title: Radiofrequency ablation for the treatment of autonomously functioning thyroid nodules.
abstract: BACKGROUND
  Some patients with autonomously functioning thyroid nodules (AFTN) are not suitable for surgery or radioiodine therapy. Therefore, minimally invasive alternative treatments, such as ethanol ablation or radiofrequency ablation (RFA), are necessary.
  
  
  METHODS
  This study included nine patients (4 toxic and 5 pretoxic patients; male to female ratio = 1:8; mean age, 47 +/- 17 (range, 25-71) years) who were not eligible for surgery or radioiodine therapy. All of the patients showed hot nodule with suppression of normal thyroid gland in (99m)Tc pertechnetate scintigraphy. RFA was performed using a 17- and 18-gauge internally cooled electrode. Nodule volume, thyroid function, scintigraphy, symptom score (visual analogue scale, 0-10 cm), cosmetic grading score (4-point scale), and complications were evaluated before treatment and at 1, 3, and 6 months follow-up.
  
  
  RESULTS
  Mean volume of the index nodule was 14.98 +/- 25.53 (range, 0.29-82.29) mL. After RFA it decreased at 1 month (12.01 +/- 25.97 mL, p = 0.015), 3 months (7.27 +/- 15.13 mL, p = 0.011), 6 months (8.27 +/- 21.29 mL, p = 0.008), and the last month (7.57 +/- 19.99 mL, p = 0.008). Initial mean T3, fT4, and TSH were 156.2 +/- 42.1 ng/dL, 1.73 +/- 0.40 ng/dL, and 0.052 +/- 0.087 mU/mL, respectively. A significant improvement of mean T3, fT4, and TSH were observed at last follow-up (T3: 116.8 +/- 20.7 ng/dL, p = 0.015; fT4: 1.37 +/- 0.26 ng/dL, p = 0.036; TSH: 1.454 +/- 1.756 mU/mL, p = 0.012). After ablation, four patients became a cold or normal scan and five remained as a hot nodule. The mean symptom and cosmetic grading score was reduced from 2.4 +/- 1.7 to 0.6 +/- 0.7 (p = 0.011) and from 3.1 +/- 1.2 to 1.4 +/- 1.0 (p = 0.017), respectively. No major complications were encountered.
  
  
  CONCLUSIONS
  RFA seems to be effective and safe for the treatment of AFTN.
authors: Department of Radiology, Thyroid Center, Daerim St. Mary's Hospital, #978-13 Daerim-dong, Youngdeunpo-gu, Seoul, 150-070, Korea. radbaek@naver.com
authors: Jung Hwan
authors: JH
authors: Baek
authors: Won-Jin
authors: WJ
authors: Moon
authors: Yoon Suk
authors: YS
authors: Kim
authors: Jeong Hyun
authors: JH
authors: Lee
authors: Ducky
authors: D
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D044963:Biopsy, Fine-Needle; D017115:Catheter Ablation / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013960:Thyroid Function Tests; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome