Korean J Radiol.  2015 Dec;16(6):1332-1340. 10.3348/kjr.2015.16.6.1332.

Radiofrequency versus Ethanol Ablation for Treating Predominantly Cystic Thyroid Nodules: A Randomized Clinical Trial

• Baek JH
• Ha EJ
• Choi YJ
• Sung JY
• Kim JK
• Shong YK

• KMID: 2344289
• DOI: http://doi.org/10.3348/kjr.2015.16.6.1332

Abstract

OBJECTIVE
To compare single-session radiofrequency ablation (RFA) and ethanol ablation (EA) for treating predominantly cystic thyroid nodules (PCTNs).
MATERIALS AND METHODS
This single-blind, randomized trial was approved by the Institutional Review Board of two centers and informed consent was obtained from all patients before enrollment. Fifty patients with a single PCTN (cystic portion less than 90% and greater than 50%) were randomly assigned to be treated by either RFA (25 patients) or EA (25 patients) at two hospitals. The primary outcome was the tumor volume reduction ratio (%) at the six-month follow-up and the superiority margin was set at 13% (RFA minus EA). Analysis was performed primarily in an intention-to-treat manner. The secondary outcomes were the therapeutic success rate, improvement of symptomatic and cosmetic problems, and the number of major complications.
RESULTS
The mean volume reduction was 87.5 ± 11.5% for RFA (n = 22) and 82.4 ± 28.6% for EA (n = 24) (p = 0.710; mean difference [95% confidence interval], 5.1% [-8.0 to 18.2]), indicating no significant difference. Regarding the secondary outcomes, therapeutic success (p = 0.490), mean symptom (p = 0.205) and cosmetic scores (p = 0.710) showed no difference. There were no major complications in either group (p > 0.99).
CONCLUSION
The therapeutic efficacy of RFA is not superior to that of EA; therefore, EA might be preferable as the first-line treatment for PCTNs.

Keyword

Ultrasound; Radiofrequency; Ethanol; Predominantly cystic thyroid nodule; Thyroid

MeSH Terms

Adult
Aged
Catheter Ablation
Ethanol/*therapeutic use
Female
Humans
Male
Middle Aged
Single-Blind Method
Thyroid Nodule/*drug therapy/*surgery/ultrasonography
Treatment Outcome
Tumor Burden
Ethanol

Figure

• 

  Fig. 1 Flowchart of patient enrollment process.

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