Predictor Analysis in Radiofrequency Ablation of Benign Thyroid Nodules: A Single Center Experience

Purpose: To confirm the efficacy of ultrasound (US) guided radiofrequency ablation (RFA) in treatment of benign thyroid nodules, we evaluated as primary outcome the technical efficacy and clinical success in a single center dataset. The secondary outcome was to find a correlation between nodules’ pre-treatment features and volume reduction rate (VRR)  75% at 12 months after RFA and during follow-up period. Methods: This retrospective study included 119 consecutive patients (99 females, 20 males, 51.514.4 years) with benign thyroid nodules treated in our hospital between October 2014 and December 2018 with a mean follow-up of 26.8 months (range 3 - 48). Clinical and US features before and after RFA were evaluated by a US examination at 1, 3, 6, 12 months and annually thereafter up to 48 months. Results: The median pre-treatment volume was 22.4 mL; after RFA we observed a statistically significant volume reduction from the first month (11.7 ml) to the last follow-up (p 22.4 mL (HR 0.54, p 0.036) were found independent positive and negative predictors of VRR 75% respectively. One-month post RFA VRR 50% represented the best positive predictor of technical success. Conclusions: This study confirmed the efficacy of RFA in treatment of benign thyroid nodules. In particular we show that by selecting macrocystic nodules smaller than 22.4 mL better long-term response can be achieved, which is predicted by an early shrinkage of the nodule.