Percutaneous thermal microwave ablation of thyroid nodules. Preparation, feasibility, efficiency.
Microwave ablation (MWA) is a new minimal invasive method for thermal ablation of benign thyroid nodules. In contrast to well-established radiofrequency ablation (RFA), MWA offers several advantages with similarly successful results. There has not been any use of functional imaging with 99mTc-pertechnetate and 99mTc-MIBI-scans as a mere qualitative analysis of this imaging in the field of MWA in Europe until now. The aim of this study has been to demonstrate the feasibility of MWA as well as the applicability of functional imaging to verify effectiveness with a centerspecific score.


METHODS
11 patients (5 women, 6 men, average age 62.3 years) with 18 benign thyroid nodules were treated. MWA was operated under local anesthesia with a system working in a wavelength field of 902 to 928 MHz (Avecure MWG881, MedWaves, Inc. San Diego, CA). Pre- and postablative scans were controlled by two specialists in nuclear medicine with longtime work experience.


RESULTS
A center specific functional imaging score (CSFIS) was defined, a decrease of 1.4 points at an average was noticeable (range 1-3 points). In 66.7% (n = 12) of all nodules the score decreased by 1 point, 27.8% (n = 5) by 2 points and 5.6% (n = 1) by 3 points. The treatment was well tolerated and no severe complications were observed.


CONCLUSIONS
The preliminary data suggests that MWA is an effective method to treat benign thyroid nodules. Functional imaging is a promising technique for early verification of effectiveness of thermal ablation.
Priv.-Doz. Dr. Dr. Hüdayi Korkusuz, Klinik für Nuklearmedizin, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany, Tel. +49/(0)69/63 01 43 30, Fax: +49/(0)69/63 01 38 58, E-mail: Huedayi.Korkusuz@kgu.de.
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D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013670:Sodium Pertechnetate Tc 99m; D017256:Technetium Tc 99m Sestamibi; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000628:therapy*; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D013670:Sodium Pertechnetate Tc 99m
99mTc-MIBI scintigraphy; 99mTc-pertechnetate scintigraphy; Thyroid nodules; microwave ablation; thermal ablation