Ultrasound-guided percutaneous laser ablation of unifocal T1N0M0 papillary thyroid microcarcinoma: Preliminary results

Eur Radiol. 2017 Jul;27(7):2934-2940. doi: 10.1007/s00330-016-4610-1. Epub 2016 Nov 16.

Abstract

Objectives: To evaluate the efficacy and safety of percutaneous laser ablation (PLA) for unifocal T1N0M0 papillary thyroid microcarcinoma(PTMC).

Methods: A retrospective study was conducted in 30 patients with single PTMC which was diagnosed by fine-needle aspiration biopsy (FNAB). PLA was performed for proper time to achieve adequate ablation zones. The extent of ablation was assessed by contrast-enhanced ultrasound (CEUS) immediately and 7 days after PLA. Complications were recorded. The size and volume of the ablation area and thyroid hormones were measured, and clinical evaluations were performed at 1, 3, 6 and12 months, and every half year thereafter.

Results: The procedure was well tolerated without serious complications. Of the 30 patients, 29 were treated successfully under local anaesthesia in a single session. Only one incomplete ablation was detected by immediate CEUS after PLA, and a second ablation was performed. At the last follow-up, ten (33.3 %) ablation zones had disappeared, and 20 (66.67 %) ablation zones remained as scar-like lesions. No regrowth of treated tumours, local recurrence or distant metastases were detected.

Conclusions: During the short-term follow-up period, ultrasound-guided PLA appears to be effective and safe for treating solitary T1N0M0 PTMC in selected patients who are ineligible for surgery.

Key points: • Ultrasound is a useful tool in percutaneous laser ablation (PLA). • PLA is safe for treating papillary thyroid microcarcinoma. • PLA is effective for single papillary thyroid microcarcinoma.

Keywords: Laser; Minimally invasive treatment; Papillary thyroid microcarcinoma; Thermal ablation; Ultrasound.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Fine-Needle / methods
  • Carcinoma, Papillary / diagnosis
  • Carcinoma, Papillary / surgery*
  • Female
  • Humans
  • Laser Therapy / methods*
  • Male
  • Middle Aged
  • Neoplasm Staging*
  • Retrospective Studies
  • Surgery, Computer-Assisted / methods*
  • Thyroid Neoplasms / diagnosis
  • Thyroid Neoplasms / surgery*
  • Ultrasonography / methods*
  • Young Adult

Supplementary concepts

  • Papillary Thyroid Microcarcinoma