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Thyroid tissue: US-guided percutaneous laser thermal ablation.
Claudio Maurizio Pacella1, Giancarlo Bizzarri, Stefano Spiezia
1Departments of Radiology and Diagnostic Imaging, Ospedale Regina Apostolorum, Via San Francesco 50, 00041 Albano Laziale, Rome, Italy. cmpacel@katamail.com
Radiology
|May 25, 2004
Summary
Percutaneous laser thermal ablation (LTA) effectively debulked thyroid lesions in patients unsuitable for surgery. This minimally invasive technique showed significant nodule volume reduction and symptom improvement.
Area of Science:
- Endocrinology
- Minimally Invasive Surgery
- Oncology
Background:
- Thyroid nodules are common, and treatment options for patients at high surgical risk are limited.
- Percutaneous laser thermal ablation (LTA) offers a minimally invasive approach to thyroid lesion management.
Purpose of the Study:
- To evaluate the in vivo safety and effectiveness of percutaneous laser thermal ablation (LTA) for debulking thyroid lesions.
- To assess the impact of LTA on compression symptoms and hormonal function in patients with thyroid nodules.
Main Methods:
- Twenty-five adult patients with thyroid nodules (cold, autonomously hyperfunctioning, or anaplastic carcinoma) underwent LTA under ultrasonographic guidance.
- Nd:YAG laser energy was delivered via optical fibers inserted through spinal needles.
- Safety, complications, clinical outcomes, hormonal changes, and nodule volume reduction were assessed during follow-up.
Main Results:
- LTA was safely performed in 76 sessions with minimal side effects like transient dysphonia.
- Significant improvement in local compression symptoms was observed in 86% of patients.
- Mean nodule volume reduction at 6 months was 63% for both hyperfunctioning and cold nodules, with a strong correlation between energy delivered and volume reduction (r² =.75, P <.001).
Conclusions:
- Percutaneous laser thermal ablation (LTA) is a safe and effective therapeutic option for selected thyroid lesions, particularly in patients with poor surgical risk.
- LTA demonstrates significant efficacy in reducing thyroid nodule volume and alleviating compression symptoms.