Comparative Efficacy and Safety of Radiofrequency Ablation and Microwave Ablation in the Treatment of Benign Thyroid Nodules: A Systematic Review and Meta-Analysis.

IF 4.4 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Korean Journal of Radiology Pub Date : 2024-03-01 DOI:10.3348/kjr.2023.1004

Hendra Zufry, Timotius Ivan Hariyanto

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Abstract

Objective: The current body of evidence lacks clarity regarding the comparative efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) as minimally invasive treatments for benign thyroid nodules. The primary objective of this study is to clarify these concerns.

Materials and methods: A comprehensive search was conducted using the Cochrane Library, Scopus, Europe PMC, and Medline databases until October 10th, 2023, using a combination of relevant keywords. This study incorporated literature that compared RFA and MWA for benign thyroid nodules. The primary outcome was the volume reduction ratio (VRR) from baseline to follow-up. Secondary outcomes were symptom score, cosmetic score, ablation time, major complications rate, hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury. We used Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tool to assess the risk of bias in the included studies. We employed random effects models to analyze the standardized mean difference (SMD) and odds ratio for the presentation of outcomes.

Results: Nine studies with 2707 nodules were included. The results of our meta-analysis indicated similar efficacy between RFA and MWA in terms of VRR during the 1 (SMD 0.06; 95% confidence interval [CI]: -0.13 to 0.26; P = 0.52) and 3 (SMD 0.11; 95% CI: -0.03 to 0.25; P = 0.12) months of follow-up. VRR was significantly higher in RFA than in MWA at the 6 (SMD 0.25; 95% CI: 0.06-0.43; P = 0.008) and 12 month of follow-up (SMD 0.38; 95% CI: 0.17 to 0.59; P < 0.001). There were no significant differences between RFA and MWA in symptom scores, cosmetic scores, or the incidence of complications, including hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury.

Conclusion: RFA showed a higher VRR than MWA at 6 and 12-month follow-ups, with a comparable safety profile.

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射频消融和微波消融治疗良性甲状腺结节的疗效和安全性比较：系统回顾与元分析》。

目的：射频消融（RFA）和微波消融（MWA）作为甲状腺良性结节的微创治疗方法，其疗效和安全性的比较目前尚缺乏明确的证据。本研究的主要目的是澄清这些问题：在 2023 年 10 月 10 日之前，我们使用 Cochrane Library、Scopus、Europe PMC 和 Medline 数据库，结合相关关键词进行了全面检索。本研究纳入了比较 RFA 和 MWA 治疗良性甲状腺结节的文献。主要结果是从基线到随访的体积缩小率（VRR）。次要结果包括症状评分、外观评分、消融时间、主要并发症发生率、出血、声音嘶哑、皮肤灼伤、咳嗽和交感神经损伤。我们使用非随机干预研究中的偏倚风险（ROBINS-I）工具来评估纳入研究的偏倚风险。我们采用随机效应模型分析了结果显示的标准化平均差（SMD）和几率比：结果：共纳入九项研究，2707 个结节。我们的荟萃分析结果表明，就随访 1 个月（SMD 0.06；95% 置信区间 [CI]：-0.13 至 0.26；P = 0.52）和 3 个月（SMD 0.11；95% 置信区间 [CI]：-0.03 至 0.25；P = 0.12）的 VRR 而言，RFA 和 MWA 的疗效相似。随访 6 个月（SMD 0.25；95% CI：0.06-0.43；P = 0.008）和 12 个月（SMD 0.38；95% CI：0.17-0.59；P < 0.001）时，RFA 的 VRR 明显高于 MWA。RFA和MWA在症状评分、外观评分以及出血、声音嘶哑、皮肤灼伤、咳嗽和交感神经损伤等并发症的发生率方面没有明显差异：结论：在6个月和12个月的随访中，RFA的VRR高于MWA，安全性相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Korean Journal of Radiology 医学-核医学

CiteScore

10.60

自引率

12.50%

发文量

141

审稿时长

1.3 months

期刊介绍： The inaugural issue of the Korean J Radiol came out in March 2000. Our journal aims to produce and propagate knowledge on radiologic imaging and related sciences. A unique feature of the articles published in the Journal will be their reflection of global trends in radiology combined with an East-Asian perspective. Geographic differences in disease prevalence will be reflected in the contents of papers, and this will serve to enrich our body of knowledge. World''s outstanding radiologists from many countries are serving as editorial board of our journal.