Efficacy of Percutaneous Ultrasound-Guided Ethanol Ablation as a Treatment Method of Cystic Thyroid Nodules
Author: 1
Abstracts:
Ultrasound-guided percutaneous ethanol ablation (PEA) is an alternative non-surgical method for the treatment of cystic thyroid nodules.
The aim of the present study was to evaluate the therapeutic effectiveness of PEA by monitoring the reduction in volume of the treated nodules within 12 months after the procedure.
Materials and methods: One hundred and twenty-six subjects (97 females, 29 males; mean age 46,2±15 years) with predominantly cystic thyroid nodules were enrolled in this three-year prospective study. All patients un derwent an ultrasound examination with evaluation of the baseline nodule size and volume, followed by a fine-nee dle aspiration biopsy (FNAB) with cytology to exclude malignancy. Ultrasound-guided aspiration of the cystic fluid was performed and 95% ethanol was applied into the cavity to a volume of 47% (33-54) of the aspirated fluid. The effect was evaluated at three (M3), six (M6), and twelve (M12) months after the PEA when the changes in the volume and the presence of residual cystic component were assessed.
Results: Compared to the baseline, the mean volume of the nodules decreased significantly at M3 (81,1%) and M6 (89%). The volume reduction between M3 and M6 was also significant (p<0,001). In 11 patients (11,6%), a second PEA was done at M3 due to suboptimal effect (volume reduction less than 50% of the initial volume). The reduction in volume was maintained at M12 in all patients who were followed-up. The procedure was well tolerated with transient pain at the injection site, reported by some of the patients.
Conclusion: PEA is a highly effective and safe method and should be considered as a first-line treatment for patients with cystic thyroid nodules.
