One-step ethanol ablation of viscous cystic thyroid nodules.
OBJECTIVE
The purpose of this study was to evaluate the efficacy and safety of one-step ethanol ablation in the management of viscous cystic thyroid nodules.


METHODS
Viscous cystic thyroid nodules are defined as nodules that cannot be aspirated with an 18-gauge needle. Nine euthyroid patients underwent one-step ethanol ablation of benign single compressive viscous cystic thyroid nodules (cystic portion > 90%). The thick content of the nodules was removed with either a 16-gauge needle (n = 8) or an 8.5-French pigtail catheter (n = 1) connected to a suction pump. An injection of 99% sterile ethanol then was administered. After 10 minutes, all of the injected ethanol was withdrawn. Additional treatment was prescribed if the cystic portion of the nodule remained larger than 1 mL. Follow-up sonography was performed 1 and 6 months after treatment. At each follow-up examination, nodule volume, symptom score (centimeter visual analog scale, 0-10), cosmetic grade (grade 1-4), and complications were evaluated.


RESULTS
The mean volume of index nodules was 24.4 +/- 20.3 (SD) mL (range, 4.5-57.4 mL). The mean amount of ethanol injected was 11.8 +/- 10.1 mL (range, 2-27 mL). The mean total procedure time was 27.8 +/- 10.4 minutes (range, 15-45 minutes). One month after ablation, the mean volume of the nodules had decreased significantly (7.2 +/- 9.4 vs 24.4 +/- 20.3 mL, p = 0.008). Additional reduction was found at the 6-month follow-up examination, the mean nodule volume being 2.1 +/- 3.8 mL (p = 0.008). The mean volume reductions at 1 and 6 months were 78.4% +/- 14.4% and 93.6% +/- 6.8%. The mean symptom score decreased from 3.2 +/- 1.5 to 0.4 +/- 1.0 (p < 0.05) and the mean cosmetic grade from 3.9 +/- 0.3 to 1.3 +/- 0.7 (p < 0.05). No major complications were encountered.


CONCLUSIONS
One-step ethanol ablation is an effective and safe method of management of viscous cystic thyroid nodules.
Sung
Jin Yong
JY
Department of Radiology, Thyroid Center, Daerim St. Mary's Hospital, 978-13 Daerim-dong, Youngdeunpo-gu, Seoul, 150-070 Korea.
Baek
Jung Hwan
JH
Kim
Yoon Suk
YS
Jeong
Hyun Jo
HJ
Kwak
Min Sook
MS
Lee
Ducky
D
Moon
Won-Jin
WJ
D000328:Adult; D000368:Aged; D003560:Cysts / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D008297:Male; D013959:Thyroid Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014783:Viscosity
D000431:Ethanol