [111 of 174] in the T1b group; < .001). The postablation disease progression rate was 1.1% (nine of 847 patients; 0.9% [six of 673 patients] in the T1a group vs 1.7% [three of 174 patients] in the T1b group; = .54). The overall complication rate was 3.4% (29 of 847 patients; 2.7% [18 of 673 patients] in the T1a group vs 6.3% [11 of 174 patients] in the T1b group; = .02). Conclusion This multicenter study provided evidence that thermal ablation is an effective and safe treatment option in selected -patients with solitary T1N0M0 papillary thyroid carcinoma. © RSNA, 2021 See also the editorial by Baek and Cho in this issue.
背景 微波消融（MWA）和射频消融（RFA）最近作为甲状腺乳头状癌（PTC）的微创治疗方法引起了关注。然而，T1N0M0 PTC 的消融效果尚不清楚。目的 评估热消融（MWA 或 RFA）治疗不适合（由于存在合并心血管疾病、肾衰竭、其他恶性肿瘤等）或拒绝手术的单发 T1N0M0 PTC 患者的疗效和安全性。材料与方法 这是一项回顾性多中心研究，纳入了 847 名（660 名女性）接受热消融治疗的 PTC 患者（673 名 T1a，174 名 T1b），时间为 2015 年 3 月至 2020 年 3 月；其中 645 名患者接受 MWA，202 名患者接受 RFA。患者平均年龄为 46 岁±11（标准差）（年龄范围：18-81 岁）；平均随访时间为 22 个月±13（范围：6-60 个月）。评估肿瘤大小和体积的变化，以及技术成功率、肿瘤消失、疾病进展和并发症的发生率。结果 技术成功率为 100%。与消融前测量值相比，消融后 1 个月时消融区域的最大直径和体积增加（<.001），但第 3 个月时无差异；随后，6、9 和 12 个月时肿瘤大小减小（均<.001）。68%的患者肿瘤完全消失（847 例患者中有 577 例[68%（673 例中的 466 例）与 T1a 组相比，T1b 组为 64%（174 例中的 111 例）；<.001]）。消融后疾病进展率为 1.1%（847 例患者中有 9 例[673 例患者中有 0.9%（6 例）与 T1a 组相比，T1b 组为 1.7%（174 例患者中有 3 例）；=.54）。总体并发症发生率为 3.4%（847 例患者中有 29 例[673 例患者中有 2.7%（18 例）与 T1a 组相比，T1b 组为 6.3%（174 例患者中有 11 例）；=.02））。结论 这项多中心研究表明，热消融是治疗选择合适的单发 T1N0M0 甲状腺乳头状癌患者的有效和安全的治疗选择。©RSNA，2021 也可参见本期 Baek 和 Cho 的社论。
