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Efficacy of Radiofrequency Ablation in Autonomous Functioning Thyroid Nodules: A Comprehensive Systematic Review and
Mona Javid1, Arian Mirdamadi1, Fateme Sheida2
1Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Academic Radiology
|July 27, 2024
Summary
Radiofrequency ablation (RFA) effectively treats autonomous functioning thyroid nodules (AFTNs), significantly reducing nodule size and normalizing thyroid-stimulating hormone (TSH) levels. This minimally invasive option shows promise as an alternative to surgery for AFTN management.
Area of Science:
- Endocrinology
- Minimally Invasive Procedures
- Thyroid Disorders
Background:
- Autonomous functioning thyroid nodules (AFTNs) are a growing concern.
- Radiofrequency ablation (RFA) is an emerging minimally invasive outpatient procedure for AFTNs.
- RFA offers a less invasive alternative to traditional surgical interventions.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy of RFA for AFTNs.
- To evaluate key outcomes including volume reduction and TSH normalization.
- To assess secondary outcomes such as cosmetic and symptom scores, and complications.
Main Methods:
- Systematic search of major databases (PubMed, Scopus, Embase, Web of Science, Cochrane Library) from 1990 to January 2024.
- Inclusion of 10 studies with 254 patients, focusing on volume reduction ratio (VRR) and TSH normalization.
- Random-effects model meta-analysis used to pool data, with heterogeneity assessed by Cochrane and I² statistics.
Main Results:
- Pooled VRR increased from 46.6% at 1 month to 77.2% at 12 months post-RFA.
- Overall TSH normalization rate was 76.4%.
- Subclinical hypothyroidism occurred in 4% of cases, indicating a favorable safety profile.
Conclusions:
- RFA is a promising non-surgical treatment for AFTNs, demonstrating significant nodule size reduction and high TSH normalization rates.
- The procedure also shows potential for improving cosmetic and symptom scores.
- Further research is warranted to compare RFA with surgical options and evaluate long-term outcomes.
