Nodule size as predictive factor of efficacy of radiofrequency ablation in treating autonomously functioning thyroid nodules.

CONTEXT: No defined pre-treatment factors are able to predict the response to radiofrequency ablation (RFA) of an autonomously functioning thyroid nodule (AFTN). OBJECTIVE: Primary endpoint was to evaluate the success rate of RFA to restore euthyroidism in a cohort of adult patients with small solitary AFTN compared with medium-sized nodules. Secondary endpoints included nodule volume reduction and rate of conversion from hot nodules to cold using scintiscan. METHODS: This was a 24-month prospective monocentric open parallel-group trial. Twenty-nine patients with AFTN were divided into two groups based on thyroid volume: 15 patients with small nodules (<12 mL) in group A and 14 patients with medium nodules (>12 mL) in group B. All patients underwent a single session of RFA and were clinically, biochemically, and morphologically evaluated at baseline and at 1, 6, 12 and 24 months after treatment. RESULTS: After RFA, there was greater nodule volume reduction in group A compared with group B (p < 0.001 for each follow-up point). In group A, there was a greater increase in TSH levels than in group B at 6 (p = 0.01), 12 (p = 0.005), and 24 months (p < 0.001). At 24 months, the rate of responders was greater in group A than in group B (86 vs. 45%; p < 0.001). In group A, 86% of nodules converted from hot to cold compared with 18% in group B (p < 0.001). CONCLUSIONS: A single session of RFA was effective in restoring euthyroidism in patients with small AFTNs. Nodule volume seems to be a significant predictive factor of the efficacy of RFA in treating AFTN.

[Organization of the methods of early diagnosis and surgical tactics in treatment of nodular thyroid diseases in flying personnel]. / Optimizatsiia metodov rannei diagnostiki i khirurgicheskoi taktiki pri uzlovykh zabolevaniiakh shchitovidnoi zhelezy u letnogo sostava.

Complex analysis of the methods of early diagnostics and tactics of surgery treatment of 340 professional flyers with various forms of nodal thyroid diseases in the 5-yr period (1996-2002) showed effectiveness of a specialized diagnostic program including USI-controlled biopsy, in reliable estimate of structural changes of nodal thyroid formations already at early phases of disease in the majority of patients (83.2%). Organ-preserving and economical operations for removal of benign thyroid knottings led to recovery and professional rehabilitation of 90.3% of the patient-pilots.