HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Tarantino, L. Articles by Parmeggiani, U. Search for Related Content PubMed PubMed Citation Articles by Tarantino, L. Articles by Parmeggiani, U. Social Bookmarking                      What's this?

Percutaneous Ethanol Injection of Hyperfunctioning Thyroid Nodules: Long-Term Follow-Up in 125 Patients

¹ Interventional US Unit, Department of Medicine, S. Giovanni di Dio Hospital, 80059 Torre del Greco (NA), Italy.
² Present address: via montedoro 43 is. B (parco montedoro), 80059 Torre del Greco (NA), Italy.
³ VS. Maria della Pietà Hospital, ASLNA3, Casoria (NA), Italy.
⁴ Division of Surgery, Department of Surgery, Anesthesiology, and Emergency, Faculty of Medicine and Surgery, Second University of Naples, Naples, Italy.

OBJECTIVE. The purpose of this study was to assess the long-term efficacy of percutaneous ethanol injection (PEI) for the treatment of hyperfunctioning thyroid nodules.

MATERIALS AND METHODS. One hundred twenty-five patients (88 women, 37 men; age range, 17–76 years; mean age, 53 years) with 127 hyperfunctioning thyroid nodules (volume, 1.2–90 mL; mean, 10.3 mL) were treated with PEI. There were 1–11 PEI sessions per patient (average, 3.9) performed, with injection of 1–14 mL of ethanol per session (total injected ethanol per patient, 3–108 mL; mean, 14.0 mL). Efficacy of the treatment was assessed with color Doppler sonography; scintigraphy; and free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) assays. Follow-up (9–144 months; median, 60 months) was performed with TSH and color Doppler sonography every 2 months for 6 months and every 6 months thereafter.

RESULTS. Three (2.4%) of 125 patients refused completion of PEI therapy because of pain. Results are reported in 122 patients with 124 nodules. All 122 patients showed posttreatment normal levels of FT3, FT4, and TSH. A complete cure (absent uptake in the nodule and recovery of normal uptake in the thyroid parenchyma) was obtained in 113 (93%) of 122 patients—115 (92.7%) of 124 treated nodules. Residual hyperfunctioning nodular tissue along with decreased thyroid parenchyma uptake (partial cure) was present in nine patients accounting for nine (7.3%) of 124 nodules. Rates of complete cure after PEI were: overall nodules, 115 (92.7%) of 124; nodules 10 mL, 63 (94.0%) of 67; nodules > 10 to 30 mL, 32 (91.4%) of 35; nodules > 30 to 60 mL, 17 (89.5%) of 19; nodules > 60 mL, three (100%) of three. The overall rate of major complications (transient laryngeal nerve damage, two patients; abscess and hematoma, one patient each) was four (3.2%) of 125 patients. Follow-up examinations showed marked shrinkage of 112 treated nodules ranging from 50% to 90% of the pretreatment volume (mean, 66%) and new growth of hyperfunctioning tissue in four patients at color Doppler sonography and scintigraphy at 12, 18, 18, and 48 months' follow-up, respectively. However, all patients remained euthyroid (low or normal TSH and normal FT3 and FT4) during follow-up.

CONCLUSION. PEI of hyperfunctioning thyroid nodules seems to be an effective and safe alternative to traditional treatment. It also appears to be effective in patients with hyperfunctioning thyroid nodules larger than 30 mL.

Keywords: hyperthyroidism • interventional procedures • percutaneous ethanol injection • sonographic guidance • thyroid • thyroid nodules

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?