Bipolar Radiofrequency Ablation of Benign Symptomatic Thyroid Nodules: Initial Experience.

PURPOSE: To determine the safety and efficacy of bipolar radiofrequency ablation (RFA) in benign thyroid nodules.
METHODS: 23 patients with 24 symptomatic benign thyroid nodules (21 regressive, 3 adenomas) ranging in volume from 0.5 to 112 ml (mean ± sd: 18 ± 24.4 ml) underwent bipolar RFA. Pain during the procedure was measured on a 10-point scale. Side-effects revealed by ultrasound or patients' complaints were documented. Periablative efficacy was measured 24 hours after RFA as change (Δ) in serum thyreoglobulin (Tg) and sonographic criteria (echogenity, Doppler blood flow and elasticity) categorized on a 3-point scale (echogenity, Doppler blood flow) or 4-point scale (elasticity). Efficacy in the 3 autonomous adenomas was measured as normalization of (99 m)Tc-pertechnate scintigraphy.
RESULTS: Bipolar RFA was well tolerated by all patients with a median pain score of 3 ± 1.5 (range: 1 - 7). Side-effects were hematomas in 4 of 23 patients (17 %). Bipolar RFA resulted in a significant (p < 0.01) decrease in echogenity, blood flow, elasticity (Δ = 1 ± 0.28, 1 ± 0.46 and 1 ± 0.85 points, respectively), a median increase in Tg of 403 ± 2568 ng/ml as well as in a normalization of scintigraphy.
CONCLUSION: Bipolar RFA is a safe and effective treatment option for symptomatic benign thyroid nodules. KEY POINTS: • Bipolar RFA is a safe and effective treatment for benign thyroid nodules.• Ultrasound imaging allows guidance during bipolar radiofrequency ablation.• (99 m)Tc-pertechnetate is able to detect the ablation area of autonomous adenomas. Citation Format: • Korkusuz Y, Erbelding C, Kohlhase K et al. Bipolar Radiofrequency Ablation of Benign Symptomatic Thyroid Nodules: Initial experience with Bipolar Radiofrequency. Fortschr Röntgenstr 2016; 188: 671 - 675. © Georg Thieme Verlag KG Stuttgart · New York.