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Tesi etd-07182018-125755


Thesis type
Tesi di specializzazione (5 anni)
Author
CERVELLI, ROSA
URN
etd-07182018-125755
Title
Comparison between radioiodine therapy and radiofrequency ablation in single-session treatment of autonomously functioning thyroid nodules.
Struttura
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
RADIODIAGNOSTICA
Commissione
relatore Prof. Caramella, Davide
correlatore Dott. Mazzeo, Salvatore
Parole chiave
  • Radioiodine therapy
  • Radiofrequency Ablation
  • Autonomously functioning thyroid nodule
Data inizio appello
08/08/2018;
Consultabilità
parziale
Data di rilascio
08/08/2021
Riassunto analitico
Abstract<br>Purpose<br>To compare the efficacy of Radioiodine (RI) and Radiofrequency ablation (RFA) in the treatment of autonomously functioning thyroid nodules (AFTNs). End points: nodule volume reduction (NVR) and thyroid function normalization.<br><br>Materials and methods<br>Twenty-two patients (2:20 M:F; 51.9±13.9 years) affected by 25 AFTN and treated by RFA were compered with 25 patients (8:17 M:F; 57.2±12.8 years) affected by a single AFTN treated by RI. The series of patients included in each group showed analogous characteristics as to age, gender, toxic/pretoxic phase, and pre-treatment nodule volume. The thyroid hormone levels and the autoimmune thyroid profile were assessed before the treatment. The RI dose administered was 15 mCi; RFA was performed with an 18G, single-tipped electrode, by applying the ‘modified moving shot technique’. Twelve months after treatment, the thyroid hormones were assessed again and the nodule post-treatment volume was calculated.<br><br>Results<br>No statistical difference was found between the post-treatment nodule volumes by comparing RI and RFA (p=0.69). The volume reduction rates were 68.4±28.9% and 76.4±16.9% after RI and RFA, respectively. As to the thyroid function, after RI, 5/25 patients developed clinical hypothyroidism. After RFA, all the 22 patients silenced their AFTN and normalized the thyroid hormones. <br><br>Conclusions<br>No statistical difference in NVR was found between RI and RFA. All patients responded to RI but 5/25 were ‘over-treated’ developing hypothyroidism (20%). RFA was effective in all patients with no case of post-treatment clinical hypothyroidism. Thus, the absence of radiation exposure and the lower risk of post-treatment hypothyroidism made RFA the favorite option especially for young patients. <br><br>
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