Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Radiofrequency versus Ethanol Ablation for Treating Predominantly Cystic Thyroid Nodules: A Randomized Clinical Trial

  • Baek, Jung Hwan (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Ha, Eun Ju (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Choi, Young Jun (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Sung, Jin Yong (Department of Radiology, Thyroid Center, Daerim St. Mary's Hospital) ;
  • Kim, Jae Kyun (Department of Radiology, Chung-Ang University College of Medicine) ;
  • Shong, Young Kee (Department of Endocrinology and Metabolism, University of Ulsan College of Medicine, Asan Medical Center)
  • Received : 2015.02.08
  • Accepted : 2015.07.21
  • Published : 2015.11.01
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Abstract

Objective: To compare single-session radiofrequency ablation (RFA) and ethanol ablation (EA) for treating predominantly cystic thyroid nodules (PCTNs). Materials and Methods: This single-blind, randomized trial was approved by the Institutional Review Board of two centers and informed consent was obtained from all patients before enrollment. Fifty patients with a single PCTN (cystic portion less than 90% and greater than 50%) were randomly assigned to be treated by either RFA (25 patients) or EA (25 patients) at two hospitals. The primary outcome was the tumor volume reduction ratio (%) at the six-month follow-up and the superiority margin was set at 13% (RFA minus EA). Analysis was performed primarily in an intention-to-treat manner. The secondary outcomes were the therapeutic success rate, improvement of symptomatic and cosmetic problems, and the number of major complications. Results: The mean volume reduction was $87.5{\pm}11.5%$ for RFA (n = 22) and $82.4{\pm}28.6%$ for EA (n = 24) (p = 0.710; mean difference [95% confidence interval], 5.1% [-8.0 to 18.2]), indicating no significant difference. Regarding the secondary outcomes, therapeutic success (p = 0.490), mean symptom (p = 0.205) and cosmetic scores (p = 0.710) showed no difference. There were no major complications in either group (p > 0.99). Conclusion: The therapeutic efficacy of RFA is not superior to that of EA; therefore, EA might be preferable as the first-line treatment for PCTNs.

Keywords

References

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