Microwave ablation for benign thyroid nodules with cosmetic problems and related factors for post-ablative complete relief: a two-center retrospective study

Xiao-Long Li; Zi-Tong Chen; Yun-Jie Jin; Ben-Hua Xu; Ya-Dan Xu; Qiong Cao; Xiao-Wan Bo; Jie-Xian Wen; Zheng-Biao Ji; Pei-Li Fan; Hui-Xiong Xu

doi:10.1007/s12020-024-04103-9

Microwave ablation for benign thyroid nodules with cosmetic problems and related factors for post-ablative complete relief: a two-center retrospective study

Endocrine. 2024 Nov 28. doi: 10.1007/s12020-024-04103-9. Online ahead of print.

Authors

Xiao-Long Li^#¹, Zi-Tong Chen^#¹, Yun-Jie Jin¹, Ben-Hua Xu¹, Ya-Dan Xu¹, Qiong Cao¹, Xiao-Wan Bo², Jie-Xian Wen¹, Zheng-Biao Ji¹, Pei-Li Fan³, Hui-Xiong Xu⁴

Affiliations

¹ Department of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
² Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, 200072, China.
³ Department of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. fan.peili@zs-hospital.sh.cn.
⁴ Department of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. xuhuixiong@126.com.

^# Contributed equally.

PMID: 39609368
DOI: 10.1007/s12020-024-04103-9

Abstract

Purpose: To investigate the efficacy of ultrasound (US)-guided percutaneous MWA for benign thyroid nodules with cosmetic problems and identify related factors contributing to post-ablative complete relief (CR).

Methods: This retrospective study reviewed the efficacy of MWA in treating thyroid nodules in patients with cosmetic problems who underwent MWA from January 2021 to May 2023. Patients were followed up at 1, 3, and 6 months after MWA. Pre-treatment clinical characteristics, conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) features were analyzed to explore their correlation with cosmetic improvement, defined as a cosmetic score of 1 or 2 at the 6-month follow-up. Univariable and multivariable regression analyses were carried out to identify variables associated with CR, and the related nomogram was established. Calibration curve and decision curve analysis were used to evaluate the nomogram performance.

Results: 118 patients with 118 nodules were included in the study. During the 1-, 3- and 6-month follow-up, the mean volume reduction ratios (VRR) were 2%, 36% and 73%, respectively. 22.0% (26/118), 57.6% (68/118), and 89.8% (106/118) patients achieved CR of cosmetic problems at 1, 3, and 6 months after MWA. In multivariable analysis, three variables (i.e., non-hashimoto's thyroiditis [HT] [OR: 90.036, P = 0.001], nodule location not close to danger triangle area [OR: 66.812, P = 0.003], early hyperenhancement on CEUS [OR: 0.035, P = 0.024]) were found to be closely associated with CR of cosmetic problems at 6 months after MWA. A nomogram model was constructed, and its accuracy was well validated (i.e., C-index = 0.914).

Conclusion: MWA was effective and safe for treating benign thyroid nodules with cosmetic problems. Non-HT, nodule location not close to danger triangle area, and early hyperenhancement on CEUS were associated with CR of cosmetic problems after MWA.

Keywords: Complete relief; Cosmetic problems; Microwave ablation; Nomogram; Thyroid nodule.