J Korean Thyroid Assoc.  2014 Nov;7(2):111-117. 10.11106/cet.2014.7.2.111.

Non-surgical, Image-guided Management of Benign Thyroid Nodules

• Shin JH

• KMID: 2095121
• DOI: http://doi.org/10.11106/cet.2014.7.2.111

Abstract

Most thyroid nodules are cytologically benign and can be managed nonsurgically. Asymptomatic benign nodules require follow-up without treatment. Cosmetic problems and/or compression-related symptoms may be indications for treatment. Until now in clinical practices, nonsurgical image-guided therapy includes percutaneous ethanol injection, radiofrequency ablation, laser ablation, and high intensity focused ultrasound. Percutaneous ethanol injection should be used as the first-line therapy for recurrent symptomatic cystic nodules. Radiofrequency ablation is an effective procedure for obtaining shrinkage and improving symptoms of solid thyroid nodules. Better understanding of image-guided therapy makes physicians personalize the management of benign thyroid nodules according to a cost-benefit analysis.

Keyword

Thyroid nodule; Ultrasonography; Radiofrequency ablation

MeSH Terms

Catheter Ablation
Cost-Benefit Analysis
Ethanol
Follow-Up Studies
Humans
Laser Therapy
Thyroid Nodule*
Ultrasonography
Ethanol

Figure

• 

  Fig. 1. A 38-year-old female patient with visible protruded thyroid mass underwent ethanol injection. A 3.9 cm sized cystic nodule (20.1 mL in volume) is seen in the right thyroid gland (A; transverse image, B; longitudinal image). This cystic nodule (arrows) was markedly decreased to 1.6 cm (0.47 mL in volume) 8 months after ethanol ablation (C; transverse image, D; longitudinal image). Volume reduction rate was 97.7%. Her symptom and cosmetic problem were improved.

• 

  Fig. 2. A 3.9 cm sized solid thyroid nodule (9.0 mL in volume) is noted in the left thyroid gland (A; transverse image, B; longitudina image). Echogenic bubbles (arrows) occur from the tip of the electrode during active radiofrequency ablation (C). Hypoechoic change with echogenic portion of entire nodule indicates acceptable ablation (D). At 3 years after ablation, volume reduction rate of nodule (arrows) was 95.6% (E; transverse image, F; longitudinal image).

Reference

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