Cooled tip radiofrequency ablation of benign thyroid nodules: preliminary experience with two different devices

Background: Thyroid nodules are very common in general population. Even if benign, they may require a
treatment in case of symptoms or cosmetic concerns. In the last years, minimally invasive treatments alternative
to surgery have been developed, in particular ultrasound (US) guided radiofrequency ablation (RFA).
Methods: Twenty-four patients (9 males; 15 females; mean age 57.9 years) were treated and divided
in two groups (A and B) according to the RFA needle used (18 gauge needle, AMICA; 17 gauge needle,
COVIDIEN). Nodules and patients characteristics, together with procedural data were registered pretreatment
and at 1-month follow-up. US visibility of the needle, volume of the nodules, symptoms and
cosmetic concerns, complications were registered.
Results: Visibility of the needle was not significantly different in the two groups (P=0.0787). At 1 month
the mean volume of the nodules dropped from 37.1 to 25 mL in group A and from 23.2 to 15.4 mL in group
B; shrinkage rate (36.9% and 39.5%, respectively) was not significantly different (P=0.3137). Symptoms
decreased from 3.1 to 1.4 in group A and from 4 to 1.6 in group B: no significant differences in reductions
were observed (P=0.3305). Cosmetic score decreased from 3.7 to 3.4 in group A and from 3.9 to 3.6 in group
B: no significant differences in reductions were observed (P=0.96). Total complication rate (18.2% in group
A vs. 23.1% in group B) did not showed significant differences (P=0.5049).
Conclusions: The two systems used in our study resulted equivalent in terms of US needle visibility,
efficacy, symptom/cosmetic relief, safety. More patients and a longer follow-up are necessary to confirm our
results.