Comparison of Ultrasound-Guided Percutaneous Polidocanol Injection Versus Percutaneous Ethanol Injection for Treatment of Benign Cystic Thyroid Nodules

2017 ◽  
Vol 37 (6) ◽  
pp. 1423-1429 ◽  
Author(s):  
Xiaohua Gong ◽  
Fang Wang ◽  
Haiyan Du ◽  
Xiaojun Chen ◽  
Bimin Shi
Keyword(s):  
Thyroid Nodules ◽  
Percutaneous Ethanol Injection ◽  
Ultrasound Guided ◽  
Ethanol Injection

Percutaneous ethanol injection therapy in the treatment of thyroid and parathyroid diseases

1997 ◽  
Vol 136 (3) ◽  
pp. 240-250 ◽  
Author(s):  
Finn Noe Bennedbæk ◽  
Steen Karstrup ◽  
Laszlo Hegedüs
Keyword(s):  
Standard Therapy ◽  
Thyroid Nodules ◽  
Percutaneous Ethanol Injection ◽  
Ultrasound Guided ◽  
Ethanol Injection ◽  
Experimental Procedure ◽  
Percutaneous Ethanol Injection Therapy ◽  
Ethanol Injection Therapy ◽  
Parathyroid Tumours

Abstract Relevant English language articles published from 1966 to 1995 regarding ethanol therapy in the treatment of thyroid and parathyroid diseases were identified through a MEDLINE search and manual searches of identified articles. The sclerosing properties of ethanol have been recognized for many years and have offered interventional possibilities in the management of various benign as well as malignant lesions. The mechanism of action of ethanol appears to be related to a direct coagulative necrosis and local partial or complete small vessel thrombosis. Ultrasound-guided percutaneous ethanol injection therapy (PEIT) is rapid and performed on an out-patient basis and has now gained wide acceptance due to the accumulating evidence of the efficacy and safety of this therapeutic tool. Yet, there is a lack of prospective, randomized clinical trials comparing PEIT with 131I therapy or surgery with regard to its effects, especially long-term ones and it should therefore still be considered an experimental procedure. In benign endocrine diseases, PEIT has shown promising results in the treatment of autonomous thyroid nodules, benign solitary cold solid as well as cystic thyroid nodules and parathyroid tumours. Its use in pretoxic and toxic thyroid nodules has been evaluated in several uncontrolled studies, all demonstrating a high success rate in spite of the large number of treatments needed. So far efficacy and cost-effectiveness seem inferior to 131I and surgery. Short-term results of PEIT in benign cystic thyroid nodules are convincing with a high cure rate, but no controlled studies with long-term results are available. Preliminary results suggest that PEIT could become an alternative to surgical excision or levothyroxine therapy in the symptomatic solid cold benign thyroid nodule. Ultrasound-guided PEIT of parathyroid tumours has proven to be a useful method in highly selected patients in whom surgery has been found non-attractive and medical treatment ineffective. However, no prospective randomized trials have been published comparing the results of PEIT in parathyroid tumours with conventional surgical and medical treatments. PEIT has never been tested against standard therapy, but seems inferior to 131I and surgery. Side-effects caused by ethanol injection are generally few and transient and are related to the injection into solid nodules rather than cysts. Ethanol injection into solid profund nodules may seriously jeopardize subsequent surgery because of perinodular fibrosis. As an experimental procedure, not yet evaluated sufficiently, it should be reserved for patients who cannot or will not undergo standard therapy. Caution in routine use is advisable. European Journal of Endocrinology 136 240–250

scholarly journals Possibilities of nontoxic autonomous thyroid nodules treatment by percutaneous ethanol injection

2011 ◽  
Vol 68 (9) ◽  
pp. 767-773 ◽  
Author(s):  
Zoran Andjelkovic ◽  
Snezana Kuzmic-Jankovic ◽  
Dragan Pucar ◽  
Ivan Tavcar ◽  
Tamara Dragovic
Keyword(s):  
Thyroid Nodules ◽  
Soft Tissues ◽  
Percutaneous Ethanol Injection ◽  
Thyroid Stimulating Hormone ◽  
Ultrasound Guided ◽  
Percutaneous Injection ◽  
Ethanol Injection ◽  
Nodule Size ◽  
Starting Point ◽  
Average Size

Background/Aim. According to the current principles, autonomous functional thyroid nodules are treated by surgery or by radioiodin therapy. Ultrasound guided percutaneous ethanol injection into solid tumors of the soft tissues was a starting point in attempts to treat the thyroid nodules by the same method. The aim of the study was to assess the efficiency of percutaneous injection in treating solitary, nontoxic, autonomous thyroid nodules of up to 15 mL volume. Methods. In 25 patients with solitary nontoxic autonomous thyroid nodules diagnosed by tehnetium-99m scanning as an intensive area having a complete supremacy in the paranodal tissue, an ultrasound guided percutaneous ethanol injection was applied. The procedure was carried out repeatedly once a week until the reduction in nodule size to 50% of the initial size was achieved. Results. An average size of the nodule before curing was 9.68 ? 5.01 mL. An average quantity of the injected ethanol was 9.52 ? 5.08 mL, ie 1.06 ? 0.48 mL/mg of the tissue. The regression of the nodule size in the successfully (?vol% u = - 57.09 ? 13.75%, p < 0.001) and partly successfully cured (?vol du = -48.45 ? 14.35%, p < 0.05) was statistically significant compared to the size before the treatment. After ceasing ethanol injection, 18 months later, a further size regression (?vol% = -79.20 ? 9.89%) compared to the initial one (p < 0.001) was noticed. Soon, after the procedure was finished, a statistically significant concentration increase of Thyroid Stimulating Hormone (TSH) was noticed compared to the initial values (0.18 ? 0.16 vs 0.34 ? 0.31 mU/L, p < 0.01). According to the given criteria, in two female patients satisfactory results were not achieved, but, a year later, in one of them the nodule was not seen by repeated scintigram. The number and frequency of side effects were insignificant. Conclusion. Repeated percutaneous ethanol injections into nontoxic solitary autonomous thyroid nodules result in disappearing of authonomy. The regression of the nodule size of more than 50% compared to its initial volume, as well as the increase in concentration of TSH for more than 50% are the signs of a successful treatment.

scholarly journals Ultrasound Guided Percutaneous Ethanol Ablation of Benign Thyroid Nodule: A Study From a Tertiary Hospital in Eastern India

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A873-A873
Author(s):  
Arjun Baidya ◽  
Saba Faiz ◽  
Ram Chandra Bhadra
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Response Rate ◽  
Percutaneous Ethanol Injection ◽  
Ultrasound Guided ◽  
Ethanol Ablation ◽  
Ethanol Injection ◽  
Benign Thyroid Nodule ◽  
Benign Thyroid

Abstract Introduction: Ultrasound guided percutaneous ethanol injection (PEI) of benign thyroid nodule is an easy and effective procedure particularly in cystic and predominantly cystic nodule. Aims: To evaluate efficacy and safety of PEI in managing purely cystic and mixed cystic and solid thyroid nodules. Materials and Methods: Patients of either sex presented with solitary purely cystic benign thyroid nodule, solitary benign mixed with predominantly cystic (&gt;50% of total volume) thyroid nodule, solitary benign mixed with predominantly solid (&gt;50% of total volume) thyroid nodule, solitary solid thyroid nodule were included in this study. Patients who had a nodule BETHESDA 3 and above, pregnancy, patients with critical or terminal illness, patients with other malignancies, multinodular lesions of thyroid, patients with raised T3, T4 and/ or suppressed TSH level were excluded from the study. One hundred sixty patients presenting with thyroid nodule were initially evaluated with thyroid function test and USG. Only those patients with euthyroid solitary thyroid nodules are subjected for fine needle aspiration (FNA). Nodules under BETHESDA 2 are considered for US guided percutaneous ethanol injection (PEI). One hundred twenty-three patients were excluded because of various reasons. Finally ethanol ablation was done in 37 patients. Benign, purely cystic and mixed thyroid nodules were aspirated under ultrasonography guidance. Sterile absolute alcohol (99.99%) (50% of volume aspirated/ maximum 10 ml) was injected and reviewed after 2, 5and 7 months. In case of solid nodule alcohol (50% of nodule volume) was injected. A reduction in volume is calculated at each follow up visit. An adequate response is considered as ≥50 percent reduction in size from baseline after 7 months. If the reduction is &lt;50%, then a second session of absolute ethanol injection is given. Again, patients were similarly followed up after 2, 5 and 7 months. Results: Thirty seven patients underwent PEI. Thirty three patients were considered for final analysis (4 lost to follow up). Response rate of PEI for purely cystic nodule was 100.0% and the overall response rate for mixed nodule was 53.57%. None of the solid nodule responded to PEI even after second session. Among the responder in the mixed nodules, 93.33% responded after first session of PEI. Minor complications like headache occurred in 54.1% patients in the first session. Transient pain at injection site were complained by 86.5% and 37.8% patients in the first and second session respectively. Nausea and vomiting were complained by 18.9% and 16.2% patients in the first and second session respectively. Conclusions: PEI is an effective and safe for purely cystic and mixed thyroid nodules. It is a relatively safe and less invasive procedure from management of benign solitary cystic and mixed thyroid nodules.

Ultrasound guided percutaneous ethanol injection in the treatment of cystic thyroid nodules

1994 ◽  
Vol 41 (6) ◽  
pp. 719-724 ◽  
Author(s):  
Giuseppe Verde ◽  
Enrico Paplni ◽  
Claudio M. Pacella ◽  
Cesare Gallotti ◽  
Sergio Delpiano ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Percutaneous Ethanol Injection ◽  
Ultrasound Guided ◽  
Ethanol Injection

scholarly journals Ultrasound-Guided Percutaneous Ethanol Injection Protocol to Treat Solid and Mixed Thyroid Nodules

2016 ◽  
Vol 7 ◽  
Author(s):  
João Soares Felício ◽  
Antônio Maria Silva Conceição ◽  
Flávia Marques Santos ◽  
Michelle Masuyo Minami Sato ◽  
Fabíola de Arruda Bastos ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Percutaneous Ethanol Injection ◽  
Ultrasound Guided ◽  
Ethanol Injection ◽  
Injection Protocol

Percutaneous ethanol injection for benign cystic and mixed thyroid nodules

2018 ◽  
Author(s):  
Aysenur Ozderya ◽  
Kadriye Aydin ◽  
Naile Gokkaya ◽  
Sule Temizkan
Keyword(s):  
Thyroid Nodules ◽  
Percutaneous Ethanol Injection ◽  
Ethanol Injection

Percutaneous Ethanol Injection of Hyperfunctioning Thyroid Nodules: Long-Term Follow-Up in 125 Patients

2008 ◽  
Vol 190 (3) ◽  
pp. 800-808 ◽  
Author(s):  
Luciano Tarantino ◽  
Giampiero Francica ◽  
Ignazio Sordelli ◽  
Pasquale Sperlongano ◽  
Domenico Parmeggiani ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Percutaneous Ethanol Injection ◽  
Ethanol Injection ◽  
Long Term Follow Up
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