Araştırma Makalesi
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Comparison of Volumetric and Cosmetic Scoring Changes After Treatment of Benign Thyroid Nodules Using Microwave Ablation and Ethanol Ablation Therapy

Yıl 2021, , 87 - 92, 23.04.2021
https://doi.org/10.30565/medalanya.874438

Öz

Aim: This study retrospectively evaluated the effects of treatment of benign mixed-type and spongy-type thyroid nodules with microwave ablation (MWA) and ethanol ablation (EA) therapies. The changes in volume obtained by ultrasonography and cosmetic scores were examined. The efficiency of both treatment methods was also compared by statistical analyses.

Methods: Between July 2015 and July 2020, archive scanning was performed for patients who underwent MWA and EA in the radiology clinic. As a result, 57 MWA and 55 EA patients were included in the study. Nodule volumes from before the treatment, 3 months, and 6 months after ablation treatment were noted for each case. Cosmetic scores for all patients were also examined.

Results: A statistically significant difference was found in the mean nodule volume at 6 months between MWA and EA, with MWA being more successful (p<0.05). The MWA technique also resulted in significantly higher mean cosmetic score reduction (p<0.05).

Conclusion: Minimally invasive approaches are increasingly adopted in the treat¬ment of benign thyroid nodules, and both MWA and EA are effective and safe treat¬ments techniques. The results show that MWA treatment leads to better cosmetic scores and nodule volume changes in patients with benign mixed-type and spongy-type thyroid nodules.

Kaynakça

  • 1. Popoveniuc G, Jonklaas J. Thyroid nodules. Med Clin North Am. 2012; 96(2): 329-349. doi: 10.1016/j.mcna.2012.02.002
  • 2. Pemayun TG. Current Diagnosis and Management of Thyroid Nodules. Acta Med Indones. 2016; 48(3): 247-257. PMID:27840362.
  • 3. Wong R, Farrell SG, Grossmann M. Thyroid nodules: diagnosis and management. Med J Aust. 2018; 209(2): 92-98. doi:10.5694/mja17.01204
  • 4. Singaporewalla RM, Hwee J, Lang TU, Desai V. Clinico-pathological Correlation of Thyroid Nodule Ultrasound and Cytology Using the TIRADS and Bethesda Classifications. World J Surg. 2017; 41(7): 1807-1811. doi:10.1007/s00268-017-3919-5
  • 5. Durante C, Grani G, Lamartina L, Filetti S, Mandel SJ, Cooper DS. The Diagnosis and Management of Thyroid Nodules: A Review [published correction appears in JAMA. 2018 Apr 17; 319(15): 1622]. JAMA. 2018; 319(9): 914-924. doi:10.1001/jama.2018.0898
  • 6. Del Prete S, Caraglia M, Russo D, Vitale G, Giuberti G, Marra M, et al. Percutaneous ethanol injection efficacy in the treatment of large symptomatic thyroid cystic nodules: ten-year follow-up of a large series. Thyroid. 2002; 12(9): 815-821. doi:10.1089/105072502760339398
  • 7. Bennedbaek FN, Hegedüs L. Treatment of recurrent thyroid cysts with ethanol: a randomized double-blind controlled trial. J Clin Endocrinol Metab. 2003; 88(12): 5773-5777. doi:10.1210/jc.2003-031000
  • 8. Cho YS, Lee HK, Ahn IM, Lim SM, Kim DH, Choi CG, et al. Sonographically guided ethanol sclerotherapy for benign thyroid cysts: results in 22 patients. AJR Am J Roentgenol. 2000; 174(1): 213-216. doi:10.2214/ajr.174.1.1740213
  • 9. Zingrillo M, Torlontano M, Ghiggi MR, D'Aloiso L, Nirchio V, Bisceglia M, et al. Percutaneous ethanol injection of large thyroid cystic nodules. Thyroid. 1996; 6(5): 403-408. doi:10.1089/thy.1996.6.403
  • 10. Kim JH, Lee HK, Lee JH, Ahn IM, Choi CG. Efficacy of sonographically guided percutaneous ethanol injection for treatment of thyroid cysts versus solid thyroid nodules. AJR Am J Roentgenol. 2003; 180(6): 1723-1726. doi:10.2214/ajr.180.6.1801723
  • 11. Zingrillo M, Torlontano M, Chiarella R, Ghiggi MR, Nirchio V, Bisceglia M, et al. Percutaneous ethanol injection may be a definitive treatment for symptomatic thyroid cystic nodules not treatable by surgery: five-year follow-up study. Thyroid. 1999; 9(8): 763-767. doi:10.1089/thy.1999.9.763
  • 12. Korkusuz H, Nimsdorf F, Happel C, Ackermann H, Grünwald F. Percutaneous microwave ablation of benign thyroid nodules. Functional imaging in comparison to nodular volume reduction at a 3-month follow-up. Nuklearmedizin. 2015; 54(1): 13-19. doi:10.3413/Nukmed-0678-14-06
  • 13. Korkusuz H, Happel C, Heck K, Ackermann H, Grünwald F. Percutaneous thermal microwave ablation of thyroid nodules. Preparation, feasibility, efficiency. Nuklearmedizin. 2014; 53(4): 123-130. doi:10.3413/Nukmed-0631-13-10
  • 14. Feng B, Liang P, Cheng Z, Yu X, Yu J, Han Z, et al. Ultrasound-guided percutaneous microwave ablation of benign thyroid nodules: experimental and clinical studies. Eur J Endocrinol. 2012; 166(6): 1031-1037. doi:10.1530/EJE-11-0966
  • 15. Monzani F, Lippi F, Goletti O, Del Guerra P, Caraccio N, Lippolis PV, et al. Percutaneous aspiration and ethanol sclerotherapy for thyroid cysts. J Clin Endocrinol Metab. 1994; 78(3): 800-802. doi:10.1210/jcem.78.3.8126160
  • 16. Filetti S, Durante C, Torlontano M. Nonsurgical approaches to the management of thyroid nodules. Nat Clin Pract Endocrinol Metab. 2006; 2(7): 384-394. doi:10.1038/ncpendmet0215
  • 17. Jayesh SR, Mehta P, Cherian MP, Ilayaraja V, Gupta P, Venkatesh K. Efficacy and safety of USG-guided ethanol sclerotherapy in cystic thyroid nodules. Indian J Radiol Imaging. 2009; 19(3): 199-202. doi:10.4103/0971-3026.54879
  • 18. Nishad RK, Jain AK, Kumar A, Kumar R, Singh M. Efficacy and Safety of USG-guided 95% Ethanol Sclerotherapy in Solitary Benign Thyroid Cysts. Int J Phonosurg Laryngol. 2020; 10(1): 9-12. doi:10.5005/jp-journals-10023-1181
  • 19. Yue W, Wang S, Wang B, Xu Q, Yu S, Yonglin Z, et al. Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: safety and imaging follow-up in 222 patients. Eur J Radiol. 2013; 82(1): e11-e16. doi:10.1016/j.ejrad.2012.07.020
  • 20. Iñiguez-Ariza NM, Lee RA, Singh-Ospina NM, Stan MN, Castro MR. Ethanol Ablation for the Treatment of Cystic and Predominantly Cystic Thyroid Nodules. Mayo Clin Proc. 2018; 93(8): 1009-1017. doi:10.1016/j.mayocp.2018.05.020
  • 21. Sung JY, Baek JH, Kim YS, Jeong HJ, Kwak MS, Lee D, et al. One-step ethanol ablation of viscous cystic thyroid nodules. AJR Am J Roentgenol. 2008; 191(6): 1730-1733. doi:10.2214/AJR.08.1113

Mikrodalga Ablasyon ve Etanol Ablasyon Tedavisi Uygulanan Benign Tiroid Nodüllerinin Tedaviden Sonra Hacimsel ve Kozmetik Skorlama Değişikliklerinin Karşılaştırması

Yıl 2021, , 87 - 92, 23.04.2021
https://doi.org/10.30565/medalanya.874438

Öz

Amaç: Bu çalışma geriye dönük olarak benign mikst-tip ve süngerimsi-tip tiroid nodüllerinin mikrodalga ablasyon (MWA) ve etanol ablasyon (EA) terapileri ve tedavi etkinliğini değerlendirmiştir. Ultrasonografi ve kozmetik skorlarla elde edilen hacim değişiklikleri incelendi. Her iki tedavi yönteminin etkinliği de istatistiksel analizlerle karşılaştırıldı.

Yöntem: Temmuz 2015 ile Temmuz 2020 tarihleri arasında radyoloji kliniğinde MWA ve EA yapılan hastalara arşiv taraması yapıldı. Sonuç olarak 57 MWA ve 55 EA hastası çalışmaya dahil edildi. Her vaka için tedavi öncesi, ablasyon tedavisinden 3 ay ve 6 ay sonraki nodül hacimleri not edildi. Tüm hastalar için kozmetik skorlar da incelendi.

Bulgular: MWA ile EA arasında 6. ayda ortalama nodül hacminde istatistiksel olarak anlamlı bir fark bulunmuş olup, MWA daha başarılıydı (p<0.05). Ayrıca MWA tekniği, anlamlı olarak daha yüksek ortalama kozmetik skor azalmasıyla sonuçlanmıştır (p<0.05).

Sonuç: Minimal invaziv yaklaşımlar, benign tiroid nodüllerinin tedavisinde gider-ek daha fazla benimsenmektedir ve hem MWA hem de EA etkili ve güvenli teda-vi teknikleridir. Sonuçlar, MWA tedavisinin benign mikst-tip ve süngerimsi-tip tiroid nodülleri olan hastalarda daha iyi kozmetik skorlara ve nodül hacim değişikliğine yol açtığını göstermektedir.

Kaynakça

  • 1. Popoveniuc G, Jonklaas J. Thyroid nodules. Med Clin North Am. 2012; 96(2): 329-349. doi: 10.1016/j.mcna.2012.02.002
  • 2. Pemayun TG. Current Diagnosis and Management of Thyroid Nodules. Acta Med Indones. 2016; 48(3): 247-257. PMID:27840362.
  • 3. Wong R, Farrell SG, Grossmann M. Thyroid nodules: diagnosis and management. Med J Aust. 2018; 209(2): 92-98. doi:10.5694/mja17.01204
  • 4. Singaporewalla RM, Hwee J, Lang TU, Desai V. Clinico-pathological Correlation of Thyroid Nodule Ultrasound and Cytology Using the TIRADS and Bethesda Classifications. World J Surg. 2017; 41(7): 1807-1811. doi:10.1007/s00268-017-3919-5
  • 5. Durante C, Grani G, Lamartina L, Filetti S, Mandel SJ, Cooper DS. The Diagnosis and Management of Thyroid Nodules: A Review [published correction appears in JAMA. 2018 Apr 17; 319(15): 1622]. JAMA. 2018; 319(9): 914-924. doi:10.1001/jama.2018.0898
  • 6. Del Prete S, Caraglia M, Russo D, Vitale G, Giuberti G, Marra M, et al. Percutaneous ethanol injection efficacy in the treatment of large symptomatic thyroid cystic nodules: ten-year follow-up of a large series. Thyroid. 2002; 12(9): 815-821. doi:10.1089/105072502760339398
  • 7. Bennedbaek FN, Hegedüs L. Treatment of recurrent thyroid cysts with ethanol: a randomized double-blind controlled trial. J Clin Endocrinol Metab. 2003; 88(12): 5773-5777. doi:10.1210/jc.2003-031000
  • 8. Cho YS, Lee HK, Ahn IM, Lim SM, Kim DH, Choi CG, et al. Sonographically guided ethanol sclerotherapy for benign thyroid cysts: results in 22 patients. AJR Am J Roentgenol. 2000; 174(1): 213-216. doi:10.2214/ajr.174.1.1740213
  • 9. Zingrillo M, Torlontano M, Ghiggi MR, D'Aloiso L, Nirchio V, Bisceglia M, et al. Percutaneous ethanol injection of large thyroid cystic nodules. Thyroid. 1996; 6(5): 403-408. doi:10.1089/thy.1996.6.403
  • 10. Kim JH, Lee HK, Lee JH, Ahn IM, Choi CG. Efficacy of sonographically guided percutaneous ethanol injection for treatment of thyroid cysts versus solid thyroid nodules. AJR Am J Roentgenol. 2003; 180(6): 1723-1726. doi:10.2214/ajr.180.6.1801723
  • 11. Zingrillo M, Torlontano M, Chiarella R, Ghiggi MR, Nirchio V, Bisceglia M, et al. Percutaneous ethanol injection may be a definitive treatment for symptomatic thyroid cystic nodules not treatable by surgery: five-year follow-up study. Thyroid. 1999; 9(8): 763-767. doi:10.1089/thy.1999.9.763
  • 12. Korkusuz H, Nimsdorf F, Happel C, Ackermann H, Grünwald F. Percutaneous microwave ablation of benign thyroid nodules. Functional imaging in comparison to nodular volume reduction at a 3-month follow-up. Nuklearmedizin. 2015; 54(1): 13-19. doi:10.3413/Nukmed-0678-14-06
  • 13. Korkusuz H, Happel C, Heck K, Ackermann H, Grünwald F. Percutaneous thermal microwave ablation of thyroid nodules. Preparation, feasibility, efficiency. Nuklearmedizin. 2014; 53(4): 123-130. doi:10.3413/Nukmed-0631-13-10
  • 14. Feng B, Liang P, Cheng Z, Yu X, Yu J, Han Z, et al. Ultrasound-guided percutaneous microwave ablation of benign thyroid nodules: experimental and clinical studies. Eur J Endocrinol. 2012; 166(6): 1031-1037. doi:10.1530/EJE-11-0966
  • 15. Monzani F, Lippi F, Goletti O, Del Guerra P, Caraccio N, Lippolis PV, et al. Percutaneous aspiration and ethanol sclerotherapy for thyroid cysts. J Clin Endocrinol Metab. 1994; 78(3): 800-802. doi:10.1210/jcem.78.3.8126160
  • 16. Filetti S, Durante C, Torlontano M. Nonsurgical approaches to the management of thyroid nodules. Nat Clin Pract Endocrinol Metab. 2006; 2(7): 384-394. doi:10.1038/ncpendmet0215
  • 17. Jayesh SR, Mehta P, Cherian MP, Ilayaraja V, Gupta P, Venkatesh K. Efficacy and safety of USG-guided ethanol sclerotherapy in cystic thyroid nodules. Indian J Radiol Imaging. 2009; 19(3): 199-202. doi:10.4103/0971-3026.54879
  • 18. Nishad RK, Jain AK, Kumar A, Kumar R, Singh M. Efficacy and Safety of USG-guided 95% Ethanol Sclerotherapy in Solitary Benign Thyroid Cysts. Int J Phonosurg Laryngol. 2020; 10(1): 9-12. doi:10.5005/jp-journals-10023-1181
  • 19. Yue W, Wang S, Wang B, Xu Q, Yu S, Yonglin Z, et al. Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: safety and imaging follow-up in 222 patients. Eur J Radiol. 2013; 82(1): e11-e16. doi:10.1016/j.ejrad.2012.07.020
  • 20. Iñiguez-Ariza NM, Lee RA, Singh-Ospina NM, Stan MN, Castro MR. Ethanol Ablation for the Treatment of Cystic and Predominantly Cystic Thyroid Nodules. Mayo Clin Proc. 2018; 93(8): 1009-1017. doi:10.1016/j.mayocp.2018.05.020
  • 21. Sung JY, Baek JH, Kim YS, Jeong HJ, Kwak MS, Lee D, et al. One-step ethanol ablation of viscous cystic thyroid nodules. AJR Am J Roentgenol. 2008; 191(6): 1730-1733. doi:10.2214/AJR.08.1113
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi
Bölüm Araştırma Makalesi
Yazarlar

Emrah Karatay 0000-0002-8667-1125

Mirkhalig Javadov 0000-0002-4288-0400

Yayımlanma Tarihi 23 Nisan 2021
Gönderilme Tarihi 4 Şubat 2021
Kabul Tarihi 5 Şubat 2021
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

Vancouver Karatay E, Javadov M. Comparison of Volumetric and Cosmetic Scoring Changes After Treatment of Benign Thyroid Nodules Using Microwave Ablation and Ethanol Ablation Therapy. Acta Med. Alanya. 2021;5(1):87-92.

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