title: Image-guided thermal ablation of benign thyroid nodules.
abstract: Benign thyroid nodules are a common disease in the general population. Most often, they are completely asymptomatic and discovered occasionally during routine ultrasound examinations, and do not require any treatment. When thyroid nodules become symptomatic, surgical excision is still considered standard treatment. In the last few years, several experiences in the treatment of benign thyroid nodules through image-guided percutaneous thermal ablation have been reported with encouraging results, so that currently, these treatments are often proposed as first-choice options for patients with symptomatic benign thyroid nodules. In this paper, we discuss the present literature on the topic, focusing on different techniques available for image-guided percutaneous ablation, particularly radiofrequency (RFA), laser (LA), microwave (MWA), and high-intensity-focus ultrasound (HIFU). Little evidence about the efficacy of MWA and HIFU is now available. According to the literature, good results have been obtained with RFA and LA. Regarding RFA, volume reduction after ablative treatment has been found to range from 47 to 84 % at 3-6 months, and from 62 to 93 % at 1 year; LA also seems to be effective in achieving shrinkage of thyroid nodules, with volume reduction from 37 to 81 % at 3-6 months, and from 13 to 82 % at 1-year follow-up. Moreover, applications of advanced image-guidance modality, such as contrast-enhanced ultrasound and virtual navigation with fusion imaging, are discussed.
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy.
authors.forename: Anna Pisani
authors.initials: AP
authors.lastname: Mainini
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy.
authors.forename: Cristian
authors.initials: C
authors.lastname: Monaco
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy.
authors.forename: Lorenzo Carlo
authors.initials: LC
authors.lastname: Pescatori
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: De Angelis
authors.affiliation: Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20100 Milan, Italy.|Unità di Radiologia, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097 Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sardanelli
authors.affiliation: Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20100 Milan, Italy.|Radiologia/Diagnostica per immagini con servizio di radiologia Interventistica, IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161 Milan, Italy.
authors.forename: Luca Maria
authors.initials: LM
authors.lastname: Sconfienza
authors.affiliation: Dipartimento di Radiologia Interventistica, Istituto Europeo di Oncologia, Via Ripamonti 435, 20100 Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mauri
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000601:surgery*
keywords: High-intensity focused ultrasound; Laser; Microwave; Radiofrequency; Thyroid nodule