Academic radiology · 2025
Clinical Outcomes and Volume Reduction Predictors Following Microwave Ablation of Benign Thyroid Nodules: A Comparative Study of Solitary Nodules and Multinodular Goiters.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Eryuruk Uluhan, Bekci̇ Tumay, Tonkaz Mehmet, Tasdemir Merve Nur, Emur Gunay Yasemin, Dikbas Oguz
Аннотация
RATIONALE AND OBJECTIVES: To investigate the efficacy and safety of microwave ablation (MWA) for benign thyroid nodules, including a comparison of volume reduction rates (VRR) between solitary nodules and multinodular goiters (MNG), and an assessment of autonomously functioning thyroid nodules (AFTN).
MATERIALS AND METHODS: A single-center retrospective evaluation was conducted on 112 patients treated with MWA between June 2023 and June 2024. Routine ultrasound and clinical evaluations were performed at 3, 6, and 12 months postoperatively after the MWA procedure. Technical efficacy was defined as a 50% or more reduction in the initial nodule volume after ablation. Outcomes assessed included VRR, technical efficacy, complication rates, cosmetic scores, and therapeutic success for AFTN. A multiple linear regression model was employed to examine potential factors influencing the VRR.
RESULTS: The majority of patients were female (68.48%), with a mean age of 57.84±11.10years. The median initial nodule volume was 10.66 mL. Of the 112 ablations performed, 50 (44.6%) targeted solitary nodules and 62 (55.4%) MNGs. The median VRR was 62.9% at 3 months, 80.5% at 6 months, and 88.2% at 12 months. Technical efficacy was achieved in 94.6% of nodules at 12 months. No significant difference in VRR was found between solitary nodules and MNG at any follow-up interval (12-month VRR: 89.0% vs. 87.5%, p=0.973). Multivariate analysis identified the presence of calcification, nodule composition, and energy delivered per mL as significant independent predictors of the VRR (p<0.001 for all). Of the 18 patients with AFTNs, 11 required antithyroid medication before treatment. Following MWA, seven of these 11 patients (63.6%) successfully discontinued medication and maintained euthyroidism, a result that was statistically significant (p<0.001). There were no major complications. Transient hoarseness was observed in three patients three patients (2.7%), with no permanent deficits. Cosmetic scores showed significant improvement (p<0.001).
CONCLUSION: MWA is an effective and safe treatment for benign thyroid nodules, demonstrating high technical efficacy and significant volume reduction for both solitary nodules and MNG. Energy delivery per mL, nodule composition, and the presence of calcification were identified as significant independent predictors of the VRR. Furthermore, MWA shows promise as a viable treatment option for AFTNs.
MATERIALS AND METHODS: A single-center retrospective evaluation was conducted on 112 patients treated with MWA between June 2023 and June 2024. Routine ultrasound and clinical evaluations were performed at 3, 6, and 12 months postoperatively after the MWA procedure. Technical efficacy was defined as a 50% or more reduction in the initial nodule volume after ablation. Outcomes assessed included VRR, technical efficacy, complication rates, cosmetic scores, and therapeutic success for AFTN. A multiple linear regression model was employed to examine potential factors influencing the VRR.
RESULTS: The majority of patients were female (68.48%), with a mean age of 57.84±11.10years. The median initial nodule volume was 10.66 mL. Of the 112 ablations performed, 50 (44.6%) targeted solitary nodules and 62 (55.4%) MNGs. The median VRR was 62.9% at 3 months, 80.5% at 6 months, and 88.2% at 12 months. Technical efficacy was achieved in 94.6% of nodules at 12 months. No significant difference in VRR was found between solitary nodules and MNG at any follow-up interval (12-month VRR: 89.0% vs. 87.5%, p=0.973). Multivariate analysis identified the presence of calcification, nodule composition, and energy delivered per mL as significant independent predictors of the VRR (p<0.001 for all). Of the 18 patients with AFTNs, 11 required antithyroid medication before treatment. Following MWA, seven of these 11 patients (63.6%) successfully discontinued medication and maintained euthyroidism, a result that was statistically significant (p<0.001). There were no major complications. Transient hoarseness was observed in three patients three patients (2.7%), with no permanent deficits. Cosmetic scores showed significant improvement (p<0.001).
CONCLUSION: MWA is an effective and safe treatment for benign thyroid nodules, demonstrating high technical efficacy and significant volume reduction for both solitary nodules and MNG. Energy delivery per mL, nodule composition, and the presence of calcification were identified as significant independent predictors of the VRR. Furthermore, MWA shows promise as a viable treatment option for AFTNs.