Ultrasound-Guided Percutaneous Microwave Ablation for Solid Benign Thyroid Nodules: Comparison of MWA versus Control Group

Wenjun Wu, Xiaohua Gong, Qi Zhou, Xiong Chen, Xiaojun Chen, Wenjun Wu, Xiaohua Gong, Qi Zhou, Xiong Chen, Xiaojun Chen

Abstract

Background: The aim of this research is to investigate the feasibility of percutaneous ultrasound-guided microwave ablation (MWA) for benign solid thyroid nodules.

Methods: Ultrasound-guided percutaneous microwave ablation was performed for 90 benign solid thyroid nodules in 75 patients. The volume changes of the nodules were evaluated before and after microwave ablation, and the cosmetic grading and clinical symptoms were assessed as well.

Results: The volume of all the 90 benign thyroid nodules obviously decreased after microwave ablation at 3-, 6-, 9-, and 12-month follow-ups (p < 0.01), while that of the control group increased at the follow-up of 12 months (p < 0.01). The volume reduction rate (VRR) at 3-, 6-, 9-, and 12-month follow-ups was 55.98%, 69.31%, 76.65%, and 84.67% in the MWA group, respectively. The cosmetic problems and clinical symptoms were also improved in the MWA group. All the patients are well tolerated to the procedure. Hoarseness occurred in 2 cases (2.7%) and Horner syndrome in 1 case (1.3%), and 1 patient (1.3%) developed slight burn on cervical skin.

Conclusions: Ultrasound-guided percutaneous microwave ablation is a practical method for treating benign solid thyroid nodules, and the complications were acceptable. The trial is registered with clinicaltrials.gov with the registration number NCT03057925.

Figures

Figure 1
Figure 1
A 21-year-old female had a solid nodule in the left lobe of her thyroid gland. (a) The transverse of US examination showed a mainly solid nodule (arrow) which caused cosmetic problem in the superficial layer, and the volume of index nodule was approximately 5.40 ml (2.72 × 1.56 × 2.43 cm). (b) The long axis of index nodule. (c) At 1-month follow-up, US examination showed a little reduction in volume, and the volume was approximately 4.79 ml. (d) Three months after microwave ablation, the volume of the nodule significantly decreased to 3.75 ml. (e) Six months after the procedure, the index nodule shrunk to a volume of 0.96 ml. (f) At 1-year follow-up, the volume of the nodule greatly decreased to 0.08 ml, the VRR was 98.51%, and cosmetic grade significantly improved.
Figure 2
Figure 2
Comparison of the mean volume reduction rate (VRR) of the nodules at baseline (time of microwave ablation) and at follow-up after treatment. The VRR at 3-, 6-, 9-, and 12-month follow-ups was 55.98%, 69.31%, 76.65%, and 84.67% in the MWA group, respectively, while the VRR at 3-, 6-, 9-, and 12-month follow-up in the control group was 2.07%, −13.03%, −16.67%, and −24.53%, respectively.
Figure 3
Figure 3
Positive correlation between ablation time and index nodule volume. Y = 0.011x + 2.12; r2 = 0.472; p < 0.001.

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