Ultrasound-guided microwave ablation combined with ethanol injection for the treatment of solitary nodular retrosternal goiter: a prospective study of 72 patients.

Abstract

OBJECTIVES:

We prospectively evaluated the efficacy and safety of microwave ablation (MWA) combined with ethanol injection (EI) in solitary nodular retrosternal goiters (RSGs).

METHODS:

From November 2018 to November 2020, 72 patients diagnosed with solitary nodular RSG were treated by ultrasound-guided MWA with EI. Patients were followed up at 1, 3, 6, and 12 months and every 6-12 months thereafter by ultrasound and contrast-enhanced ultrasound (CEUS). The nodule volume, volume reduction ratio (VRR), neck circumference, symptom score, and cosmetic grading score were recorded to evaluate the treatment efficacy.

RESULTS:

All patients successfully underwent treatment. The mean initial nodule volume was 71.25 mL ± 61.61 mL, which decreased significantly to 7.47 mL ± 9.19 mL at a mean follow-up time of 23.89 months ± 7.66 months (range 15-39 months) with a mean VRR of 90.99% ± 7.52%. The neck circumference, symptom score, and cosmetic grading score significantly decreased from 36.94 cm ± 3.04 cm to 35.06 cm ± 2.84 cm, from 3.78 ± 1.19 to 0.36 ± 0.63, and from 3.42 ± 0.76 to 1.13 ± 0.37, at the 12 months after treatment, respectively (all 7 p < 0.001). Of all the nodules, eight (11.1%) received a second ablation. No major complications occurred.

CONCLUSION:

Ultrasound-guided MWA combined with EI is an effective and safe treatment for solitary nodular RSG and may be a potential alternative to surgery in selected patients, especially for those who are ineligible or unwilling to receive surgical treatment.

KEY POINTS:

• MWA combined with EI is an effective and safe approach for the treatment of solitary nodular RSG. • This treatment should be conducted by experienced physicians. • It provides a potential alternative to surgery for solitary nodular RSG in patients who are ineligible or unwilling to receive surgical treatment.

• Authors: Yingying Li, Xinyang Li, Jing Xiao, Lin Yan, Menglu Li, Mingbo Zhang, Yukun Luo
• Journal: European radiology (Eur Radiol) Vol. 33 Issue 2 Pg. 752-762 (Feb 2023) ISSN: 1432-1084 [Electronic] Germany
• PMID: 35976394 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s), under exclusive licence to European Society of Radiology.

Chemical References

• Ethanol

Topics

• Humans
• Prospective Studies
• Microwaves (therapeutic use)
• Treatment Outcome
• Ultrasonography, Interventional
• Goiter (surgery)
• Ethanol
• Catheter Ablation (adverse effects)
• Thyroid Nodule (diagnosis)
• Retrospective Studies