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The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data

Induced radiofrequency thermal ablation is the cytoreductive treatment of symptomatic benign thyroid nodules, metastatic and recurrent thyroid tumors and papillary thyroid microcarcinomas. It is a safe and effective alternative to surgery and it allows to obtain satisfactory results in terms of volu...

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Autores principales: Offi, Chiara, Garberoglio, Sara, Antonelli, Giovanni, Esposito, Maria Grazia, Brancaccio, Umberto, Misso, Claudia, D’Ambrosio, Edoardo, Pace, Daniela, Spiezia, Stefano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7906008/
https://www.ncbi.nlm.nih.gov/pubmed/33643218
http://dx.doi.org/10.3389/fendo.2020.565000
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author Offi, Chiara
Garberoglio, Sara
Antonelli, Giovanni
Esposito, Maria Grazia
Brancaccio, Umberto
Misso, Claudia
D’Ambrosio, Edoardo
Pace, Daniela
Spiezia, Stefano
author_facet Offi, Chiara
Garberoglio, Sara
Antonelli, Giovanni
Esposito, Maria Grazia
Brancaccio, Umberto
Misso, Claudia
D’Ambrosio, Edoardo
Pace, Daniela
Spiezia, Stefano
author_sort Offi, Chiara
collection PubMed
description Induced radiofrequency thermal ablation is the cytoreductive treatment of symptomatic benign thyroid nodules, metastatic and recurrent thyroid tumors and papillary thyroid microcarcinomas. It is a safe and effective alternative to surgery and it allows to obtain satisfactory results in terms of volumetric reduction of the nodule with significant improvement in the quality of life. The trans-isthmic approach and the moving shot technique are the two basic techniques; however, an advanced technique, artery-first feeding radiofrequency ablation, has been developed and validated. We have prospectively included 29 consecutive patients who have undergone radiofrequency ablation (Group A) or artery- first vRFA (Group B). All included patients had a diagnosis of benign nodular goiter and they underwent a single session of radiofrequency ablation. All patients followed a follow-up program at 1 month, 3 months, and 6 months. Continuous variables (age, TSH value, basal volume of nodule, used Joule, time in second of the procedure, nodules’ volume at 1-, 3-, and 6- months of follow-up and percentage of volume reduction at 1-, 3-, and 6- months of follow-up) were described as mean, standard deviation and range, while categorical variables (gender, nodule structure and nodule vascularization) were described as number of cases and percentage. Independent samples t-test were performed to compare the continuous variables. A Test of Proportions was applied to the categorical variables. The Fisher’s exact test was used to analyze the gender. Statistical significance was considered in case of p-value <0.05. Solid structure and spongiform structure showed statistic differences with p-values of 0.022 and 0.023 respectively between two groups. The percentage of reduction at 1 month did not show a significant difference between two groups; instead, the percentage of volume reduction was decreased mostly in the Group B at 3 months and 6 months of follow-up with a p-value of 0.003 and 0.013, respectively. The Joules/energy used showed a statistically significant difference (p-value=0.05), more energy must be used in vascular radiofrequency ablation. These data allow us to hypothesize that vRFA may improve the effectiveness of the procedure, allowing for a reduction in volume more quickly. They were preliminary but promising results, clearly a larger series of cases and prolonged follow-up are needed to clarify and confirm our observations.
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spelling pubmed-79060082021-02-26 The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data Offi, Chiara Garberoglio, Sara Antonelli, Giovanni Esposito, Maria Grazia Brancaccio, Umberto Misso, Claudia D’Ambrosio, Edoardo Pace, Daniela Spiezia, Stefano Front Endocrinol (Lausanne) Endocrinology Induced radiofrequency thermal ablation is the cytoreductive treatment of symptomatic benign thyroid nodules, metastatic and recurrent thyroid tumors and papillary thyroid microcarcinomas. It is a safe and effective alternative to surgery and it allows to obtain satisfactory results in terms of volumetric reduction of the nodule with significant improvement in the quality of life. The trans-isthmic approach and the moving shot technique are the two basic techniques; however, an advanced technique, artery-first feeding radiofrequency ablation, has been developed and validated. We have prospectively included 29 consecutive patients who have undergone radiofrequency ablation (Group A) or artery- first vRFA (Group B). All included patients had a diagnosis of benign nodular goiter and they underwent a single session of radiofrequency ablation. All patients followed a follow-up program at 1 month, 3 months, and 6 months. Continuous variables (age, TSH value, basal volume of nodule, used Joule, time in second of the procedure, nodules’ volume at 1-, 3-, and 6- months of follow-up and percentage of volume reduction at 1-, 3-, and 6- months of follow-up) were described as mean, standard deviation and range, while categorical variables (gender, nodule structure and nodule vascularization) were described as number of cases and percentage. Independent samples t-test were performed to compare the continuous variables. A Test of Proportions was applied to the categorical variables. The Fisher’s exact test was used to analyze the gender. Statistical significance was considered in case of p-value <0.05. Solid structure and spongiform structure showed statistic differences with p-values of 0.022 and 0.023 respectively between two groups. The percentage of reduction at 1 month did not show a significant difference between two groups; instead, the percentage of volume reduction was decreased mostly in the Group B at 3 months and 6 months of follow-up with a p-value of 0.003 and 0.013, respectively. The Joules/energy used showed a statistically significant difference (p-value=0.05), more energy must be used in vascular radiofrequency ablation. These data allow us to hypothesize that vRFA may improve the effectiveness of the procedure, allowing for a reduction in volume more quickly. They were preliminary but promising results, clearly a larger series of cases and prolonged follow-up are needed to clarify and confirm our observations. Frontiers Media S.A. 2021-02-11 /pmc/articles/PMC7906008/ /pubmed/33643218 http://dx.doi.org/10.3389/fendo.2020.565000 Text en Copyright © 2021 Offi, Garberoglio, Antonelli, Esposito, Brancaccio, Misso, D’Ambrosio, Pace and Spiezia http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Offi, Chiara
Garberoglio, Sara
Antonelli, Giovanni
Esposito, Maria Grazia
Brancaccio, Umberto
Misso, Claudia
D’Ambrosio, Edoardo
Pace, Daniela
Spiezia, Stefano
The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data
title The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data
title_full The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data
title_fullStr The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data
title_full_unstemmed The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data
title_short The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data
title_sort ablation of thyroid nodule’s afferent arteries before radiofrequency ablation: preliminary data
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7906008/
https://www.ncbi.nlm.nih.gov/pubmed/33643218
http://dx.doi.org/10.3389/fendo.2020.565000
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