- Thyroid
- The Diagnostic Role of Repeated Biopsy of Thyroid Nodules with Atypia of Undetermined Significance with Architectural Atypia on Core-Needle Biopsy
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Hye Hyeon Moon, Sae Rom Chung, Young Jun Choi, Tae-Yon Sung, Dong Eun Song, Tae Yong Kim, Jeong Hyun Lee, Jung Hwan Baek
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Endocrinol Metab. 2024;39(2):300-309. Published online January 3, 2024
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DOI: https://doi.org/10.3803/EnM.2023.1818
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Abstract
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- Background
We aimed to evaluate the utility of repeat biopsy of thyroid nodules classified as atypia of undetermined significance with architectural atypia (IIIB) on core-needle biopsy (CNB).
Methods This retrospective study evaluated patients with thyroid nodules categorized as IIIB on CNB between 2013 and 2015. Demographic characteristics, subsequent biopsy results, and ultrasound (US) images were evaluated. The malignancy rates of nodules according to number of CNBs and the number of IIIB diagnoses was compared. Demographic and US features were evaluated to determine factors predictive of malignancy.
Results Of 1,003 IIIB nodules on CNB, the final diagnosis was determined for 328 (32.7%) nodules, with 121 of them confirmed as malignant, resulting in a malignancy rate of 36.9% (95% confidence interval, 31.7% to 42.1%). Repeat CNB was performed in 248 nodules (24.7%), with 75 (30.2%), 131 (52.8%), 13 (5.2%), 26 (10.5%), one (0.4%), and two (0.8%) reclassified into categories II, IIIB, IIIA, IV, V, and VI, respectively. Malignancy rates were not significantly affected by the number of CNBs (P=0.291) or the number of IIIB diagnoses (P=0.473). None of the nodules confirmed as category II on repeat CNB was malignant. US features significantly associated with malignancy (P<0.003) included solid composition, irregular margins, microcalcifications, and high suspicion on the US risk stratification system.
Conclusion Repeat biopsy of nodules diagnosed with IIIB on CNB did not increase the detection of malignancy but can potentially reduce unnecessary surgery. Repeat biopsy should be performed selectively, with US features guiding the choice between repeat biopsy and diagnostic surgery.
- Clinical Study
- Long-Term Results of Thermal Ablation of Benign Thyroid Nodules: A Systematic Review and Meta-Analysis
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Se Jin Cho, Jung Hwan Baek, Sae Rom Chung, Young Jun Choi, Jeong Hyun Lee
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Endocrinol Metab. 2020;35(2):339-350. Published online June 24, 2020
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DOI: https://doi.org/10.3803/EnM.2020.35.2.339
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Abstract
PDFSupplementary MaterialPubReader ePub
- Background
Ultrasound-guided thermal ablations have become one of the main options for treating benign thyroid nodules. To determine efficacy of thermal ablation of benign thyroid nodules, we performed a meta-analysis of studies with long-term follow-up of more than 3 years.
Methods Databases were searched for studies published up to August 25, 2019, reporting patients with benign thyroid nodules treated with thermal ablation and with follow-up data of more than 3 years. Data extraction and quality assessment were performed according to PRISMA guidelines. The analysis yielded serial volume reduction rates (VRRs) of ablated nodules for up to 3 years or more, and adverse effect of ablation during follow-up. Radiofrequency ablation (RFA) and laser ablation (LA) were compared in a subgroup analysis.
Results The pooled VRRs for ablated nodules showed rapid volume reduction before 12 months, a plateau from 12 to 36 months, and more volume reduction appearing after 36 months, demonstrating long-term maintenance of treatment efficacy. Thermal ablation had an acceptable complication rate of 3.8%. Moreover, patients undergoing nodule ablation showed no unexpected delayed complications during the follow-up period. In the subgroup analysis, RFA was shown to be superior to LA in terms of the pooled VRR and the number of patients who underwent delayed surgery.
Conclusion Thermal ablations are safe and effective methods for treating benign thyroid nodules, as shown by a long follow-up analysis of more than 3 years. In addition, RFA showed superior VRRs compared with LA for the treatment of benign thyroid nodules, with less regrowth and less delayed surgery.
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Citations
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Catherine F. Sinclair, Jung Hwan Baek, Kathleen E. Hands, Steven P. Hodak, Timothy C. Huber, Iram Hussain, Brian Hung-Hin Lang, Julia E. Noel, Maria Papaleontiou, Kepal N. Patel, Gilles Russ, Jonathon Russell, Stefano Spiezia, Jennifer H. Kuo Thyroid®.2023; 33(10): 1150. CrossRef - A comprehensive review of interventional ablation techniques for the management of thyroid nodules and metastatic lymph nodes
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Michael Douek Techniques in Vascular and Interventional Radiology.2022; 25(2): 100821. CrossRef - Efficacy and Safety of Thermal Ablation for Treating Lymph Node Metastasis From Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis
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- Clinical Study
- Effectiveness of Injecting Cold 5% Dextrose into Patients with Nerve Damage Symptoms during Thyroid Radiofrequency Ablation
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Min Kyoung Lee, Jung Hwan Baek, Sae Rom Chung, Young Jun Choi, Yu-Mi Lee, Tae Yong Kim, Jeong Hyun Lee
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Endocrinol Metab. 2020;35(2):407-415. Published online June 24, 2020
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DOI: https://doi.org/10.3803/EnM.2020.35.2.407
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Abstract
PDFPubReader ePub
- Background
Although radiofrequency ablation (RFA) is a safe treatment for thyroid tumors, nerve damage is a frequent complication. A previous retrospective study suggested that an injection of cold 5% dextrose in water (5% DW) can reduce nerve damage during RFA. This study validated the efficacy of injecting cold 5% DW for management of nerve damage during RFA.
Methods Between November 2017 and December 2018, 242 patients underwent 291 RFA sessions for treatment of benign thyroid nodules or recurrent thyroid cancers. Using a standardized technique, cold (0°C to 4°C) 5% DW was immediately injected around the damaged nerve into patients with any symptoms suggesting nerve damage. The incidence of nerve damage, the volume of 5% DW injected, symptom recovery time and the incidence of permanent nerve damage were evaluated.
Results Nineteen patients experienced nerve damage symptoms related to 21 RFA sessions, including 17 patients during 19 sessions and two patients on the day after two sessions. Patients with nerve damage symptoms detected during RFA were treated by injection of a mean 41 mL (range, 3 to 260) cold 5% DW, but the two patients who experienced symptoms the next day did not receive cold 5% DW injections. Immediate recovery was observed after 15 RFA sessions in 14 patients. No patient experienced permanent nerve damage.
Conclusion Injection of cold 5% DW is effective in managing nerve damage during RFA of thyroid lesions.
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Citations
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- The Role of Radiofrequency Ablation in Benign and Malignant Thyroid Nodules
Meghal Shah, Catherine McManus Surgical Clinics of North America.2024;[Epub] CrossRef - Clinical and Economic Evaluation of Ultrasound-Guided Radiofrequency Ablation vs. Parathyroidectomy for Patients with Primary Hyperparathyroidism: A Cohort Study
Hui-hui Chai, Zhan-jing Dai, Bai Xu, Qiao-hong Hu, Hong-feng He, Ying Xin, Wen-wen Yue, Cheng-zhong Peng Academic Radiology.2023; 30(11): 2647. CrossRef - Efficacy of single-session radiofrequency ablation (RFA) in rendering euthyroidism for persistent/relapsed Graves’ disease, a pilot study
Man Him Matrix Fung, Brian Hung Hin Lang European Radiology.2023; 33(9): 6534. CrossRef - Radiofrequency Ablation of Cervical Thyroid Cancer Metastases—Experience of Endocrinology Practices in the United States
Shahzad Ahmad, Jules Aljammal, Ian Orozco, Sheharyar Raashid, Fizza Zulfiqar, Sean P Nikravan, Iram Hussain Journal of the Endocrine Society.2023;[Epub] CrossRef - Radiofrequency ablation of benign thyroid nodules: the value of anterolateral hydrodissection
So Yeong Jeong, Jung Hwan Baek, Sae Rom Chung, Young Jun Choi, Ki-Wook Chung, Tae Yong Kim, Jeong Hyun Lee Ultrasonography.2023; 42(3): 432. CrossRef - Effective and Safe Application of Radiofrequency Ablation for Benign Thyroid Nodules
Jin Yong Sung Journal of the Korean Society of Radiology.2023; 84(5): 985. CrossRef - Assessment of thyroid-specific quality of life in patients with benign symptomatic thyroid nodules treated with radiofrequency or ethanol ablation: a prospective multicenter study
So Yeong Jeong, Eun Ju Ha, Jung Hwan Baek, Tae Yong Kim, Yu-Mi Lee, Jeong Hyun Lee, Jeonghun Lee Ultrasonography.2022; 41(1): 204. CrossRef - Management of Recurrent Laryngeal Nerve Injury During Radiofrequency Ablation of Thyroid Nodules
Jules Aljammal, Iram Hussain, Shahzad Ahmad AACE Clinical Case Reports.2022; 8(2): 102. CrossRef - Thermal Ablation for the Management of Papillary Thyroid Microcarcinoma in the Era of Active Surveillance and Hemithyroidectomy
Sae Rom Chung, Jung Hwan Baek, Young Jun Choi, Jeong Hyun Lee Current Oncology Reports.2022; 24(8): 1045. CrossRef - Improving Voice Outcomes after Thyroid Surgery and Ultrasound-Guided Ablation Procedures
Pia Pace-Asciak, Jon O. Russell, Ralph P. Tufano Frontiers in Surgery.2022;[Epub] CrossRef - Using Intra‐Operative Laryngeal Ultrasonography as a Real‐Time Tool in Assessing Vocal Cord Function During Radiofrequency Ablation of the Thyroid Gland
Matrix Man Him Fung, Brian Hung Hin Lang World Journal of Surgery.2022; 46(9): 2206. CrossRef - Long-term outcome of microwave ablation for benign thyroid nodules: Over 48-month follow-up study
Jia-Rui Du, Wen-Hui Li, Cheng-Hai Quan, Hui Wang, Deng-Ke Teng Frontiers in Endocrinology.2022;[Epub] CrossRef - Continuous neuromonitoring during radiofrequency ablation of benign thyroid nodules provides objective evidence of laryngeal nerve safety
Catherine F. Sinclair, Maria J. Téllez, Roberto Peláez-Cruz, Alba Díaz-Baamonde, Sedat Ulkatan The American Journal of Surgery.2021; 222(2): 354. CrossRef - Future Considerations and Directions for Thermal Ablative Technologies
Jonathon Russell, Catherine F. Sinclair Current Otorhinolaryngology Reports.2021; 9(2): 210. CrossRef
- Clinical Study
- Does Radiofrequency Ablation Induce Neoplastic Changes in Benign Thyroid Nodules: A Preliminary Study
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Su Min Ha, Jun Young Shin, Jung Hwan Baek, Dong Eun Song, Sae Rom Chung, Young Jun Choi, Jeong Hyun Lee
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Endocrinol Metab. 2019;34(2):169-178. Published online May 15, 2019
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DOI: https://doi.org/10.3803/EnM.2019.34.2.169
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PDFSupplementary MaterialPubReader ePub
- Background
To evaluate the clinical feasibility of radiofrequency ablation (RFA) of benign thyroid nodules along with cytomorphological alteration, and any malignant transformation through biopsy. MethodsThe data were retrospectively collected between April 2008 and June 2013 and core needle biopsy (CNB) was performed on 16 benign thyroid nodules previously treated using RFA. The parameters of the patients were compared, between the time of enrollment and the last follow-up examination, using linear mixed model statistical analysis. ResultsNo atypical cells or neoplastic transformation were detected in the undertreated peripheral portion of treated benign nodules on the CNB specimen. RFA altered neither the thyroid capsule nor the thyroid tissue adjacent to the treated area. On histopathological examinations, we observed 81.2% acellular hyalinization, which was the most common finding. After a mean follow-up period of over 5 years, the mean volume of thyroid nodule had decreased to 6.4±4.2 mL, with a reduction rate of 81.3%±5.8% (P<0.0001). ConclusionRFA is a technically feasible treatment method for benign thyroid nodules, with no carcinogenic effect or tissue damage of the normal thyroid tissue adjacent to the RFA-treated zone.
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Robert M. Eisele, Philipp R. Scherber, Monika Schlüter, Thorsten Drews, Matthias Glanemann, Gereon Gäbelein Technology and Health Care.2022; 30(3): 683. CrossRef - Radiofrequency ablation and related ultrasound‐guided ablation technologies for treatment of benign and malignant thyroid disease: An international multidisciplinary consensus statement of the American Head and Neck Society Endocrine Surgery Section with
Lisa A. Orloff, Julia E. Noel, Brendan C. Stack, Marika D. Russell, Peter Angelos, Jung Hwan Baek, Kevin T. Brumund, Feng‐Yu Chiang, Mary Beth Cunnane, Louise Davies, Andrea Frasoldati, Anne Y. Feng, Laszlo Hegedüs, Ayaka J. Iwata, Emad Kandil, Jennifer K Head & Neck.2022; 44(3): 633. CrossRef - Thyroid Nodule Radiofrequency Ablation: Complications and Clinical Follow Up
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Lin Yan, Xinyang Li, Yingying Li, Jing Xiao, Mingbo Zhang, Yukun Luo European Radiology.2022; 33(1): 730. CrossRef - A systematic review and meta-analysis comparing tumor progression and complications between radiofrequency ablation and thyroidectomy for papillary thyroid carcinoma
Yuan-dong Sun, Hao Zhang, Hai-tao Zhu, Chun-xue Wu, Miao-ling Chen, Jian-jun Han Frontiers in Oncology.2022;[Epub] CrossRef - RFA and benign thyroid nodules: Review of the current literature
Haris Muhammad, Prasanna Santhanam, Jonathon O. Russell, Jennifer H. Kuo Laryngoscope Investigative Otolaryngology.2021; 6(1): 155. CrossRef - Radiofrequency ablation and thyroid nodules: updated systematic review
Haris Muhammad, Prasanna Santhanam, Jonathon O. Russell Endocrine.2021; 72(3): 619. CrossRef - Complications of RFA for Thyroid Nodules: Prevention and Management
Rahul K. Sharma, Jennifer H Kuo Current Otorhinolaryngology Reports.2021; 9(1): 79. CrossRef - Long-Term Results of Ultrasound-Guided Radiofrequency Ablation of Benign Thyroid Nodules: State of the Art and Future Perspectives—A Systematic Review
Hervé Monpeyssen, Ahmad Alamri, Adrien Ben Hamou Frontiers in Endocrinology.2021;[Epub] CrossRef - Long-Term Outcomes of Thermal Ablation for Benign Thyroid Nodules: The Issue of Regrowth
Jung Suk Sim, Jung Hwan Baek, Rosaria Meccariello International Journal of Endocrinology.2021; 2021: 1. CrossRef - Ultrasound-Guided Radiofrequency Ablation Versus Thyroid Lobectomy for Low-Risk Papillary Thyroid Microcarcinoma: A Propensity-Matched Cohort Study of 884 Patients
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- Thyroid
- A Comparison of Ultrasound-Guided Fine Needle Aspiration versus Core Needle Biopsy for Thyroid Nodules: Pain, Tolerability, and Complications
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Eun Ji Jeong, Sae Rom Chung, Jung Hwan Baek, Young Jun Choi, Jae Kyun Kim, Jeong Hyun Lee
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Endocrinol Metab. 2018;33(1):114-120. Published online March 21, 2018
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DOI: https://doi.org/10.3803/EnM.2018.33.1.114
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- Background
To compare pain, tolerability, and complications associated with fine needle aspiration (FNA) versus core needle biopsy (CNB). MethodsFNAs were performed using 23-gauge needles and CNBs were performed using 18-gauge double-action spring-activated needles in 100 patients for each procedure. Patients were asked to record a pain score using a 10-cm visual analog scale and procedure tolerability. Complications and number of biopsies were recorded. ResultsThe median pain scores were similar for the FNA and CNB approaches during and 20 minutes after the biopsy procedures (3.7 vs. 3.6, P=0.454; 0.9 vs. 1.1, P=0.296, respectively). The procedure was tolerable in all 100 FNA patients and in 97 CNB patients (P=0.246). The mean number of biopsies was fewer in the CNB group (1.4 vs. 1.2, P=0.002). By subgroup analysis (staff vs. non-staff), no significant difference was detected in any parameter. There were no major complications in either group, but three patients who underwent CNB had minor complications (P=0.246). ConclusionFNA and CNB show no significant differences for diagnosing thyroid nodules in terms of pain, tolerability, or complications.
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- Growth Hormone-Releaser Diet Attenuates Cognitive Dysfunction in Klotho Mutant Mice via Insulin-Like Growth Factor-1 Receptor Activation in a Genetic Aging Model
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Seok Joo Park, Yoon Hee Chung, Jeong Hyun Lee, Duy-Khanh Dang, Yunsung Nam, Ji Hoon Jeong, Yong Sun Kim, Toshitaka Nabeshima, Eun-Joo Shin, Hyoung-Chun Kim
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Endocrinol Metab. 2014;29(3):336-348. Published online September 25, 2014
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DOI: https://doi.org/10.3803/EnM.2014.29.3.336
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Abstract
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- Background
It has been recognized that a defect in klotho gene expression accelerates the degeneration of multiple age-sensitive traits. Accumulating evidence indicates that aging is associated with declines in cognitive function and the activity of growth hormone (GH)/insulin-like growth factor-1 (IGF-1). MethodsIn this study, we examined whether a GH-releaser diet could be effective in protecting against cognitive impairment in klotho mutant mice. ResultsThe GH-releaser diet significantly induced the expression of IGF-1 and IGF-1 receptors in the hippocampus of klotho mutant mice. Klotho mutant mice showed significant memory impairments as compared with wild-type mice. In addition, the klotho mutation significantly decreased the expression of cell survival/antiapoptotic factors, including phospho-Akt (p-Akt)/phospho-glycogen synthase kinase3β (p-GSK3β), phospho-extracellular signal-related kinase (p-ERK), and Bcl-2, but significantly increased those of cell death/proapoptotic factors, such as phospho-c-jun N-terminal kinase (p-JNK), Bax, and cleaved caspase-3 in the hippocampus. Treatment with GH-releaser diet significantly attenuated both decreases in the expression of cell survival/antiapoptotic factors and increases in the expression of cell death/proapoptotic factors in the hippocampus of klotho mutant mice. In addition, klotho mutation-induced oxidative stress was significantly attenuated by the GH-releaser diet. Consequently, a GH-releaser diet significantly improved memory function in the klotho mutant mice. GH-releaser diet-mediated actions were significantly reversed by JB-1, an IGF-1 receptor antagonist. ConclusionThe results suggest that a GH-releaser diet attenuates oxidative stress, proapoptotic changes and consequent dysfunction in klotho mutant mice by promoting IGF-1 expression and IGF-1 receptor activation.
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Ka Hee Yi, Young Joo Park, Sung Soo Koong, Jung Han Kim, Dong Gyu Na, Jin Sook Ryu, So Yeon Park, In Ae Park, Chung Hwan Baek, Young Kee Shong, Young Don Lee, Jaetae Lee, Jeong Hyun Lee, Jae Hoon Chung, Chan Kwon Jung, Seung Ho Choi, Bo Youn Cho
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Endocrinol Metab. 2010;25(4):270-297. Published online December 1, 2010
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DOI: https://doi.org/10.3803/EnM.2010.25.4.270
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Won Bae Kim, Tae Yong Kim, Hyuk Sang Kwon, Won Jin Moon, Jae Bok Lee, Young Sik Choi, Seok Ki Kim, Sun Wook Kim, Ki wook Chung, Jung Hwan Baek, Byung Il Kim, Do Joon Park, Dong Gyu Na, Jun Ho Choe, Jae Hoon Chung, Hye Seung Jung, Jeong Han Kim, Kee Hyun Nam, Hang Seok Chang, Woong Youn Chung, Soon Won Hong, Suck Joon Hong, Jeong Hyun Lee, Ka Hee Yi, Young Suk Jo, Ho Cheol Kang, Minho Shong, Jin Woo Park, Jong Ho Yoon, Seong Joon Kang, Kwang Woo Lee
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