Medium-Term Study Results of Ultrasound-Guided Radiofrequency Ablation for Thyroid Follicular Neoplasm With Low SUV...

This study aimed to evaluate the medium-term outcomes of radiofrequency ablation (RFA) for thyroid nodules with cytology of follicular neoplasm and low standard uptake value (SUV) in a positron emission tomography (PET/CT) study.

Between January 2018 and January 2021, 40 patients diagnosed with follicular neoplasm underwent ultrasound, fine needle aspiration (FNA), or core needle biopsy (CNB) before RFA. PET/CT scans were performed in 34 patients before treatment. RFA, conducted under local anesthesia with an 18-gauge internally cooled electrode and RF generator, was followed by evaluations of nodule volume modifications via ultrasonography, changes in symptomatic and cosmetic scores, and assessment of complications during and after the procedure. Six to twelve months post-RFA, 33 patients received FNA for reassessment.

Significant volume reductions were observed during follow-up, comparing values before RFA and at 6 months post-RFA (7.31 ± 12.83 cm³, p < 0.001). The mean volume reduction ratios at 6 months and final follow-up were 71.5% and 81.45%, respectively. The mean follow-up time was 2.38 ± 0.9 years. Complications included vocal cord palsy and ptosis in one patient each, both recovering after RFA. No post-RFA hypothyroidism was reported. Positive correlation was found between pre-RFA thyroglobulin levels and PET/CT SUVmax values (p = 0.001).

RFA is a safe and effective treatment for patients with low-risk follicular neoplasm (SUVmax value < 5) in medium-term follow-up. For patients who are either ineligible for or prefer to avoid surgery, RFA presents a feasible alternative treatment option.