Comparative study evaluating the efficiency of cooled and uncooled single-treatment MWA in thyroid nodules after a 3-month follow up

Oscar Maximilian Mader; Nadine Farivar Tanha; Alexander Mader; Christian Happel; Yücel Korkusuz; Frank Grünwald

doi:10.1016/j.ejro.2017.01.004

Comparative study evaluating the efficiency of cooled and uncooled single-treatment MWA in thyroid nodules after a 3-month follow up

Eur J Radiol Open. 2017 Feb 5;4:4-8. doi: 10.1016/j.ejro.2017.01.004. eCollection 2017.

Authors

Oscar Maximilian Mader¹, Nadine Farivar Tanha¹, Alexander Mader¹, Christian Happel², Yücel Korkusuz¹, Frank Grünwald²

Affiliations

¹ Department of Nuclear Medicine, University Hospital Frankfurt, Germany.
² Department of Nuclear Medicine, University Hospital Frankfurt, Germany; German Centre for Thermoablation of Thyroid Nodules, University Hospital, Frankfurt, Germany.

Abstract

Objective: The aim of this study was to evaluate and compare the efficacy of single-treatment cooled and uncooled microwave ablation in thyroid nodules.

Methods: Eighteen patients (11 women) with an average age of 62 years (range: 41-80) with 18 cold, mainly solid or solid thyroid nodules were treated with cooled or uncooled microwave ablation. Pain during the treatment was measured on a 10-point score. Side effects revealed by ultrasound or patients' complaints were documented. Laboratory data was evaluated before, 24 h and three months after MWA. Nodule volumes were measured before and three months after MWA.

Results: Cooled MWA was better tolerated than uncooled MWA. A significant reduction of thyroid nodule volume was observed in all cases. The reduction after cMWA was higher (40%) than after uMWA (29%). Pain intensity during cMWA was significantly lower than after uMWA. CMWA and uMWA led to a significant decrease of nodule blood circulation and echogenicity and to a significant increase of nodule elasticity. Thyroid function remained intact in all cases. The energy (kJ/s) administered into the nodules in relation to the ablation time during cMWA was higher than during uMWA.

Conclusions: CMWA leads to a slightly higher but statistically not significant nodule volume reduction than uMWA. Patient comfort during cMWA is higher than during uMWA. The risk of unintended side effects is less in cMWA. A Single-treatment provides sufficient results.

Keywords: IC, internally cooled shaft antenna; MWA, microwave ablatio; Microwave ablation; NIC, non-internally; PEIT, Percutaneous ethanol injection; Pain scale MWA; RFA, radiofrequency ablation; RIT, radioiodine therapy cooled shaft antenna; Single-treatment; US, ultrasound; Volume reduction of thyroid nodules; cMWA, cooled microwave ablation; uMWA, uncooled microwave ablation.