Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Thyroid Head and Neck Ablation Center, Kaohsiung Chang Gung Memorial Hospital, Taiwan.
Eur Thyroid J. 2023 Oct 9;12(6). doi: 10.1530/ETJ-23-0105. Print 2023 Dec 1.
The purpose of this study was to evaluate the feasibility of radiofrequency ablation (RFA) for thyroid nodules with cytological atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS, Bethesda III).
A total of 28 adults presenting with 30 initial Bethesda III nodules underwent thyroid RFA at a single medical center. Thyroid nodules with Bethesda IV or V according to the second aspiration were excluded. All RFA procedures were performed using the free-hand, 'moving-shot' technique under local anesthesia. Clinical features and demographics, RFA details, nodule volume reduction rate (VRR), and complications were analyzed.
The mean age of patients was 47.6 years, 82.1% of whom were females. Mean nodule volumes at pre-RFA, and at 6 months and 12 months post-RFA were 7.92, 2.42, and 1.25 mL, respectively, with a VRR of 77.9% at 6 months, and 87.4% at 12 months. Post-RFA complications were noted in two patients, one with transient vocal cord palsy and another with isthmus minor rupture.
RFA may be another safe alternative except for active surveillance or surgical excision for AUS/FLUS nodules with low-suspicion Thyroid Imaging Reporting and Data System features for patients who are unsuitable or strongly refuse surgery. Long-term results remain uncertain, thus further follow-up study is necessary.
本研究旨在评估射频消融（RFA）治疗细胞学不确定意义的甲状腺滤泡性病变或滤泡性肿瘤（AUS/FLUS，BethesdaIII 级）的可行性。
本研究共纳入了 28 名成年人，共 30 个初始 BethesdaIII 级甲状腺结节，在一家医疗中心接受了甲状腺 RFA 治疗。根据第二次抽吸结果为 BethesdaIV 或 V 级的结节被排除在外。所有 RFA 手术均在局部麻醉下采用徒手、“移动射击”技术进行。分析了临床特征和人口统计学资料、RFA 细节、结节体积缩小率（VRR）和并发症。
患者的平均年龄为 47.6 岁，82.1%为女性。RFA 前、6 个月和 12 个月时的平均结节体积分别为 7.92、2.42 和 1.25mL，6 个月时的 VRR 为 77.9%，12 个月时为 87.4%。两名患者在 RFA 后出现并发症，一名患者出现短暂性声带麻痹，另一名患者出现峡部小裂伤。
对于低可疑性甲状腺影像报告和数据系统特征的 AUS/FLUS 结节，如果患者不适合手术或强烈拒绝手术，RFA 可能是一种安全的替代治疗方法，除了主动监测或手术切除。长期结果尚不确定，因此需要进一步的随访研究。
