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Comparison between Radioiodine therapy and single-session Radiofrequency ablation of autonomously functioning thyroid nodules

There is widespread distrust of radio-iodine treatment of thyroid.

Two major problem areas seem prevalent:

The probability of over-treatment resulting in hypothyroidism;

The possibility of side-effects/unintended damage such as where salivary glands are partially destroyed.

The possibility of a treatment which is as effective as radio-iodine but without these problems is very much to be welcomed.

In this report, it is only treatment for nodules that are producing thyroid hormone on their own. I do wonder how effective it would be for other thyroid issues?

Clin Endocrinol (Oxf). 2019 Jan 18. doi: 10.1111/cen.13938. [Epub ahead of print]

Comparison between Radioiodine therapy and single-session Radiofrequency ablation of autonomously functioning thyroid nodules: a retrospective study.

Cervelli R1, Mazzeo S1, Boni G2, Boccuzzi A1, Bianchi F2, Brozzi F2, Santini P2, Vitti P3, Cioni R1, Caramella D1.

Author information

1 Diagnostic and Interventional Radiology - Department of Translational Research and New Technologies in Medicine - University of Pisa.

2 Department of Nuclear medicine, University of Pisa.

3 Endocrine Unit - Department of Clinical and Experimental Medicine, University of Pisa.

Abstract

OBJECTIVE:

To compare the efficacy of Radioiodine (RI) and Radiofrequency ablation (RFA) in the treatment of autonomously functioning thyroid nodules (AFTNs).

END POINTS:

nodule volume reduction (NVR) and thyroid function normalization.

DESIGN, PATIENTS AND MEASUREMENTS:

Twenty-two patients (2:20 M:F; 51.9±13.9 years) affected by 25 AFTNs, treated by RFA were retrospectively compared with 25 patients (8:17 M:F; 57.2±12.8 years) affected by a single AFTN treated by RI. Both group showed analogous characteristics as to age, gender, toxic/pretoxic phase, and pre-treatment nodule volume (calculated by the ellipsoid formula). Thyroid hormone levels and autoimmune thyroid profile were assessed before treatment. A fixed RI activity of 555MGb (15mCi) was administered. RFA was performed with an 18G, single-tipped electrode, by the 'modified moving shot technique'. Thyroid hormones were assessed and the nodule post-treatment volume calculated 12 months after treatment.

RESULTS:

No statistical difference was found between the post-treatment NVR by comparing RI and RFA (p=0.69). The volume reduction rates were 68.4±28.9% and 76.4±16.9% after RI and RFA, respectively. As to the thyroid function, 5/25 patients developed clinical hypothyroidism after RI. After RFA, all the 22 patients silenced their AFTN and normalized the thyroid hormones. Subclinical hypothyroidism was recorded in 2 patients after both RI and RFA. Thus, the functional therapeutic success, defined as the restoration of euthyroidism, was achieved in 18/25 (72%) patients treated by RI and in 20/22 (90.9%) treated by RFA.

CONCLUSIONS:

No statistical difference in NVR was found between RI and RFA. All patients responded to RI but 5/25 were 'over-treated' developing hypothyroidism. RFA was effective in all patients with no case of post-treatment clinical hypothyroidism. No radiation exposure and lower risk of post-treatment hypothyroidism might make RFA the favorite option especially for young patients. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

PMID: 30657603

DOI: 10.1111/cen.13938

ncbi.nlm.nih.gov/pubmed/306...

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Helvella, many thanks for that information, I feel I’m going to need all the back up I can get soon, overactive again! Vbgr

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