title: Ultrasonography-guided percutaneous radiofrequency ablation for cervical lymph node metastasis from thyroid carcinoma.
abstract: OBJECTIVE
  The aim was to explore the efficacy and safety of ultrasonography-guided percutaneous radiofrequency ablation (RFA) for cervical lymph node metastases from thyroid carcinoma.
  
  
  METHODS
  Eight patients with previous total thyroidectomy and radioiodine therapy were enrolled in this study. A total of 20 cervical lymph node metastases were confirmed by percutaneous biopsy. Participants underwent ultrasonography-guided RFA treatment for all confirmed metastatic lymph nodes. Contrast-enhanced ultrasound (CEUS) and sonoelastography were performed to rapidly evaluate treatment responses before and shortly after RFA. Routine follow-up consisted of conventional US, CEUS, sonoelastography, thyroglobulin level, and necessary fine needle aspiration cytology.
  
  
  RESULTS
  All eight patients were successfully treated without obvious complications. Post-RFA CEUS showed that total metastatic lymph nodes were ablated. The sonoelastographic score of ablated area elevated significantly shortly after RFA (P < 0.001). With a mean follow-up of 9.4 ± 5.1 months, there were no evidences of recurrence at ablated sites; however, two new cervical recurrent lymph nodes occurred in one case, which was successfully ablated as well. The mass volume shrinkages of the ablated nodes were observed in all cases. We found that 5 treated lymph nodes disappeared, 4 were reduced more than 80%, 9 were reduced between 50% and 80%, and 2 were reduced less than 50%. At the last follow-up evaluation, the serum thyroglobulin levels had decreased in 6 of 8 patients.
  
  
  CONCLUSIONS
  Ultrasonography-guided percutaneous RFA for cervical lymph node metastasis of thyroid malignancy is a feasible, effective, and safe therapy. This procedure shows a nonsurgical therapeutic option for metastatic lymph nodes in patients with difficult reoperations or inoperations, it may reduce or delay a large number of highly invasive repeated neck dissections.
authors.forename: Liping
authors.initials: L
authors.lastname: Wang
authors.forename: Minghua
authors.initials: M
authors.lastname: Ge
authors.affiliation: Department of Ultrasonography, Zhejiang Cancer Hospital, Hangzhou 310022, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Xu
authors.forename: Liyu
authors.initials: L
authors.lastname: Chen
authors.forename: Chaowen
authors.initials: C
authors.lastname: Qian
authors.forename: Kaiyuan
authors.initials: K
authors.lastname: Shi
authors.forename: Junping
authors.initials: J
authors.lastname: Liu
authors.forename: Yong
authors.initials: Y
authors.lastname: Chen
mesh_terms: D000328:Adult; D044963:Biopsy, Fine-Needle / Q000379:methods; D017115:Catheter Ablation / Q000379:methods; D002584:Cervix Uteri / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D014463:Ultrasonography / Q000379:methods