Boris Brkljacic MD, PhD, Presenter: Nothing to Disclose

Igor Cikara MD, Abstract Co-Author: Nothing to Disclose

Diana Delic-Brkljacic MD, Abstract Co-Author: Nothing to Disclose

Velimir Bozikov MD, Abstract Co-Author: Nothing to Disclose

To evaluate short term outcome and long-term (> 5 years follow-up) results of US guided percutaneous ethanol injection (PEI) in the treatment of thyroid autonomous and toxic nodules

US guided PEI was performed in 73 patients (68 female, 5 male) with thyroid autonomous (26) and toxic adenomas (47) between September 1996 and August 2006. Nodular volumes were 2.5-38 ccm (mean 20.8). 96% ethanol was used, with total volumes injected (4-57 ml) of 1.5 times thyroid nodule volume. Procedure was performed without anaesthesia, usually twice a weak until the sufficient volume of ethanol was administered. Three to six months after the completion of PEI, the initial evaluation of the outcome (complete recovery, partial recovery,or failure) was performed by scintigraphy, US and serum hormonal status (T3,T4,TSH). After that hormonal status was assessed regulary annualy or biannualy, as well as US, and scintigraphy was performed at least once. In 30 patients regular annual or biannual follow-up was longer than 5 years (5-10 years).

Technically successful PEI was performed in 69/73 pts (94.5%). Volume reduction > 50% was noted in 64/69 pts (92.8%). Initial evaluation showed the complete recovery in 42/69 pts (60.9%), partial recovery in 20/69 pts (29%) and failure in 7/69(10.1%). Failure was noted in four patients with toxic adenomas and three pts with toxic nodular goiters. In 30 patients regular annual or biannual follow-up was longer than 5 years (5-10 years). Long-term (>5 years) follow up in 30 pts showed four cases of recurrence of hyperthyroidism (13.3%), after two, three, four and six years, with scintigraphically hot nodules in treated (2) and non-treated (2) parts of thyroid gland. All were successfully retreated with PEI. 26/30 patients were euthyroid (86.7%), with no new hot nodules visible on scintigraphy. There were no permanent complications observed.

US-guided PEI is efficient method for treatment of thyroid autonomous and toxic nodules.

US guided PEI is very efficient alternative to surgery and radioidine therapy for the treatment of thyroid toxic and autonomous nodules with no long-term complications observed.

Brkljacic, B, Cikara, I, Delic-Brkljacic, D, Bozikov, V, Results and Long-term Follow-up of Ultrasound-guided Percutaneous Ethanol Injection Treatment of Autonomous and Toxic Nodules of the Thyroid Gland.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5001890.html