Abstract
Objective
To evaluate the efficacy, safety, and improvement of symptoms by ultrasound-guided microwave ablation (MWA) for patients with large benign thyroid nodules (BTNs).
Methods
Eighty-seven patients with 87 BTNs (≥ 4 cm) treated with MWA between April 2015 and March 2021 were enrolled in this retrospective multicenter study, with clinical and ultrasound examinations performed at the 1st, 3rd, 6th, and 12th months. A multivariable linear mixed effects model was employed to explore the alterations in volume and volume reduction ratio (VRR), as well as the potential factors associated with VRR.
Results
The mean age of the 87 patients was 45.69 ± 14.21 years (range 18–76 years), and the ratio of men to women was 1:4.8. The mean volumes were much decreased at the 12th month after ablation compared to the initial volumes (p < .001). The mean VRR was 76.09% at the 12th month. The technique efficacy (VRR > 50%) was 90.80% at the 12th month. A multivariate analysis revealed that VRR was related to the initial volume (p = .015), annular flow (p = .010), and nodule composition (p = .024). The mean symptomatic score decreased from 4.40 ± 0.28 to 0.26 ± 0.06 at the 12th month (p < .001). At the same time, the mean cosmetic score decreased from 3.22 ± 0.10 to 1.31 ± 0.08 (p < .001).
Conclusion
MWA could serve as a safe and effective therapy for large BTNs, significantly reducing the volume of BTNs and significantly improving compressive symptoms and appearance problems.
Clinical relevance statement
Microwave ablation could serve as a safe and effective therapy for large benign thyroid nodules, leading to significant volume reduction and satisfied symptom and cosmetic alleviation period.
Key Points
• This multicenter study investigated the feasibility and safety of microwave ablation for large benign thyroid nodules.
• After ablation, the nodule volume was significantly reduced, and patients’ symptoms and appearance problems were significantly improved.
• Microwave ablation is feasible for large benign thyroid nodules and has been a supplement treatment.
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Abbreviations
- BTN:
-
Benign thyroid nodule
- CEUS:
-
Contrast-enhanced ultrasound
- CNB:
-
Core needle biopsy
- FNA:
-
Fine-needle aspiration
- MWA:
-
Microwave ablation
- US:
-
Ultrasound
- VRR:
-
Volume reduction ratio
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Funding
This work was supported by grant 82102044 from the National Scientific Foundation Committee of China (NSFC).
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Dr. Jie Yu had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
• Study concept and design: Yuan-Cheng Cang, Jie Yu, and Lei Chen
• Acquisition of data: Yuan-Cheng Cang, Dong Xu, Ying Che, Chun-Lai Zhang, Gang Dong, Yang Liu, Fang-Ying Fan
• Analysis and interpretation of data: Yuan-Cheng Cang, Jie Yu
• Drafting of the manuscript: Yuan-Cheng Cang and Jie Yu
• Critical revision of the manuscript for important intellectual content: Yuan-Cheng Cang, Jie Yu, Zhi-Gang Cheng, Fang-Yi Liu, Xiao-Ling Yu, Zhi-Yu Han, and Ping Liang
The data involved in this article was not shared. Data generated or analyzed during the study are available from the corresponding author by request.
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Dr. Jie Yu had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Informed consent
Written informed consent was obtained from all patients in this study.
Ethical approval
The study was approved by five hospitals’ ethics committees, including Chinese PLA General Hospital, Cancer Hospital of the University of Chinese Academy of Sciences, the First Affiliated Hospital of Dalian Medical University; Lishui people’s Hospital, and the First Affiliated Hospital of Zhengzhou University, and written informed consent was obtained from each patient before treatment.
Study subjects or cohorts overlap
No study subjects or cohorts have been previously reported.
Methodology
• retrospective
• diagnostic or prognostic study
• multicenter study
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Jie Yu and Lei Chen are co-corresponding authors of the article.
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Cang, YC., Fan, FY., Liu, Y. et al. Efficacy of microwave ablation in the treatment of large benign thyroid nodules: a multi-center study. Eur Radiol (2024). https://doi.org/10.1007/s00330-024-10614-w
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DOI: https://doi.org/10.1007/s00330-024-10614-w