Cold Benign Thyroid Nodule Volume Reduction Predictability After Percutaneous Ethanol Injection

2009 ◽  
Vol 53 (3) ◽  
pp. 292-296
Author(s):  
Vincenzo Nirchio ◽  
Francesco Nirchio ◽  
Umberto Crocetti ◽  
Paola Tizzani ◽  
Vincenzo Trischitta ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Percutaneous Ethanol Injection ◽  
Volume Reduction ◽  
Ethanol Injection ◽  
Benign Thyroid Nodule ◽  
Nodule Volume ◽  
Benign Thyroid

Efficacy of Thyroid Hormone Suppression for Benign Thyroid Nodules: Meta-Analysis of Randomized Trials

2005 ◽  
Vol 133 (3) ◽  
pp. 391-396 ◽  
Author(s):  
Matthew T. Sdano ◽  
Mercedes Falciglia ◽  
Jeffrey A. Welge ◽  
David L. Steward
Keyword(s):  
Thyroid Nodule ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Term Treatment ◽  
Volume Reduction ◽  
Benign Thyroid Nodule ◽  
Long Term Treatment ◽  
Nodule Volume ◽  
Benign Thyroid

OBJECTIVE: To determine the efficacy of thyroid hormone suppressive therapy (THST) to decrease benign thyroid nodule volume. DESIGN: Meta-analysis. METHODS: Systematic search using electronic databases (PubMed, Medline, Cochrane Library) through August 2004, paper review, and contacting experts and drug manufacturers. Only randomized controlled studies of THST vs no treatment or placebo, for reduction of benign thyroid nodule volume, were included. Exclusion criteria were: >6-month treatment, lack of ultrasound volume measurement, and region of endemic goiter. Primary outcome was clinically relevant nodule volume reduction (>50%), with a random effects model (RevMan4.2). RESULTS: Nine randomized trials were included (609 subjects). Subjects were 88% more likely to experience >50% nodule volume reduction with THST than placebo or no treatment (relative risk = 1.88; 95% CI = 1.18-3.01; P = 0.008). However, 8 subjects must be subjected to the risk of cardiac and skeletal side effects from THST, for one to benefit from therapy (number needed to treat = 8, risk difference = 0.13; 95% CI = 0.06-0.19; P = 0.0003). Sensitivity analysis reveals that 15 null studies would have to have been missed to reverse statistical significance (fail-safe N = 15). Review of the only study with long-term treatment (5 years) suggests no significant difference in nodule volume reduction between THST and placebo. Further, studies with follow-up after THST withdrawal demonstrate rapid increase in thyroid nodule and goiter volumes. CONCLUSION: THST appears more likely than placebo or no treatment to significantly reduce benign thyroid nodule volume, but long-term treatment may be less effective and regrowth is likely following cessation of therapy. Given the risks of THST, routine use is not recommended for benign nodules.

Is Percutaneous Ethanol Injection a Useful Alternative for the Treatment of the Cold Benign Thyroid Nodule? Five Years' Experience

Thyroid ◽  
1997 ◽  
Vol 7 (5) ◽  
pp. 699-704 ◽  
Author(s):  
NADIA CARACCIO ◽  
ORLANDO GOLETTI ◽  
PIERO VINCENZO LIPPOLIS ◽  
ARTURO CASOLARO ◽  
ENRICO CAVINA ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Percutaneous Ethanol Injection ◽  
Ethanol Injection ◽  
Benign Thyroid Nodule ◽  
Benign Thyroid

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 (>50% of total volume) thyroid nodule, solitary benign mixed with predominantly solid (>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 <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.

scholarly journals Evaluation of percutaneous ethanol injections in benign thyroid nodules

2014 ◽  
Vol 58 (9) ◽  
pp. 912-917 ◽  
Author(s):  
Camila Luhm Silva Perez ◽  
Tayane Muniz Fighera ◽  
Fabiola Miasaki ◽  
Cleo Otaviano Mesa Junior ◽  
Gilberto Jorge da Paz Filho ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Percutaneous Ethanol Injection ◽  
Complete Response ◽  
Free T4 ◽  
Ethanol Injection ◽  
Volume Response ◽  
Nodule Volume ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid ◽  
Tsh Levels

Objective The objective of this study was to evaluate the efficacy and safety of percutaneous ethanol injection (PEI) in the treatment of benign thyroid nodules. Subjects and methods We evaluated 120 patients with benign thyroid nodules. Patients underwent evaluation of serum TSH and free T4, cervical ultrasound, and thyroid scintigraphy (in those with suppressed TSH levels). The application of sterile ethanol 99% was guided by ultrasound, with the injected volume amounting to one-third of the nodule volume. Response was considered complete (reduction of 90%); partial (reduction between 50 and 90%); or none (reduction of < 50%). Autonomous nodules were evaluated for normalization of TSH levels. Results Among the nodules studied, 30.8% were solid, 56.7% were mixed, 12.5% were cystic, and 21.6% were hyperfunctioning. The initial volume of the treated nodules ranged from 0.9 to 74.8 mL (mean 13.1 ± 12.4 mL). We performed 1-8 sessions of PEI, applying an average of 6.2 mL of ethanol for patient. After 2 years of follow-up, 17% of patients achieved a complete response (94% reduction); 53%, a partial response (70% reduction); and 30%, no response. A reduction in the volume of autonomous nodules was noted in 70% of cases, and 54% had a normalized value of TSH. The main side effect is local pain, lasting less than 24 hours in most cases. Conclusion This study showed that PEI is a safe and effective procedure for treatment of benign, solid or mixed thyroid nodules. Most cases resulted in significant reduction in nodule volume, with normalization of thyroid function. Arq Bras Endocrinol Metab. 2014;58(9):912-7

Benign Thyroid Nodule Laser Ablation

2019 ◽  
pp. 61-73
Author(s):  
Enrico Papini ◽  
Rinaldo Guglielmi ◽  
Agnese Persichetti ◽  
Claudio Maurizio Pacella
Keyword(s):  
Laser Ablation ◽  
Thyroid Nodule ◽  
Benign Thyroid Nodule ◽  
Benign Thyroid

scholarly journals Four years of experience of minimally invasive treatment of benign thyroid nodule

2015 ◽  
Vol 10 (4) ◽  
pp. 49
Author(s):  
Viktor Gennad'evich Petrov ◽  
Alsu Asatovna Nelaeva ◽  
Elena Valer'evna Antonova ◽  
Ekaterina Vladimirovna Molozhavenko ◽  
Irina Al'tafovna Khuchasheva ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Thyroid Nodule ◽  
Minimally Invasive Treatment ◽  
Years Of Experience ◽  
Invasive Treatment ◽  
Benign Thyroid Nodule ◽  
Benign Thyroid

VASCULARITY-TARGETED PERCUTANEOUS ETHANOL INJECTION OF TOXIC THYROID ADENOMAS: OUTCOMES OF A FEASIBILITY STUDY PERFORMED IN THE USA

2020 ◽  
Vol 26 (1) ◽  
pp. 22-29
Author(s):  
Anu Sharma ◽  
Dev Abraham
Keyword(s):  
Radioactive Iodine ◽  
Power Doppler ◽  
Percutaneous Ethanol Injection ◽  
Free Thyroxine ◽  
Interquartile Range ◽  
Toxic Adenoma ◽  
Ethanol Injection ◽  
The Usa ◽  
Nodule Volume ◽  
Radioactive Iodine Ablation

Objective: The recommended treatment options for toxic adenoma (TA) in the USA are radioactive iodine ablation and surgical resection, with continued observation for pre-toxic adenoma (PTA). Percutaneous ethanol ablation (PEI) has proven efficacy in the treatment of TA and is widely available in Europe but not in the USA. Methods: Retrospective analysis was performed of all patients who underwent PEI for TA/PTA at the University of Utah, from January 2010 to 2018. Ultrasound-guided PEI, with injections targeting power Doppler–mapped blood vessels within the adenomas, was conducted. Functionality was confirmed using thyroid scintigraphy prior to PEI. Results: Eighteen adults (15 female) underwent PEI. Mean age was 41 ± 13.7 years. Baseline thyroid-stimulating hormone (TSH) was suppressed (0.06 ± 0.09 mU/L), with normal free thyroxine (FT4) 1.43 ± 0.39 ng/dL. Median nodule volume was 5.7 cm3 (interquartile range [IQR], 4.8 to 7.7 cm3). Seventy-eight percent (n = 14) underwent two or less PEI sessions. Median volume of ethanol used was 0.46 mL/mL nodule volume (IQR, 0.3 to 0.6 mL). There was a significant increase in TSH concentrations within the first 3 months after PEI (0.06 ± 0.09 mU/L vs. 1.22 ± 1.88 mU/L; P = .02), with a concomitant significant decrease in FT4 concentrations (1.43 ± 0.39 ng/day vs. 1.13 ± 0.25 ng/day; P<.01). Significant nodular volume reduction was observed following PEI (median 5.7 cm3 [IQR 4.8–7.7 cm3] vs. 2.5 cm3 [IQR 2.0–7.8 cm3]; P<.01). Conclusion: Vascularity-targeted PEI is safe and effective for treating PTA and TA. This unique approach required lower injected alcohol volume and fewer injections for therapeutic success. Abbreviations: ATA = American Thyroid Association; FT4 = free thyroxine; IQR = interquartile range; PD = power Doppler; PEI = percutaneous ethanol injection; PTA = pre-toxic adenoma; RAI = radioactive iodine ablation; RFA = radiofrequency ablation; TA = toxic adenoma; TT3 = total triiodothyronine; US = ultrasound

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