Korean J Radiol.  2018 Feb;19(1):175-184. 10.3348/kjr.2018.19.1.175.

Quality of Life in Patients Treated with Percutaneous Laser Ablation for Non-Functioning Benign Thyroid Nodules: A Prospective Single-Center Study

• Oddo S
• Felix E
• Mussap M
• Giusti M

• KMID: 2425124
• DOI: http://doi.org/10.3348/kjr.2018.19.1.175

Abstract

OBJECTIVE
While many studies have reported that laser ablation (LA) for benign non-fuctioning thyroid nodules is efficacious in reducing nodular volume and neck symptoms, none have described changes in quality of life (QoL). The purpose of this study was to report post-LA changes in QoL in our cohort of patients.
MATERIALS AND METHODS
Fourteen patients with benign thyroid nodules were involved in a prospective, single-center study and underwent a single session of LA. We evaluated the following: changes in nodule volume, thyroid function, and autoimmunity; adverse events during and after LA; changes in neck discomfort by means of a visual analogic scale (VAS) at one week and 1, 3, 6, and 12 months; and changes in QoL through the 13-scale Thyroid-specific Patient Reported Outcome (ThyPRO) questionnaire at 1, 3, 6, and 12 months. ThyPRO is a validated questionnaire for thyroid diseases, which consists of 13 scales with multiple-choice answers. They investigate several aspects of life that may be impaired by goiter-related compression symptoms, by esthetic alterations and by hypo- or hyperthyroidism.
RESULTS
Nodule volume decrease was −37 ± 23%, −55 ± 22%, −53 ± 25%, −58 ± 25% (p < 0.01 vs. baseline) at the first, third, sixth, and twelfth month, respectively. No hypothyroidism or positivization of autoimmunity was observed. There were no major complications during or after LA. After LA, VAS scores improved significantly from 1 week onwards in 100% of patients, while a significant improvement was seen in the goiter symptoms score after one month, and in the general score and mean values of ThyPRO after six months. Scores on the other ThyPRO scales did not change significantly.
CONCLUSION
Laser ablation is safe and effective in reducing nodule volume and neck symptoms; this is confirmed by improvements in the goiter scale, general score, and mean values of ThyPRO and in the VAS score.

Keyword

Laser ablation; Quality of life; Benign thyroid nodule; Thyroid; Laser; Thyroid nodule

MeSH Terms

Autoimmunity
Cohort Studies
Goiter
Humans
Hyperthyroidism
Hypothyroidism
Laser Therapy*
Neck
Prospective Studies*
Quality of Life*
Thyroid Diseases
Thyroid Gland*
Thyroid Nodule*
Weights and Measures

Figure

• 

  Fig. 1 Mean changes (columns) with SD (error bars) in nodule (full columns) and thyroid (empty columns) volume in milliliters (A) and percentage (B).Significance vs. baseline: *p < 0.05, **p < 0.01. SD = standard deviation.

• 

  Fig. 2 Changes in volume of nodule at ultrasound scan at baseline (A, B), 12 months after LA (C, D).Transverse (A, C) and longitudinal images (B, D).

• 

  Fig. 3 Significant changes in Thyroid-Specific Patient Reported Outcome scale scores, expressed in mean percentages (boxes) and SD (error bars).A. Goiter symptoms scale. B. General score scale. C. Mean values. Significance vs. baseline: *p < 0.05, **p < 0.01

• 

  Fig. 4 Significant changes in Thyroid-Specific Patient Reported Outcome scale scores, expressed in mean percentages (boxes) and SD (error bars).A. Goiter symptoms scale. B. General score scale. C. Mean values. Significance vs. baseline: *p < 0.05, **p < 0.01

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