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- Publisher Website: 10.1007/s00330-023-09620-1
- Scopus: eid_2-s2.0-85152369549
- PMID: 37036479
- WOS: WOS:000966714400002
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Article: Efficacy of single-session radiofrequency ablation (RFA) in rendering euthyroidism for persistent/relapsed Graves’ disease, a pilot study
Title | Efficacy of single-session radiofrequency ablation (RFA) in rendering euthyroidism for persistent/relapsed Graves’ disease, a pilot study |
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Authors | |
Keywords | Graves’ disease Iodine Radiofrequency ablation Thyroidectomy Ultrasonography |
Issue Date | 2023 |
Citation | European Radiology, 2023, v. 33, n. 9, p. 6534-6544 How to Cite? |
Abstract | Objectives: Graves’ disease (GD) is the most common cause of hyperthyroidism. Antithyroid drug (ATD) is often the first-line treatment but > 50% patients suffer a relapse when ATD is discontinued. Surgery or radioiodine remains the current options of definitive treatment in these patients. This pilot study examined the short-term efficacy of single-session thyroid radiofrequency ablation (RFA) as a novel definitive treatment for persistent/relapsed GD. Methods: Consecutive patients with persistent/relapsed GD requiring ATD were considered. Those with a clear surgical indication, either thyroid lobe volume ≥ 20 mL; those who were pregnant or lactating; and those who had any severe medical conditions that would pose extra treatment risks were excluded. Eligible patients received ultrasound-guided RFA of the entire bulk of thyroid gland. Thyroid function tests were monitored bi-monthly. The primary outcome was disease remission rate, defined as a state of biochemical euthyroidism or hypothyroidism without ATD. Secondary outcomes were complication rates. Results: Of the 68 patients considered, 15 (22.1%) patients were eligible. Most were females (93.3%). The median age was 37 (IQR 31–48) years old. The disease remission rates were 79.0% at 6 months and 73.3% at 12 months. Among the 4 patients who relapsed after RFA, three required less ATD dose than before RFA. RFA was well-tolerated in the ambulatory setting. There were no vocal cord palsy, skin burn, hematoma, or thyroid storm after RFA. Conclusions: In well-selected patients, single-session RFA of the thyroid gland may be a potential treatment for patients with persistent/relapsed GD. It is a safe and well-tolerated ambulatory procedure. Key Points: • Radiofrequency ablation of the thyroid gland is an efficacious treatment for persistent/relapsed Graves’ disease in well-selected patients. • Radiofrequency ablation of the thyroid gland for the treatment of persistent/relapsed Graves’ disease is a safe and well-tolerated ambulatory procedure. • Radiofrequency ablation of the thyroid gland may be a potential alternative treatment for well-selected patients with persistent/relapsed GD who do not wish to undergo either thyroidectomy or radioactive iodine or continue antithyroid drugs. |
Persistent Identifier | http://hdl.handle.net/10722/336902 |
ISSN | 2023 Impact Factor: 4.7 2023 SCImago Journal Rankings: 1.656 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Fung, Man Him Matrix | - |
dc.contributor.author | Lang, Brian Hung Hin | - |
dc.date.accessioned | 2024-02-29T06:57:19Z | - |
dc.date.available | 2024-02-29T06:57:19Z | - |
dc.date.issued | 2023 | - |
dc.identifier.citation | European Radiology, 2023, v. 33, n. 9, p. 6534-6544 | - |
dc.identifier.issn | 0938-7994 | - |
dc.identifier.uri | http://hdl.handle.net/10722/336902 | - |
dc.description.abstract | Objectives: Graves’ disease (GD) is the most common cause of hyperthyroidism. Antithyroid drug (ATD) is often the first-line treatment but > 50% patients suffer a relapse when ATD is discontinued. Surgery or radioiodine remains the current options of definitive treatment in these patients. This pilot study examined the short-term efficacy of single-session thyroid radiofrequency ablation (RFA) as a novel definitive treatment for persistent/relapsed GD. Methods: Consecutive patients with persistent/relapsed GD requiring ATD were considered. Those with a clear surgical indication, either thyroid lobe volume ≥ 20 mL; those who were pregnant or lactating; and those who had any severe medical conditions that would pose extra treatment risks were excluded. Eligible patients received ultrasound-guided RFA of the entire bulk of thyroid gland. Thyroid function tests were monitored bi-monthly. The primary outcome was disease remission rate, defined as a state of biochemical euthyroidism or hypothyroidism without ATD. Secondary outcomes were complication rates. Results: Of the 68 patients considered, 15 (22.1%) patients were eligible. Most were females (93.3%). The median age was 37 (IQR 31–48) years old. The disease remission rates were 79.0% at 6 months and 73.3% at 12 months. Among the 4 patients who relapsed after RFA, three required less ATD dose than before RFA. RFA was well-tolerated in the ambulatory setting. There were no vocal cord palsy, skin burn, hematoma, or thyroid storm after RFA. Conclusions: In well-selected patients, single-session RFA of the thyroid gland may be a potential treatment for patients with persistent/relapsed GD. It is a safe and well-tolerated ambulatory procedure. Key Points: • Radiofrequency ablation of the thyroid gland is an efficacious treatment for persistent/relapsed Graves’ disease in well-selected patients. • Radiofrequency ablation of the thyroid gland for the treatment of persistent/relapsed Graves’ disease is a safe and well-tolerated ambulatory procedure. • Radiofrequency ablation of the thyroid gland may be a potential alternative treatment for well-selected patients with persistent/relapsed GD who do not wish to undergo either thyroidectomy or radioactive iodine or continue antithyroid drugs. | - |
dc.language | eng | - |
dc.relation.ispartof | European Radiology | - |
dc.subject | Graves’ disease | - |
dc.subject | Iodine | - |
dc.subject | Radiofrequency ablation | - |
dc.subject | Thyroidectomy | - |
dc.subject | Ultrasonography | - |
dc.title | Efficacy of single-session radiofrequency ablation (RFA) in rendering euthyroidism for persistent/relapsed Graves’ disease, a pilot study | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1007/s00330-023-09620-1 | - |
dc.identifier.pmid | 37036479 | - |
dc.identifier.scopus | eid_2-s2.0-85152369549 | - |
dc.identifier.volume | 33 | - |
dc.identifier.issue | 9 | - |
dc.identifier.spage | 6534 | - |
dc.identifier.epage | 6544 | - |
dc.identifier.eissn | 1432-1084 | - |
dc.identifier.isi | WOS:000966714400002 | - |