Percutaneous ethanol injection efficacy in benign thyroid nodules: a descriptive retrospective study

ABSTRACT

Background: In benign nodular thyroid diseases, percutaneous ethanol injection (PEI) has been introduced as an alternative to surgery for more than 10 years. Previous studies confirmed the safety and efficacy of PEI in reducing the size of thyroid nodules, including cystic thyroid. PEI can be performed as an out-patient procedure. Objective: To evaluate the efficacy and safety of PEI treatment for reducing the size of benign thyroid nodules. Material and methods: Descriptive retrospective study was made for patients with non-toxic thyroid nodules treated by PEI at Theptarin Hospital (Bangkok, Thailand) during a five year period (Jan 2002 and Dec 2006). The volume of nodules was measured using ultrasound technique before and after PEI treatment. Any complications were also recorded. In the present analysis, the nodules were classified into four groups solid, cystic, mixed solid-cystic nodules, and multinodular goiters. Results: Of the 167 treated nodules in the study, initial nodule volume was 10.14 ± 12.32 mL, median number of injections was 5 times with total ethanol volume injected 0.99 ± 0.54 mL per mL nodule volume. Percentage volume reduction was 66.67 ± 32.19% at the median time of 14 months follow-up. Overall, 80% of treated nodules achieved ≥ 50% volume reduction. The mean volume reduction in this group was 79.61%. In the subgroup of solid thyroid nodule (65 nodules), the mean volume reduction was 58.73 ± 35.33%. In the subgroup of cystic thyroid (8 nodules), the mean volume reduction was 92.38 ± 6.57%. In the subgroup of mixed solid-cystic nodule (44 nodules), the mean volume reduction was 67.35 ± 35.18%. In the subgroup of multinodular goiters (50 nodules), the mean volume reduction was 72.27 ± 23.76%. Only two patients developed temporary vocal cord paresis. No permanent or serious complications were experienced. Conclusion: PEI proved to be a safe and effective therapeutic procedure for patients with benign thyroid nodules. Recurrent thyroid cysts could be also managed with this treatment.