Advertisement

Journal of Endocrinological Investigation

, Volume 43, Issue 1, pp 95–100 | Cite as

Laser photocoagulation therapy for thyroid nodules: long-term outcome and predictors of efficacy

  • F. Magri
  • S. Chytiris
  • M. Molteni
  • L. Croce
  • F. Coperchini
  • M. Rotondi
  • R. Fonte
  • L. ChiovatoEmail author
Original Article

Abstract

Purpose

The aim of the present study was to retrospectively evaluate the efficacy of interstitial laser photocoagulation (ILP) ablation of thyroid nodules during a 6-year follow-up period and to identify possible predictors of the final outcome.

Methods

Forty-three outpatients (38 women) were assigned to ILP therapy. The study group included euthyroid patients with benign thyroid nodules. Thyroid size, nodule volume and features, and autoimmune test were collected at baseline. Patients underwent US control after the ILP procedure and 1 month, 6 months, 12 months later and then annually.

Results

During the follow-up, two distinct groups of patients emerged: the responders (N = 33) and the non-responder (N = 10) ones to ILP. In the responder group, the nodule volume significantly decreased during the follow-up, but a trend toward a slight increase in nodule volume was recorded up to the end of follow-up. No significant decrease in nodule volume was observed in the non-responder group. Neither baseline clinical nor demographic features were significantly different between responders and non-responders groups. In the whole group of patients, the energy delivered per mL of nodule tissue was significantly correlated with the percent volume decrease at the end of follow-up.

Conclusions

Interstitial laser photocoagulation is a safe technique able to reduce byabout 50% the volume of benign thyroid nodules in the majority of treated patients. However, due to the great variability of results, an active follow-up is required. The only independent predictor of ILP outcome is the energy delivered per mL of nodule tissue.

Keywords

Thyroid nodule Interstitial laser photocoagulation Ultrasound Therapeutic outcome 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Tan G, Gharib H (1997) Thyroid incidentalomas: management approaches to non palpable nodules discovered incidentally on thyroid imaging. Ann Intern Med 126:226–231CrossRefGoogle Scholar
  2. 2.
    Guth S, Theune U, Aberle J et al (2009) Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest 39:699–706CrossRefGoogle Scholar
  3. 3.
    Papini E, Rago T, Gambelunghe G et al (2014) long-term efficacy of ultrasound-guided laser ablation for benign solid thyroid nodules. Results of a three-year multicenter prospective randomized trial. J Clin Endocrinol Metab 99:3653–3659CrossRefGoogle Scholar
  4. 4.
    Mauri G, Cova L, Ierace T et al (2016) Treatment of metastatic lymph nodes in the neck from papillary thyroid carcinoma with percutaneous laser ablation. Cardiovasc Intervent Radiol 39:1023–1030CrossRefGoogle Scholar
  5. 5.
    Zhou W, Zhang L, Zhan W et al (2016) Percutaneous laser ablation for treatment of locally recurrent papillary thyroid carcinoma < 15 mm. Clin Radiol 71:1233–1239CrossRefGoogle Scholar
  6. 6.
    Zhang L, Zhou W, Zhan W (2018) Role of ultrasound in the assessment of percutaneous laser ablation of cervical metastatic lymph nodes from thyroid carcinoma. Acta Radiol 59:434–440CrossRefGoogle Scholar
  7. 7.
    Cakir B, Gul K, Ersoy E et al (2008) Subcapsular hematoma complication during percutaneous laser ablation to a hypoactive benign solitary thyroid nodule. Thyroid 18:917–918CrossRefGoogle Scholar
  8. 8.
    Pacella CM, Mauri G, Achille G et al (2015) Outcomes and risk factors for complications of laser ablation for thyroid nodules: a multicenter study on 1531 patients. J Clin Endocrinol Metab 100:3903–3910CrossRefGoogle Scholar
  9. 9.
    Bernardi S, Lanzilotti V, Papa G et al (2008) Full-thickness skin burn caused by radiofrequency ablation of a benign thyroid nodule. Thyroid 26:183–184CrossRefGoogle Scholar
  10. 10.
    Dossing H, Bonnedbaek FN, Hegedus L (2011) Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules. Eur J Endocrinol 165:123–128CrossRefGoogle Scholar
  11. 11.
    Valcavi R, Riganti F, Bertini A et al (2010) Percutaneous laser ablation of cold benign thyroid nodules: a 3-year follow-up study in 122 patients. Thyroid 20:1253–1261CrossRefGoogle Scholar
  12. 12.
    Achille G, Zizzi S, Di Stasio E et al (2016) Ultrasound-guided percutaneous laser ablation in treating symptomatic solid benign thyroid nodules: our experience in 45 patients. Head and Neck 38:667–682CrossRefGoogle Scholar
  13. 13.
    Negro R, Salem TM, Greco G (2016) Laser ablation is more effective for spongiform than solid thyroid nodules. A 4-year retrospective follow-up study. J Hyperth 32:822–828CrossRefGoogle Scholar
  14. 14.
    Kim JH, Baek JH, Lim HK et al (2018) 2017 thyroid radiofrequency ablation guideline: Korean society of thyroid radiology. Korean J Radiol 19(4):632–655CrossRefGoogle Scholar
  15. 15.
    Haugen BR, Alexander EK, Bible KC et al (2016) 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated. Thyroid Cancer 123(3):372–381PubMedGoogle Scholar
  16. 16.
    Gharib H, Hegedus L, Pacella CM et al (2013) Clinical review: nonsurgical, image-guided, minimally invasive therapy for thyroid nodules. J Clin Endocrinol Metab 98:3949–3957CrossRefGoogle Scholar
  17. 17.
    Gharib H, Papini E, Garber JR et al (2016) American Association Of Clinical Endocrinologists, American College Of Endocrinology, and Associazione Medici Endocrinologi Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules—2016 update. Endocr Pract 22:1–60CrossRefGoogle Scholar
  18. 18.
    Sui WF, Li JY, Fu JH (2017) Percutaneous laser ablation for benign thyroid nodules: a meta-analysis. Oncotarget 8:83225–83236PubMedPubMedCentralGoogle Scholar
  19. 19.
    Pacella CM, Bizzarri G, Guglielmi R et al (2000) Thyroid tissue; US-guided percutaneous interstitial laser ablation—a feasibility study. Radiology 217:673–677CrossRefGoogle Scholar
  20. 20.
    Ritz JP, Lehmann KS, Zurbuchen U et al (2009) Ex vivo and in vivo evaluation of laser-induced thermotherapy for nodular thyroid disease. Laser Surg Med 41:479–486CrossRefGoogle Scholar
  21. 21.
    Amabile G, Rotondi M, De Chiara G et al (2006) Low-energy Interstitial Laser Photocoagulation for treatment of nonfunctioning thyroid nodules: therapeutic outcome in relation to pretreatment and treatment parameters. Thyroid 16(8):749–755CrossRefGoogle Scholar
  22. 22.
    Gambelunghe G, Fede R, Bini V et al (2012) Ultrasound-guided interstitial laser ablation for thyroid nodules is effective only at high total amount of energy: results from a three-year pilot study. Surg Innov 20(4):345–350CrossRefGoogle Scholar
  23. 23.
    Papini E, Pacella CM, Solbiati LA et al (2019) Minimally-invasive treatments for benign thyroid nodules: a Delphi-based consensus statement from the Italian minimally-invasive treatments of the thyroid (MITT) group. Int J Hyperth 36(1):376–382CrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 2019

Authors and Affiliations

  • F. Magri
    • 1
    • 2
  • S. Chytiris
    • 1
  • M. Molteni
    • 1
    • 2
  • L. Croce
    • 1
    • 3
  • F. Coperchini
    • 1
  • M. Rotondi
    • 1
    • 2
  • R. Fonte
    • 1
  • L. Chiovato
    • 1
    • 2
    Email author
  1. 1.Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Department of Internal Medicine and Therapeutics, Istituti Clinici Scientifici Maugeri IRCCSUniversity of PaviaPaviaItaly
  2. 2.Department of Internal Medicine and TherapeuticsUniversity of PaviaPaviaItaly
  3. 3.PHD Course in Experimental MedicineUniversity of PaviaPaviaItaly

Personalised recommendations