Thyroid nodules are a common clinical condition. With the use of high-resolution ultrasound, the detection rate of thyroid nodules in the population is as high as 20-76%, and the detection rate of thyroid cancer in nodules is 5-15%. In 2013, the number of new thyroid cancer patients in the United States was as high as 60,220, and the 2014 Beijing Health White Paper report suggested that thyroid cancer has increased by nearly 400% in 10 years. With the high prevalence of thyroid nodular disease, various minimally invasive treatments for thyroid nodules have emerged as the medical paradigm and patient treatment needs have changed. Research progress The successful experience of Dupuy’s radiofrequency ablation for recurrent thyroid cancer in 2001 opened a new horizon of in situ inactivation of thyroid disease, followed by the emergence of literature on the clinical application of radiofrequency ablation for benign thyroid nodules.
Woo Kyoung Jeong et al. reported that radiofrequency ablation treated 236 benign thyroid nodules.
In 27.81% of benign thyroid nodules treated with radiofrequency ablation, the nodules disappeared completely and 91.06% of nodules were reduced in size by more than 50%.
Young-Sun Kim et al. reported that radiofrequency treatment of 35 benign nodules in 30 patients with normal thyroid function was followed up for 2
Young-Sun Kim et al. reported that radiofrequency treatment of 35 benign nodules in 30 patients with normal thyroid function resulted in a 36.2%±27.4% volume reduction at about 3 months after treatment, and 11.8%±10.9% of the original size at 12-24 months, and the treatment effect of cystic and mixed nodules was significantly better than that of solid nodules, and the status of blood supply to the nodules did not affect the treatment effect.
Feng et al. reported an initial attempt to apply microwave ablation to treat patients with thyroid nodular lesions. Our team reported clinical ablation of 222 benign thyroid nodules treated with microwave ablation, and all nodules achieved complete inactivation, with an effective follow-up of 258 nodules at 6 months after ablation. 78 nodules disappeared
Among them, 209 nodules had a volume reduction rate of more than 50% and 78 nodules disappeared. In ablative treatment of thyroid malignancies, ablative procedures including alcohol, radiofrequency and laser have been widely used in the treatment of recurrent and metastatic papillary thyroid carcinoma.
E reported laser ablation in the treatment of metastatic thyroid cancer , 2013 Valcavi
R reported experience with laser ablation of papillary thyroid carcinoma, where complete inactivation was achieved for microscopic papillary thyroid carcinoma. In 2014, our team also reported the initial study of microwave ablation for microscopic thyroid cancer, which achieved complete inactivation. Expansion of application scope After more than 10 years of research and development, the application scope of thyroid ablation is expanding. Microwave ablation therapy is also widely used for (1) benign thyroid nodules: thyroid adenoma, nodular goiter, recurrent benign tumor nodules, especially for patients with recurrence after open surgery and patients with surgical difficulties
(2) Malignant thyroid nodules: microscopic thyroid cancer without lymph node metastasis, recurrent thyroid cancer, postoperative lymph node metastasis, palliative treatment of thyroid cancer that cannot be surgically resected, etc.
(3) Diffuse thyroid lesions: hyperthyroidism, simple goiter, Hashimoto’s thyroiditis with enlargement, etc., for which internal treatment is ineffective.
(4) parathyroid adenoma (hyperparathyroidism) (5) isolated ectopic thyroid with tumor or enlargement, etc., to improve symptoms and preserve function. Based on the strict mastering of indications, standardization of treatment technology, medical practice and observation and research on the efficacy of ablation treatment for various thyroid diseases, we believe that thyroid thermal ablation technology will be accepted by more and more patients and become the main treatment for thyroid nodular diseases. The main treatment for thyroid nodular diseases.