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Radiofrequency ablation for symptomatic, non-functioning, thyroid nodules: a single-center learning curve
W J Bom1, F B M Joosten2, M M G J van Borren3
1Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands.
Endocrine Connections
|December 10, 2021
Summary
Radiofrequency ablation (RFA) for benign thyroid nodules requires approximately 40 procedures to achieve optimal volume reduction. Careful follow-up is crucial to monitor efficacy and rule out malignancy.
Area of Science:
- Endocrinology
- Interventional Radiology
Background:
- Radiofrequency ablation (RFA) is a leading treatment for symptomatic benign non-functioning thyroid nodules (NFTN).
- Operator experience significantly impacts RFA outcomes, but the learning curve is not well-defined.
Purpose of the Study:
- To describe the learning curve for radiofrequency ablation (RFA) in treating non-functioning thyroid nodules (NFTN).
- To determine the number of procedures needed to achieve optimal treatment efficacy.
Main Methods:
- Retrospective cohort study of 103 patients with single, symptomatic, benign NFTN treated with RFA.
- Primary outcome: 6-month nodal volume reduction ratio (VRR) >50% after single RFA session.
- Follow-up duration of at least 1 year.
Main Results:
- Technique efficacy (6-month VRR >50%) improved with experience: 45% (first 20 patients), 75% (next 20), 79% (last 63).
- Approximately 40 procedures were needed to achieve >50% VRR in most patients.
- Complications were minor; 13 patients required secondary interventions (lobectomy or repeat RFA).
- Two cases of follicular carcinoma and one B-cell lymphoma were diagnosed post-RFA.
Conclusions:
- Radiofrequency ablation (RFA) efficacy for benign thyroid nodules improves with operator experience, reaching optimal levels around 40 cases.
- Regular follow-up is essential for patients with suboptimal volume reduction or nodule regrowth to detect potential malignancies.
