title: Evaluation of percutaneous ethanol injections in benign thyroid nodules.
abstract: OBJECTIVE
  The objective of this study was to evaluate the efficacy and safety of percutaneous ethanol injection (PEI) in the treatment of benign thyroid nodules.
  
  
  METHODS
  We evaluated 120 patients with benign thyroid nodules. Patients underwent evaluation of serum TSH and free T4, cervical ultrasound, and thyroid scintigraphy (in those with suppressed TSH levels). The application of sterile ethanol 99% was guided by ultrasound, with the injected volume amounting to one-third of the nodule volume. Response was considered complete (reduction of 90%); partial (reduction between 50 and 90%); or none (reduction of < 50%). Autonomous nodules were evaluated for normalization of TSH levels.
  
  
  RESULTS
  Among the nodules studied, 30.8% were solid, 56.7% were mixed, 12.5% were cystic, and 21.6% were hyperfunctioning. The initial volume of the treated nodules ranged from 0.9 to 74.8 mL (mean 13.1 ± 12.4 mL). We performed 1-8 sessions of PEI, applying an average of 6.2 mL of ethanol for patient. After 2 years of follow-up, 17% of patients achieved a complete response (94% reduction); 53%, a partial response (70% reduction); and 30%, no response. A reduction in the volume of autonomous nodules was noted in 70% of cases, and 54% had a normalized value of TSH. The main side effect is local pain, lasting less than 24 hours in most cases.
  
  
  CONCLUSIONS
  This study showed that PEI is a safe and effective procedure for treatment of benign, solid or mixed thyroid nodules. Most cases resulted in significant reduction in nodule volume, with normalization of thyroid function.
authors: Department of Endocrinology and Metabolism, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil.
authors: Camila Luhm Silva
authors: CL
authors: Perez
authors: Department of Endocrinology and Metabolism, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil.
authors: Tayane Muniz
authors: TM
authors: Fighera
authors: Department of Endocrinology and Metabolism, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil.
authors: Fabiola
authors: F
authors: Miasaki
authors: Department of Endocrinology and Metabolism, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil.
authors: Cleo Otaviano
authors: CO
authors: Mesa Junior
authors: Department of Endocrinology and Metabolism, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil.
authors: Gilberto Jorge da
authors: GJ
authors: Paz Filho
authors: Department of Endocrinology and Metabolism, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil.
authors: Hans
authors: H
authors: Graf
authors: Department of Endocrinology and Metabolism, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil.
authors: Gisah Amaral de
authors: GA
authors: Carvalho
mesh_terms: D000431:Ethanol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D006980:Hyperthyroidism / Q000000981:diagnostic imaging; D015552:Injections, Intralesional / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011877:Radionuclide Imaging; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000431:Ethanol; D013972:Thyrotropin; D013974:Thyroxine