Efficacy and safety of percutaneous ultrasound-guided thermal ablation in the treatment of cervical metastatic lymph nodes from papillary thyroid carcinoma

Article type: Research Article

Authors: Zhang, Shen^{a; b; c; 1} | Liu, Yunyun^{b; c; 1} | Zhou, Bangguo^{b; c} | Xu, Huixiong^{d; *}

Affiliations: [a] Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People’s Hospital, Nanjing Medical University, Shanghai, China | [b] Department of Medical Ultrasound, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China | [c] Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China | [d] Department of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan University, Shanghai, China

Correspondence: [*] Corresponding author: Huixiong Xu, PhD. E-mail: xuhuixiong2022@126.com.

Note: [1] Shen Zhang and Yunyun Liu contributed equally to this work.

Abstract: OBJECTIVE:To evaluate the efficacy and safety of percutaneous ultrasound-guided thermal ablation in the treatment of cervical metastatic lymph nodes (LNs) from papillary thyroid carcinoma (PTC). MATERIALS AND METHODS:A total of 77 patients with 79 LNs ablated by microwave ablation (MWA) or radiofrequency ablation (RFA) between September 2018 and October 2022 were enrolled in this study. After treatment, patients were followed up with measurement of diameters of LNs and serum thyroglobulin (s-Tg) at 1, 3, 6, and 12 months and annually thereafter. The paired t-test was used to compare the changes of s-Tg level, diameters of LNs before and after ablation. RESULTS:There were no serious complications related to ablation while one case of incomplete ablation in MWA was found during follow-up. The mean longest and shortest diameter of the ablated LNs reduced from 11.6 ± 4.3 mm to 5.0 ± 4.1 mm (p < 0.001), and from 6.1 ± 1.9 mm to 3.0 ± 2.5 mm (p < 0.001) at the last follow-up visit. Besides, the final volume reduction rate (VRR) was 61.8 ± 56.4% (range, –67.0 –100%). The complete disappearance rate was 46.8%, but there were 4 (5.1%) LNs becoming bigger than before. The average s-Tg level was 9.2 ± 26.6 ng/mL, a data significantly decreased to 3.7 ± 7.0 ng/mL at the last follow-up, but no statistical difference was shown. CONCLUSION:Thermal ablation is an effective and safe modality for the treatment of metastatic LNs from PTC.

Keywords: Ultrasound, thermal ablation, papillary thyroid carcinoma, lymph nodes

DOI: 10.3233/CH-231998

Journal: Clinical Hemorheology and Microcirculation, vol. 87, no. 1, pp. 77-87, 2024