European radiology · 2026
Factors associated with early complete resolution after radiofrequency ablation for low-risk papillary thyroid microcarcinoma: a dual-center retrospective study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Qiu Yuxuan, Zhang Yina, Zhu Jingqi, Gong Yun, Yin Lu, Fan Pin, Zhang Lian, Bao Lingyun, Fang Jianhua, Lou Jun, Xu Chenke
Аннотация
OBJECTIVES: To identify predictors of early complete ablation zone resolution (within 1 year) after radiofrequency ablation (RFA) for low-risk papillary thyroid microcarcinoma (PTMC).
MATERIALS AND METHODS: A retrospective dual-center study enrolled 225 patients with low-risk PTMC (2017-2022). Ablation zone volume was tracked during follow-up, with the specific time of complete resolution modeled using exponential decay functions. Multivariable Cox regression and restricted cubic spline (RCS) analyses identified independent predictors of resolution.
RESULTS: Cumulative complete resolution rates were 62.2% at 1 year and 98.7% at 2 years. Independent predictors of complete resolution within 1 year included normal thyroglobulin antibody (TgAb) levels (hazard ratio (HR): 2.64, 95% confidence Interval (CI): 1.38-5.07) and thyroid peroxidase antibody (TPOAb) levels (HR: 1.92, 95% CI: 1.34-2.75), nodule diameter ≤ 5 mm (HR: 1.53, 95% CI: 1.02-2.29), and absence of intratumoral vascularity (HR: 2.77, 95% CI: 1.83-4.21). Energy density showed an inverted U-shaped relationship with resolution probability within 1 year (p < 0.001 for non-linearity).
CONCLUSION: RFA achieves favorable long-term efficacy for low-risk PTMC, and complete resolution within 1 year is predictable by normal TgAb/TPOAb, smaller nodule size, absence of intratumoral vascularity, and moderate energy density. These findings may provide valuable insights for refining RFA techniques and the development of personalized follow-up.
KEY POINTS: Question Predicting early complete resolution of low-risk PTMC after RFA is critical to mitigate concerns about treatment outcomes and optimize follow-up. Findings Normal TgAb/TPOAb, smaller nodule size, absence of intratumoral vascularity, and moderate energy density independently predict early complete ablation zone resolution within 1 year after RFA. Clinical relevance Identifying predictors of early resolution enables optimized RFA energy delivery and pretreatment decision-making. This provides doctors and patients with evidence-based guidance to refine ablation strategies and personalize management plans.
MATERIALS AND METHODS: A retrospective dual-center study enrolled 225 patients with low-risk PTMC (2017-2022). Ablation zone volume was tracked during follow-up, with the specific time of complete resolution modeled using exponential decay functions. Multivariable Cox regression and restricted cubic spline (RCS) analyses identified independent predictors of resolution.
RESULTS: Cumulative complete resolution rates were 62.2% at 1 year and 98.7% at 2 years. Independent predictors of complete resolution within 1 year included normal thyroglobulin antibody (TgAb) levels (hazard ratio (HR): 2.64, 95% confidence Interval (CI): 1.38-5.07) and thyroid peroxidase antibody (TPOAb) levels (HR: 1.92, 95% CI: 1.34-2.75), nodule diameter ≤ 5 mm (HR: 1.53, 95% CI: 1.02-2.29), and absence of intratumoral vascularity (HR: 2.77, 95% CI: 1.83-4.21). Energy density showed an inverted U-shaped relationship with resolution probability within 1 year (p < 0.001 for non-linearity).
CONCLUSION: RFA achieves favorable long-term efficacy for low-risk PTMC, and complete resolution within 1 year is predictable by normal TgAb/TPOAb, smaller nodule size, absence of intratumoral vascularity, and moderate energy density. These findings may provide valuable insights for refining RFA techniques and the development of personalized follow-up.
KEY POINTS: Question Predicting early complete resolution of low-risk PTMC after RFA is critical to mitigate concerns about treatment outcomes and optimize follow-up. Findings Normal TgAb/TPOAb, smaller nodule size, absence of intratumoral vascularity, and moderate energy density independently predict early complete ablation zone resolution within 1 year after RFA. Clinical relevance Identifying predictors of early resolution enables optimized RFA energy delivery and pretreatment decision-making. This provides doctors and patients with evidence-based guidance to refine ablation strategies and personalize management plans.