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Patient-Reported Symptom Relief from Percutaneous Benign Thyroid Nodule Radiofrequency Ablation in Routine Clinical

Michelle Mai1,2, Vincent M Levesque3, Ellen Marqusee4

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Percutaneous ultrasound-guided radiofrequency ablation (RFA) effectively relieved symptoms in 78% of patients with benign thyroid nodules (BTN). This minimally invasive procedure offers significant symptom relief, even with larger nodules, demonstrating high clinical relevance.

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Area of Science:

  • Minimally invasive procedures
  • Endocrinology
  • Interventional Radiology

Background:

  • Benign thyroid nodules (BTN) can cause bothersome symptoms impacting quality of life.
  • Previous studies on radiofrequency ablation (RFA) for BTN focused on nodule size reduction and objective symptom scores.
  • Limited data exists on patient-reported symptom relief following RFA in routine clinical practice.

Purpose of the Study:

  • To evaluate patient-reported symptom relief after percutaneous ultrasound-guided RFA for symptomatic benign thyroid nodules.
  • To assess the effectiveness of RFA in a real-world clinical setting, focusing on patient experience.
  • To compare patient-reported outcomes with pre-ablation nodule characteristics.

Main Methods:

  • Retrospective cohort study of 49 adult patients undergoing ultrasound-guided RFA for symptomatic BTN.
  • Procedures performed using a trans-isthmus moving shot technique by a single neuroradiologist.
  • Patient-reported symptom resolution (yes/no) assessed at 6-month follow-up; nodule volume reduction calculated.

Main Results:

  • Common symptoms included cosmetic deformity (77.1%), dysphagia (58.3%), and dysphonia (30.6%).
  • Post-ablation symptom resolution was achieved in 78.0% of patients with follow-up.
  • Mean nodule volume reduction was 52.3%, associated with symptom resolution (p=0.035); one minor complication occurred.

Conclusions:

  • Percutaneous ultrasound-guided RFA provides clinically relevant, patient-reported symptom relief in approximately 80% of cases for benign thyroid nodules.
  • Effectiveness is comparable to or higher than reported in efficacy studies, despite larger initial nodule volumes in this cohort.
  • Potential underestimation of effectiveness and volume reduction may be due to patient selection and follow-up rates.