Efficacy of Radiofrequency Ablation in Autonomous Functioning Thyroid Nodules: A Comprehensive Systematic Review and Meta-analysis

Mona Javid, Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Arian Mirdamadi, Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Fateme Sheida, Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran; Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
Sandeep Samethadka Nayak, Division of Hospital Medicine, Department of Internal Medicine, Yale New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, USAĪ.
Rachana Borkar, Department of Radiology, Yale New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, USA.
Rahul Hegde, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA.
Mohammadreza Javid, Department of Radiology, School of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Bita Amirian, Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Mohammad-Hossein Keivanlou, Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Ehsan Amini-Salehi, Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Soheil Hassanipour, Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran. Electronic address: soheil.epid@gmail.com.

Document Type

Article

Publication Title

Academic radiology

Abstract

BACKGROUND: Radiofrequency ablation (RFA) is a minimally invasive outpatient procedure that has recently emerged as a treatment option for autonomous functioning thyroid nodules (AFTNs), offering a less invasive alternative to surgery. The objective of this systematic review and meta-analysis is to evaluate the efficacy of RFA for AFTNs. METHOD: Global databases of PubMed, Scopus, Embase, Web of Science, and Cochrane Library were systematically searched from 1990 until January 5, 2024, for studies on AFTNs undergoing RFA that presented volume reduction ratio (VRR) for at least one of 1, 3, 6 or 12 months post-operative follow-up with the results presented as means. The primary outcomes were VRR and TSH normalization rate, and the secondary outcomes were the cosmetic score, symptom score, and post-procedure complications. Heterogeneity was assessed by Cochrane and I statistics, and a random-effects model was used for meta-analysis. The study protocol was registered on PROSPERO (CRD42024499932). RESULTS: A total of 10 eligible studies with a total sample size of 254 were included. The pooled VRR after 1, 3, 6, and 12 months of follow-up post-treatment with RFA was 46.6% (95% CI: 40.3-52.9%), 62% (95% CI: 57.6-66.4%), 67.4% (95% CI:62.3-72.6%), and 77.2% (95% CI: 79.2-81.5%), respectively. The overall rate of TSH normalization was 76.4% (95% CI: 58.1-88.4%). Based on included studies the overall rate of subclinical hypothyroidism as one of the most important side effects of this method was 4% (95% CI: 1.9%-8.1%). CONCLUSION: RFA emerges as a promising non-surgical treatment for AFTNs, showing high rates of TSH normalization, tumor size reduction, and improved cosmetic and symptom scores. However, further research is needed to compare RFA with surgical methods and assess long-term outcomes.

First Page

4843

Last Page

4855

DOI

10.1016/j.acra.2024.06.023

Publication Date

12-1-2024

Identifier

39068094 (pubmed); 10.1016/j.acra.2024.06.023 (doi); S1076-6332(24)00383-0 (pii)

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