title: Percutaneous laser ablation of metastatic lymph nodes in the neck from papillary thyroid carcinoma: preliminary results.
abstract: BACKGROUND
  Percutaneous laser ablation (PLA) may be useful in treating patients with metachronous metastatic lymph nodes in the neck.
  
  
  OBJECTIVE
  Our objective was to assess PLA as a treatment of difficult-to-treat metachronous cervical lymph node metastases from papillary thyroid carcinoma.
  
  
  METHODS
  We conducted a retrospective analysis of prospectively collected data at a public hospital.
  
  
  METHODS
  Fifteen patients with previous resection of papillary thyroid carcinoma with elevated serum levels of thyroglobulin (Tg) or anti-Tg antibodies (TgAbs) and 24 metachronous nodal metastases treated between September 2010 and April 2012 were followed with [¹⁸F]fluorodeoxyglucose (¹⁸FDG) positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced ultrasound (CEUS).
  
  
  METHODS
  Intervention was PLA.
  
  
  METHODS
  Technique feasibility and technical success were evaluated. Tg/TgAb serum levels and ¹⁸FDG-PET/CT, and CEUS appearance were assessed at 6 and 12 months and compared with baseline. Complications were recorded.
  
  
  RESULTS
  PLA was always feasible, and technical success was achieved in all patients. At 6 months, local control was achieved in 11 of 15 patients (73%), with 6 (40%) having serum Tg/TgAb normalized (P = .017 vs baseline). Whereas 20 of 24 (83%) nodes were negative at ¹⁸FDG-PET/CT and CEUS (P < .001 vs baseline), 4 were ¹⁸FDG-PET/CT-positive (3 also CEUS-positive). At the 12-month follow-up, local control was achieved in 10 of 14 patients (71.4%). Sixteen of 20 nodes (80%) were negative at ¹⁸FDG-PET/CT and CEUS (P < .001 vs baseline), 4 were ¹⁸FDG-PET/CT-positive (2 also CEUS-positive). Four of 10 (40%) patients had normalization of serum Tg/TgAb (P = .098 vs baseline). No major complications occurred.
  
  
  CONCLUSIONS
  PLA is potentially feasible, safe, and effective for the treatment of metachronous cervical nodal metastases from papillary thyroid carcinoma. This procedure may reduce or delay a large number of highly invasive repeat neck dissections.
authors.affiliation: Department of Diagnostic Imaging, Interventional Oncology Unit, Azienda Ospedaliera Ospedale di Circolo di Busto Arsizio, Busto Arsizio 21052, Italy. vanni.mauri@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Mauri
authors.forename: L
authors.initials: L
authors.lastname: Cova
authors.forename: T
authors.initials: T
authors.lastname: Tondolo
authors.forename: T
authors.initials: T
authors.lastname: Ierace
authors.forename: A
authors.initials: A
authors.lastname: Baroli
authors.forename: E
authors.initials: E
authors.lastname: Di Mauro
authors.forename: C M
authors.initials: CM
authors.lastname: Pacella
authors.forename: S N
authors.initials: SN
authors.lastname: Goldberg
authors.forename: L
authors.initials: L
authors.lastname: Solbiati
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000032:analysis; D002277:Carcinoma / Q000097:blood / Q000601:surgery*; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D011183:Postoperative Complications / Q000517:prevention & control; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D013954:Thyroglobulin / Q000097:blood / Q000378:metabolism; D000077273:Thyroid Cancer, Papillary; D013961:Thyroid Gland / Q000378:metabolism; D013964:Thyroid Neoplasms / Q000097:blood / Q000601:surgery*; D014463:Ultrasonography
chemical_list: D001323:Autoantibodies; C006606:anti-thyroglobulin; D013954:Thyroglobulin