Artery-first microwave ablation in the treatment of benign thyroid nodules

BACKGROUNDMicrowave ablation (MWA) is a safe and effective procedure for the treatment of benign thyroid nodules. The MWA causes progressive nodule shrinkage as well as the improvement of the symptoms and cosmesis. Some basic techniques have been described to further increase the efficacy and safety of this procedure. OBJECTIVESTo evaluate the efficacy of artery-first MWA as an advanced technique in the treatment of benign thyroid nodules. MATERIAL AND METHODSA total of 40 patients treated with MWA were enrolled in the study. Nineteen patients who underwent artery-first MWA were selected for the study group and 21 patients who underwent MWA alone were included in the control group. Nodular vascularization was assessed using a new Doppler technique (Superb Microvascular Imaging (SMI)) and characterized using a 3-point scale. All patients were evaluated in terms of volume, symptoms, cosmetic scores, and laboratory findings before the procedure as well as 3 months (early-term follow-up) and 6 months (intermediate-term follow-up) after the procedure. RESULTSBoth groups were comparable with respect to the baseline volume (p = 0.135). Nevertheless, the nodular volume reduction rate was significantly different at 3-month follow-up (study group: 56.97 ±11.39%, control group: 47.07 ±7.93%; p = 0.003) and 6-month follow-up (study group: 78.38 ±8.91%, control group: 69.54 ±9.41%; p = 0.004). In both groups, cosmetic and symptom scores decreased progressively (p < 0.005) and there were no major complications. Thyroid hormones and antibodies were within normal limits before the procedure, and no significant change was observed during follow-up after the ablation. CONCLUSIONSThe artery-first MWA technique can be used in the treatment of benign thyroid nodules as a method of increasing the effectiveness of MWA.