Percutaneous thermal microwave ablation of thyroid nodules

H. Korkusuz; C. Happel; K. Heck; H. Ackermann; F. Grünwald

doi:10.3413/Nukmed-0631-13-10

Nuklearmedizin - NuclearMedicine, Inhaltsverzeichnis

Nuklearmedizin 2014; 53(04): 123-130
DOI: 10.3413/Nukmed-0631-13-10

Original article

Schattauer GmbH

Percutaneous thermal microwave ablation of thyroid nodules

Preparation, feasibility, efficiencyPerkutane thermische Mikrowellenablation von SchilddrüsenknotenPräparation, Machbarkeit, Effizienz

H. Korkusuz

¹Department of Nuclear Medicine, University Medical Centre Frankfurt, Germany

,

C. Happel

¹Department of Nuclear Medicine, University Medical Centre Frankfurt, Germany

,

K. Heck

¹Department of Nuclear Medicine, University Medical Centre Frankfurt, Germany

,

H. Ackermann

²Institute of Biostatistic and Mathematic Modelling, University Medical Centre Frankfurt, Germany

,

F. Grünwald

¹Department of Nuclear Medicine, University Medical Centre Frankfurt, Germany

› Institutsangaben

Abstract

Summary

Microwave ablation (MWA) is a new minimal invasive method for thermal ablation of benign thyroid nodules. In contrast to well-established radiofrequency ablation (RFA), MWA offers several advantages with similarly successful results. There has not been any use of functional imaging with ^99mTc-per- technetate and ^99mTc-MIBI-scans as a mere qualitative analysis of this imaging in the field of MWA in Europe until now. The aim of this study has been to demonstrate the feasibility of MWA as well as the applicability of functional imaging to verify effectiveness with a centerspecific score. Patients, methods: 11 patients (5 women, 6 men, average age 62.3 years) with 18 benign thyroid nodules were treated. MWA was operated under local anesthesia with a system working in a wavelength field of 902 to 928 MHz (Avecure MWG881, MedWaves, Inc. San Diego, CA). Pre- and postablative scans were controlled by two specialists in nuclear medicine with longtime work experience. Results: A center specific functional imaging score (CSFIS) was defined, a decrease of 1.4 points at an average was noticeable (range 1-3 points). In 66.7% (n = 12) of all nodules the score decreased by 1 point, 27.8% (n = 5) by 2 points and 5.6% (n = 1) by 3 points. The treatment was well tolerated and no severe complications were observed. Conclusion: The preliminary data suggests that MWA is an effective method to treat benign thyroid nodules. Functional imaging is a promising technique for early verification of effectiveness of thermal ablation.

Zusammenfassung

Die Mikrowellenablation (MWA) ist eine neue minimal-invasive Methode im Bereich der Thermoablation benigner Schilddrüsenknoten. Im Gegensatz zur etablierten Radiofrequenz- ablation (RFA) bietet die MWA diverse Vorteile bei bisher ähnlich erfolgreichen Ergebnissen. In Europa wurde bisher keine Studie zu diesem Thema durchgeführt, in dieser Studie wurde erstmals auch funktionelle Bildgebung durch ^99mTc-Pertechnetat und ^99mTc-MIBI zur Überprüfung eingesetzt. Ziel dieser Studie ist die Darstellung der Durchführbarkeit der MWA sowie der Einsetzbarkeit funktioneller Bildgebung zur Effizienz-Prüfung. Patienten, Material, Methoden: Insgesamt wurden 11 Patienten (5 Frauen, 6 Männer, Durchschnittsalter 62,3 Jahre) mit 18 benignen Schilddrüsenknoten behandelt. Die MWA wurde unter Lokalanästhesie durchgeführt. Es wurde ein System, welches im Wellenlängenbereich von 902 bis 928 MHz arbeitet (Avecure MWG881, MedWaves, Inc. San Diego, CA), eingesetzt. Eine Kontrolle der prä- und postablativen Szintigramme wurde von zwei Nuklearmedizinern mit langjähriger Berufserfahrung durchgeführt. Ergebnisse: Ein zuvor definierter Center Specific Functional Imaging Score (CSFIS) verringerte sich im Mittel um 1,4 Punkte (Range 1-3 Punkte). In 66,7 % (n = 12) der Fälle verringerte sich der Score um 1 Punkt, in 27,8% (n = 5) um 2 Punkte und in 5,6% (n = 1) der Fälle um 3 Punkte. Die Behandlung wurde von allen Patienten gut toleriert, es traten keine schweren Komplikationen auf. Schlussfolgerung: Unsere Daten lassen darauf schließen, dass MWA eine effektive Technik zur Behandlung von benignen Schilddrüsenknoten darstellt. Die funktionelle Bildgebung kann zur frühzeitigen Überprüfung der Effektivität der Thermoablation eingesetzt werden.

Keywords

Thyroid nodules - thermal ablation - microwave ablation - ^99mTc-pertechnetate scintigraphy - ^99mTc-MIBI scintigraphy

Schlüsselwörter

Schilddrüsenknoten - Thermoablation - Mikrowellenablation - ^99mTc-Pertechnetat-Szintigraphie - ^99mTc-MIBI-Szintigraphie

Volltext

Referenzen

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