title: Treatment of Metastatic Lymph Nodes in the Neck from Papillary Thyroid Carcinoma with Percutaneous Laser Ablation.
abstract: OBJECTIVE
  To assess the effectiveness of percutaneous laser ablation (PLA) of cervical lymph node metastases from papillary thyroid carcinoma.
  
  
  METHODS
  24 patients (62.3 ± 13.2 year; range 32-80) previously treated with thyroidectomy, neck dissection, and radioiodine ablation underwent ultrasound-guided PLA of 46 (18)FDG-PET/CT-positive metachronous nodal metastases. All patients were at high surgical risk or refused surgery and were unsuitable for additional radioiodine ablation. A 300 µm quartz fiber and a continuous-wave Nd-YAG laser operating at 1.064 mm were used. Technical success, rate of complications, rate of serological conversion, and local control at follow-up were derived. Fisher's exact test and Mann-Whitney U test were used and Kaplan-Meier curve calculated.
  
  
  RESULTS
  Technical success was obtained in all 46 lymph nodes (100 %). There were no major complications. Thyroglobulin levels decreased from 8.40 ± 9.25 ng/ml before treatment to 2.73 ± 4.0 ng/ml after treatment (p = 0.011), with serological conversion in 11/24 (45.8 %) patients. Overall, local control was obtained in 40/46 (86.9 %) lymph nodes over 30 ± 11 month follow-up, with no residual disease seen at imaging in 19/24 (79.1 %) patients. Local control was achieved in 40/46 (86.9 %) lymph nodes at 1 year and in all of the 25 nodes (100 %) followed for 3 years. Estimated mean time to progression was 38.6 ± 2.7 m.
  
  
  CONCLUSIONS
  Ultrasound-guided PLA is a feasible, safe, and effective therapy for the treatment of cervical lymph node metastases from papillary thyroid carcinoma.
authors.affiliation: Division of Interventional Radiology, European Institute of Oncology, Milan, Italy. vanni.mauri@gmail.com.|Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2, 20097, San Donato Milanese, Milano, Italy. vanni.mauri@gmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mauri
authors.affiliation: Unit of Interventional Oncology, General Hospital of Busto Arsizio, Busto Arsizio, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Cova
authors.affiliation: Unit of Interventional Radiology, IRCCS Istituto Clinico Humanitas, Rozzano, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Ierace
authors.affiliation: Department of Nuclear Medicine, General Hospital of Busto Arsizio, Busto Arsizio, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Baroli
authors.affiliation: Department of Nuclear Medicine, General Hospital of Busto Arsizio, Busto Arsizio, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Di Mauro
authors.affiliation: Department of Diagnostic Imaging, Regina Apostolorum Hospital, Albano, Italy.
authors.forename: Claudio Maurizio
authors.initials: CM
authors.lastname: Pacella
authors.affiliation: Image-guided Therapy and Interventional Oncology Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Shraga Nahum
authors.initials: SN
authors.lastname: Goldberg
authors.affiliation: Unit of Interventional Radiology, IRCCS Istituto Clinico Humanitas, Rozzano, Italy.|Humanitas Research Hospital, Humanitas University, Milan, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Solbiati
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology*; D002291:Carcinoma, Papillary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D053685:Laser Therapy / Q000379:methods*; D008198:Lymph Nodes / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D007457:Iodine Radioisotopes
keywords: Laser; Neoplasm metastasis; Percutaneous ablation; Positron emission tomography; Thyroid neoplasm