Korean J Med.  2013 Dec;85(6):592-597.

The Effect of Ethanol Ablation for the Treatment of Benign Cystic Thyroid Nodules

• Kim SJ
• Kim HK
• Kim HS
• Lee KJ
• Hong HJ
• Han MG
• Yoon JH
• Kang HC

Abstract

BACKGROUND/AIMS
The aims of this study were to evaluate the efficacy and safety of ultrasound-guided percutaneous ethanol ablation for benign cystic thyroid nodules, and to identify the clinical factors associated with therapeutic outcome.
METHODS
We examined 46 patients with benign cystic nodules. After removal of cystic fluid, 99% ethanol was injected under ultrasound guidance. Follow-up ultrasonography was then performed 2 weeks and 6-36 months after the therapy to evaluate the early and late response, respectively. An effective response (ER) was defined as volume reduction > 50% or the absence of any residual cystic lesion; partial response (PR) as a 25-50% volume reduction; and no response (NR) as volume reduction < 25% or a volume expansion.
RESULTS
During the early response, ER, PR, and NR were 67.4, 30.4, and 2.2%, respectively. The initial mean cyst volume of 12.0 +/- 7.8 mL (3.4-41.3) was reduced significantly after ethanol ablation therapy to 5.4 +/- 3.2 mL (0-33.0; 55% volume reduction, p < 0.001), and to a final late response volume of 4.4 +/- 3.4 mL (0-23.3; 63% volume reduction, p < 0.01). Except for 6 patients who received additional ethanol injection therapies, ER was obtained in 31 of 40 (77.5%) patients in the late response. A large initial volume was the factor associated with therapeutic failure (p = 0.04). Eleven patients (23%) reported transient mild local pain.
CONCLUSIONS
Ultrasound-guided ethanol ablation is a safe and highly effective therapeutic method for cystic thyroid nodules. However, more sophisticated approaches are needed for large cystic nodules.

Keyword

Thyroid; Nodule; Ethanol; Ablation

MeSH Terms

Ethanol*
Follow-Up Studies
Humans
Methods
Thyroid Gland*
Thyroid Nodule*
Ultrasonography
Ethanol