title: Efficacy and Safety of Radiofrequency Ablation Versus Observation for Nonfunctioning Benign Thyroid Nodules: A Randomized Controlled International Collaborative Trial.
abstract: BACKGROUND
  Percutaneous radiofrequency thermal ablation (RFA) has been reported as an effective tool for the management of benign thyroid nodules (BTN). However, large, randomized controlled trials (RCTs) are lacking.
  
  
  OBJECTIVE
  The aims of this study were to assess the volume reduction of BTN after a single RFA performed using the moving-shot technique and to compare the volume reduction obtained in patients treated in two centers with different experience of the moving-shot technique.
  
  
  METHODS
  This study was an international prospective RCT. It was carried out at the Mauriziano Hospital (Turin, Italy) and the Asan Medical Center (Seoul, Korea). Eighty patients harboring solid, compressive, nonfunctioning BTN (volume 10-20 mL) were enrolled. Twenty patients in each country were treated by RFA using a 18-Gauge internally cooled electrode (group A); 20 nontreated patients in each country were followed as controls (group B).
  
  
  RESULTS
  At six months, BTN volume significantly decreased in group A (15.1±3.1 mL vs. 4.2±2.7 mL; p<0.0001), whereas it remained unchanged in group B (14.4±3.3 mL vs. 15.2±3.5 mL). The baseline volume was larger in the Italian series (16.4±2.5 mL vs. 13.9±3.3 mL, p=0.009). However, at six months, there was no significant difference between the Korean group and the Italian group (3.7±2.9 mL vs. 5.5±2.2 mL). Both cosmetic and compressive symptoms significantly improved (3.6±0.5 vs. 1.7±0.4 and 3.6±1.9 vs. 0.4±0.7, respectively; p<0.001). No side effects occurred.
  
  
  CONCLUSIONS
  RFA was effective in reducing the volume of BTN. The outcome was similar in centers with different experience in the moving-shot technique.
authors.affiliation: 1 Endocrinology, Diabetes, and Metabolism Unit, A.O. Ordine Mauriziano di Torino, "Umberto I" Hospital , Turin, Italy .
authors.forename: Maurilio
authors.initials: M
authors.lastname: Deandrea
authors.affiliation: 2 Department of Radiology, Thyroid Center, Daerim St. Mary's Hospital , Seoul, Korea.
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Sung
authors.affiliation: 1 Endocrinology, Diabetes, and Metabolism Unit, A.O. Ordine Mauriziano di Torino, "Umberto I" Hospital , Turin, Italy .
authors.forename: Paolo
authors.initials: P
authors.lastname: Limone
authors.affiliation: 1 Endocrinology, Diabetes, and Metabolism Unit, A.O. Ordine Mauriziano di Torino, "Umberto I" Hospital , Turin, Italy .
authors.forename: Alberto
authors.initials: A
authors.lastname: Mormile
authors.affiliation: 1 Endocrinology, Diabetes, and Metabolism Unit, A.O. Ordine Mauriziano di Torino, "Umberto I" Hospital , Turin, Italy .
authors.forename: Francesca
authors.initials: F
authors.lastname: Garino
authors.affiliation: 1 Endocrinology, Diabetes, and Metabolism Unit, A.O. Ordine Mauriziano di Torino, "Umberto I" Hospital , Turin, Italy .
authors.forename: Federico
authors.initials: F
authors.lastname: Ragazzoni
authors.affiliation: 2 Department of Radiology, Thyroid Center, Daerim St. Mary's Hospital , Seoul, Korea.
authors.forename: Kyu Sun
authors.initials: KS
authors.lastname: Kim
authors.affiliation: 3 Department of Internal Medicine, Thyroid Center, Daerim St. Mary's Hospital , Seoul, Korea.
authors.forename: Ducky
authors.initials: D
authors.lastname: Lee
authors.affiliation: 4 Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine , Asan Medical Center, Seoul, Korea.
authors.forename: Jung Hwan
authors.initials: JH
authors.lastname: Baek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D017115:Catheter Ablation / Q000379:methods*; D004566:Electrodes; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D011446:Prospective Studies; D066106:Seoul; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional