Efficacy of microwave ablation in the treatment of large benign thyroid nodules: a multi-center study.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Radiology Pub Date : 2024-10-01 Epub Date: 2024-03-28 DOI:10.1007/s00330-024-10614-w

Yuan-Cheng Cang, Fang-Ying Fan, Yang Liu, Jian-Ming Li, Chuan Pang, Dong Xu, Ying Che, Chun-Lai Zhang, Gang Dong, Ping Liang, Jie Yu, Lei Chen

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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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微波消融治疗甲状腺大良性结节的疗效：一项多中心研究。

目的评估超声引导下微波消融术（MWA）对甲状腺良性大结节（BTN）患者的疗效、安全性和症状改善情况：这项回顾性多中心研究共纳入了2015年4月至2021年3月期间接受MWA治疗的87例BTNs（≥ 4 cm）患者，分别在第1、3、6和12个月进行了临床和超声检查。研究采用多变量线性混合效应模型来探讨体积和体积缩小比（VRR）的变化以及与VRR相关的潜在因素：87名患者的平均年龄为（45.69 ± 14.21）岁（18-76岁），男女比例为1:4.8。消融术后第 12 个月的平均体积与初始体积相比大幅减少（p < .001）。第 12 个月时的平均 VRR 为 76.09%。第 12 个月时，技术有效率（VRR > 50%）为 90.80%。多变量分析显示，VRR 与初始体积（p = .015）、环形血流（p = .010）和结节成分（p = .024）有关。第 12 个月时，平均症状评分从 4.40 ± 0.28 降至 0.26 ± 0.06（p < .001）。同时，平均外观评分从 3.22 ± 0.10 降至 1.31 ± 0.08（p < .001）：结论：微波消融可作为一种安全有效的治疗方法，用于治疗大的 BTNs，可显著减少 BTNs 的体积，明显改善压迫症状和外观问题：微波消融可作为一种安全有效的治疗方法，用于治疗甲状腺良性大结节，可使结节体积明显缩小，症状和外观问题得到满意的缓解：- 这项多中心研究探讨了微波消融治疗甲状腺良性大结节的可行性和安全性。- 消融术后，结节体积明显缩小，患者的症状和外观问题明显改善。- 微波消融治疗甲状腺良性大结节是可行的，也是一种辅助治疗方法。

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

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.