Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2018) 56 GP265 | DOI: 10.1530/endoabs.56.GP265

1Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy; 2Department of Radiology, ‘S. M.Goretti’ Hospital, Latina, Italy; 3Workers Compensation Authority (INAIL) – Research Area, Rome, Italy; 4Thyroid Disease Center, ‘S. M. Goretti’ Hospital, Latina, Italy.

Background: Radiofrequency ablation(RFA) has been advocated as an alternative to radioiodine and/or surgery for the treatment of autonomously functioning benign thyroid nodule (AFTN). However, only a few studies have investigated the efficacy of RFA on AFTN. Furthermore, these studies are characterized by several biases about patient selection, number of RFA treatments, short clinical and radiographic follow-up. A recent prospective 12-month study has demonstrated that one single RFA treatment was able to withdraw anti-thyroid medication in 50% of the hyperthyroid patients who remained euthyroid afterwards. However, no defined pre-treatment factors able to predict the response to the RFA in Treating AFTN have been clearly identified.

Aim: To evaluate the success rate of RFA to restore euthyroidism in a cohort of adult patients with small solitary AFTN compared to medium-larger ones. Secondary end-points included volume reduction and conversion rate from hot to cold nodules at thyroid scintiscan.

Methods: This was a 24-month prospective monocentric open parallel-group trial. Twenty-nine patients with AFTN were divided into two groups based on thyroid volume: 15 patients with small nodules (<12 ml) in group A and 14 patients with medium nodules (>12 ml) in group B. All patients underwent a single session of RFA and were clinically, biochemically and morphologically evaluated at baseline and at 1, 6, 12 and 24 months after treatment. At the end of the study period, a thyroid scintiscan was performed.

Results: After RFA, there was a larger volume reduction in group A compared to group B (P<0.001 for each follow-up point). After RFA, there was greater nodule volume reduction in group A compared with group B (P<0.001 for each follow-up point). In group A, there was a greater increase in TSH levels than in group B at 6 (P=0.01), 12 (P=0.005) and 24 months (P<0.001). At 24 months, the rate of responders (subjects with euthyroidsm without metimazole) was greater in group A than in group B (86 vs 45%; P<0.001). At 24 months in group A, 86% of nodules converted from hot to cold compared with 18% in group B (P<0.001).

Conclusions: This study shows that a single RFA was effective in restoring euthyroidsm in patients with AFTN, mainly in small nodules. Nodule volume seems to be a significant Predictive Factor of Efficacy of RFA in Treating AFTN. Larger prospective studies are needed to confirm our findings.

Volume 56

20th European Congress of Endocrinology

Barcelona, Spain
19 May 2018 - 22 May 2018

European Society of Endocrinology 

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