ROLE OF ULTRASOUND GUIDED RADIOFREQUENCY ABLATION OF BENIGN THYROID NODULES

Abstract

Thyroid nodules are very common, they are found in about 10%–41% of people discovered by means of ultrasound, most nodules are benign, but between 3% and 7% of cases are found to be malignant. Thyroid nodules are described and characterized using ultrasound by describing its size, shape, margin, internal content, echogenicity, calcification, hypoechoic halo, and vascularity. RFA is a minimally invasive technique and an effective alternative to surgery in treatment of benign nonfunctioning, or autonomously functioning nodules, by inducing thermal injury to targeted tissue. Its efficacy can be maximized by complete ablation of the entire tumor margin, to prevent marginal regrowth and to effectively reduce the size of thyroid nodules. Use of the transisthmic approach and moving shot technique is widely used and preferable to completely ablate thyroid nodules, and avoid damaging the surrounding critical structure. Various complications can occur during RFA, yet the complication rate is low. Pain is the most common complication. The knowledge of critical structures around the targeted lesion and especially the dangerous triangle, and possible hazards associated with the technique, is important to minimize the possibility of complications. RFA of benign nonfunctioning nodules shows excellent results in reducing the nodule volume, pressure symptoms, and cosmetic problems. 66 RFA of AFTNs is effective to improve thyroid function, decrease toxic symptoms, decrease dose of antithyroid medication and to reduce the volume of treated nodules.