title: Percutaneous microwave ablation of benign thyroid nodules. Functional imaging in comparison to nodular volume reduction at a 3-month follow-up.
abstract: OBJECTIVE
  Thyroid nodules represent a common clinical issue. Amongst other minimally invasive procedures, percutaneous microwave ablation (MWA) poses a promising new approach. The goal of this retrospective study is to find out if there is a correlation between volume reduction after 3 months and 99mTc-uptake reduction of treated thyroid nodules.
  
  
  METHODS
  14 patients with 18 nodules were treated with MWA. Pre-ablative assessment included sonographical and functional imaging of the thyroid with 99mTc-pertechnetate and 99mTc-MIBI. Additionally, patients underwent thyroid scintigraphy 24 hours after ablation in order to evaluate the impact of the treatment on a functional level and to ensure sufficient ablation of the targeted area. At a 3-month follow-up, ultrasound examination was performed to assess nodular volume reduction.
  
  
  RESULTS
  Mean relative nodular volume reduction after three months was 55.4 ± 17.9% (p < 0.05). 99mTc-uptake 24 hours after treatment was 45.2 ± 31.9% (99mTc-MIBI) and 35.7 ± 20.3% (99mTc-pertechnetate) lower than prior to ablation (p < 0.05). Correlating reduction of volume and 99mTc-uptake, Pearson's r was 0.41 (p < 0.05) for nodules imaged with 99mTc-MIBI and -0.98 (p < 0.05) for 99mTc-pertechnetate. According to scintigraphy 99.6 ± 22.6% of the determined target area could be successfully ablated.
  
  
  CONCLUSIONS
  MWA can be considered as an efficient, low-risk and convenient new approach to the treatment of benign thyroid nodules. Furthermore, scintigraphy seems to serve as a potential prognostic tool for the later morphological outcome, allowing rapid evaluation of the targeted area in post-ablative examination.
authors.affiliation: Priv.-Doz. Dr. med. Dr. med. habil. Hüdayi Korkusuz, Universitätsklinikum Frankfurt, Klinik für Nuklearmedizin, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany, E-mail: Huedayi.Korkusuz@kgu.de.
authors.forename: H
authors.initials: H
authors.lastname: Korkusuz
authors.forename: F
authors.initials: F
authors.lastname: Nimsdorf
authors.forename: C
authors.initials: C
authors.lastname: Happel
authors.forename: H
authors.initials: H
authors.lastname: Ackermann
authors.forename: F
authors.initials: F
authors.lastname: Grünwald
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013670:Sodium Pertechnetate Tc 99m / Q000493:pharmacokinetics; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics; D013960:Thyroid Function Tests / Q000379:methods; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000628:therapy*; D016896:Treatment Outcome; D047368:Tumor Burden / Q000528:radiation effects
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D013670:Sodium Pertechnetate Tc 99m
keywords: 99mTc-MIBI; 99mTc-pertechnetate; Microwave ablation; functional imaging; scintigraphy; thyroid nodules