Ultrasound guided ethanol ablation of solitary thyroid nodule

Abstract

Thyroid nodules are very common in adults, found in 4–8% by palpation, in 10–41% by ultrasonography (US), and in 50% by pathologic examination at autopsy most nodules are benign, with less than 5% of them being malignant.

Solitary thyroid nodule is defined as discrete mass, greater than or equal to 1 cm in diameter which occur in up to 4% of the population and are most often found in patients 30 to 50 years of age

Surgery and radioiodine therapy have been the mainstay of therapy in the compressive thyroid nodules, but surgical complications have been reported in around 7–10% of cases as well as repeat surgery in the central or lateral compartments of the neck may be difficult because previous neck dissection may be associated with high rates of morbidity.

The non-invasive and percutaneous methods like Ethanol ablation and Radiofrequency ablation are good alternatives to benign solid thyroid nodules, especially in patients refusing surgery and those with cosmetic problems.

EA is effective in treatment of benign cystic thyroid nodules, but is less effective when used to treat benign solid thyroid nodules.

–Preprocedural US examination should be performed to evaluate thyroid nodules and to plan EA ablation:  Size  Volume calculated by the following equation: V = πabc / 6, where V is volume, a the largest diameter and b and c the other two per pendicular diameters.  Characteristics of the nodules  Composition  Vascularity  Presence of abnormal lymph nodes in the neck  Relationship between the target nodule and critical neck structures