Giovanni Mauri1,2, Franco Orsi2, Serena Carriero3, Paolo Della Vigna2, Elvio De Fiori4, Dario Monzani1,5, Gabriella Pravettoni1,5, Enrica Grosso6, Marco F Manzoni6, Mohssen Ansarin6, Gioacchino Giugliano6. 1. Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Milan, Italy. 2. Divisione di Radiologia interventistica, Istituto Europeo di Oncologia, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy. 3. Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Milan, Italy. 4. Unità di Radiologia Clinico Diagnostica, Istituto Europeo di Oncologia, IRCCS, Milan, Italy. 5. Divisione di Psiconcologia, Istituto Europeo di Oncologia, IRCCS, Milan, Italy. 6. Divisione di Otorinolaringoiatria e Chirurgia Cervico Facciale, Istituto Europeo di Oncologia, IRCCS, Milan, Italy.
Abstract
Purpose: To report the results of our preliminary experience in treating patients with papillary thyroid microcarcinoma (PTMC) with image-guided thermal ablation, in particular estimating the feasibility, safety and short-term efficacy. Materials and Methods: From 2018 patients with cytologically proven PTMC < 10 mm were discussed in a multidisciplinary team and evaluated for feasibility of image-guided thermal ablation. In case of technical feasibility, the three possible alternatives (i.e., image-guided thermal ablation, surgery, and active surveillance) were discussed with patients. Patients who agreed to be treated with image guided thermal ablation underwent radiofrequency (RFA) or laser ablation under local anesthesia and conscious sedation. Treatment feasibility, technical success, technique efficacy, change in thyroid function tests, side effects, minor and major complications, patients satisfaction and pain/discomfort perception during and after treatment, and disease recurrence during follow-up were recorded. Results: A total of 13 patients were evaluated, and 11/13 (84.6%) patients (9 female, 2 male, mean age 49.3 ± 8.7 years) resulted suitable for image-guided thermal ablation. All 11 patients agreed to be treated with image-guided thermal ablation. In addition, 3/11 (27.3%) were treated with laser ablation and 8/11 (72.7%) with RFA. All procedures were completed as preoperatively planned (technical success 100%). Technique efficacy was achieved in all 11/11 (100%) cases. Ablated volume significantly reduced from 0.87 ± 0.67 ml at first follow-up to 0.17 ± 0.36 at last follow-up (p = 0.003). No change in thyroid function tests occurred. No minor or major complications occurred. All patients graded 10 the satisfaction for the treatment, and mean pain after the procedure was reported as 1.4 ± 1.7, and mean pain after the procedure as 1.2 ± 1.1 At a median follow-up of 10.2 months (range 1.5-12 months), no local recurrence or distant metastases were found. Conclusions: Image guided thermal ablations appear to be feasible and safe in the treatment of PTMC. These techniques hold the potential to offer patients a minimally invasive curative alternative to surgical resection or active surveillance. These techniques appear to be largely preferred by patients.
Purpose: To report the results of our preliminary experience in treating patients with papillary thyroid microcarcinoma (PTMC) with image-guided thermal ablation, in particular estimating the feasibility, safety and short-term efficacy. Materials and Methods: From 2018 patients with cytologically proven PTMC < 10 mm were discussed in a multidisciplinary team and evaluated for feasibility of image-guided thermal ablation. In case of technical feasibility, the three possible alternatives (i.e., image-guided thermal ablation, surgery, and active surveillance) were discussed with patients. Patients who agreed to be treated with image guided thermal ablation underwent radiofrequency (RFA) or laser ablation under local anesthesia and conscious sedation. Treatment feasibility, technical success, technique efficacy, change in thyroid function tests, side effects, minor and major complications, patients satisfaction and pain/discomfort perception during and after treatment, and disease recurrence during follow-up were recorded. Results: A total of 13 patients were evaluated, and 11/13 (84.6%) patients (9 female, 2 male, mean age 49.3 ± 8.7 years) resulted suitable for image-guided thermal ablation. All 11 patients agreed to be treated with image-guided thermal ablation. In addition, 3/11 (27.3%) were treated with laser ablation and 8/11 (72.7%) with RFA. All procedures were completed as preoperatively planned (technical success 100%). Technique efficacy was achieved in all 11/11 (100%) cases. Ablated volume significantly reduced from 0.87 ± 0.67 ml at first follow-up to 0.17 ± 0.36 at last follow-up (p = 0.003). No change in thyroid function tests occurred. No minor or major complications occurred. All patients graded 10 the satisfaction for the treatment, and mean pain after the procedure was reported as 1.4 ± 1.7, and mean pain after the procedure as 1.2 ± 1.1 At a median follow-up of 10.2 months (range 1.5-12 months), no local recurrence or distant metastases were found. Conclusions: Image guided thermal ablations appear to be feasible and safe in the treatment of PTMC. These techniques hold the potential to offer patients a minimally invasive curative alternative to surgical resection or active surveillance. These techniques appear to be largely preferred by patients.
Authors: Glyn Elwyn; Annette O'Connor; Dawn Stacey; Robert Volk; Adrian Edwards; Angela Coulter; Richard Thomson; Alexandra Barratt; Michael Barry; Steven Bernstein; Phyllis Butow; Aileen Clarke; Vikki Entwistle; Deb Feldman-Stewart; Margaret Holmes-Rovner; Hilary Llewellyn-Thomas; Nora Moumjid; Al Mulley; Cornelia Ruland; Karen Sepucha; Alan Sykes; Tim Whelan Journal: BMJ Date: 2006-08-14
Authors: Giovanni Mauri; Laszlo Hegedüs; Steven Bandula; Roberto Luigi Cazzato; Agnieszka Czarniecka; Oliver Dudeck; Laura Fugazzola; Romana Netea-Maier; Gilles Russ; Göran Wallin; Enrico Papini Journal: Eur Thyroid J Date: 2021-05-25
Authors: Marta Tagliabue; Gioacchino Giugliano; Maria Cecilia Mariani; Manila Rubino; Enrica Grosso; Francesco Chu; Anna Calastri; Fausto Antonio Maffini; Giovanni Mauri; Elvio De Fiori; Marco Federico Manzoni; Mohssen Ansarin Journal: Cancers (Basel) Date: 2021-11-30 Impact factor: 6.639
Authors: Fourat Ridouani; R Michael Tuttle; Mario Ghosn; Duan Li; Richard J Wong; James A Fagin; Sebastien Monette; Stephen B Solomon; Juan C Camacho Journal: Cardiovasc Intervent Radiol Date: 2021-07-12 Impact factor: 2.797