Dipartimento di Radiologia e Ecografia Interventistica, Ospedale Evangelico Internazionale, Genova, Italy.
Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Genova, Italy.
Int J Hyperthermia. 2022;39(1):847-854. doi: 10.1080/02656736.2022.2091167.
The aim of the present study was to assess feasibility, safety and outcome of ultrasound (US) guided percutaneous radiofrequency (RF) ablation of large substernal benign thyroid nodules assisted by US-computed tomography (CT) fusion imaging and real-time virtual needle tracking (VT) system. Thirty patients (18 females, mean age 56 y, range 32-76 y) with 35 benign nonfunctioning thyroid nodules (mean volume ± SD 26.8 ± 7.6 mL; range 20-38mL) were selected for CT-US fusion guided RF ablation. Nodules' volume was evaluated before treatment and during 12-months follow-up. Complications' rate was also evaluated. US-CT fusion imaging with VT system was feasible in all cases (feasibility 100%) and it was always possible to complete the procedure as planned (technical success 100%). Minor complications occurred in 2/30 cases (6.6%). No major complications occurred. 50% volume reduction (technique efficacy) was achieved in 93% cases, with a significant mean volume reduction at 12 months follow-up (68.7 ± 10.8%), ( < .001). The VT system could be useful in thyroid nodules ablation procedures assistance being able to track the RF electrode tip even when this is obscured by the bubbles produced by the ablative process. The combination of fusion imaging with VT assisted RF ablation represents a safe, non-surgical treatment option for patients with large substernal benign thyroid nodules.
本研究旨在评估超声（US）引导下经皮射频（RF）消融联合 CT 融合成像和实时虚拟针道跟踪（VT）系统治疗胸骨后大良性甲状腺结节的可行性、安全性和疗效。选择 30 例（18 例女性，平均年龄 56 岁，范围 32-76 岁）35 个良性无功能甲状腺结节（平均体积 ± 标准差 26.8 ± 7.6mL；范围 20-38mL）进行 CT-US 融合引导下 RF 消融。治疗前及治疗后 12 个月评估结节体积。同时评估并发症发生率。所有病例均可行 US-CT 融合成像及 VT 系统（可行性 100%），且均能按计划完成手术（技术成功率 100%）。30 例中 2 例（6.6%）出现轻微并发症。无严重并发症发生。93%的病例达到 50%体积缩小（技术疗效），治疗后 12 个月体积明显缩小（68.7 ± 10.8%， < .001）。VT 系统在 RF 电极尖端被消融过程产生的气泡遮挡时也能跟踪电极尖端，有助于甲状腺结节消融术。融合成像联合 VT 辅助 RF 消融是治疗胸骨后大良性甲状腺结节的一种安全、非手术治疗选择。
