Radiofrequency ablation for treatment of thyroid follicular neoplasm with low SUV in PET/CT study

Abstract

Objectives

To evaluate the feasibility of radiofrequency ablation (RFA) on follicular neoplasm with low standard uptake value (SUV) in a Positron emission tomography (PET/CT) study.

Methods

From January 2018 to July 2019, 86 consecutive patients were diagnosed with follicular neoplasm. Of the patients, 28 with PET/CT scans were enrolled in this study. All patients received ultrasound, fine/core needle aspiration, and PET/CT scan prior to treatment. In accordance with previous studies, we recommended 6 patients who had follicular neoplasm with SUVmax ≥5 undergo surgical resection due to an elevated suspicion of malignancy. For 22 patients SUVmax <5, RFA was performed using the moving shot technique. Ultrasound was performed 6 to 12 months after each procedure.

Results

Statistically significant volume reductions during follow-up between values prior to RFA and 12 months post RFA were demonstrated (12.6 ± 20.9 vs. 2.4 ± 3.0 cm³, p < 0.001). Volume reduction ratios at 6–12 months (mean: 10.1 months) after RFA were 73.3% ± 17.7%. One patient presented with vocal cord palsy and recovered within 3 months after RFA. No postprocedural hypothyroidism occurred in the RFA patients.

Conclusions

By using PET/CT, we can select patients with low SUV follicular neoplasm. RFA offers a safe and feasible alternative treatment option for patients unsuitable or unwilling to undergo surgery.

KEY POINTS

• By using positron emission tomography-computed tomography, we can distinguish low SUV follicular neoplasm for radiofrequency ablation.

• For low SUV follicular neoplasm, RF ablation offers a safe and effective alternative treatment option for patients unsuitable or unwilling to undergo surgery.

Keywords:

• Thyroid gland
• follicular neoplasm
• ultrasound
• F-18 FDG PET/CT
• ablation technique

Acknowledgments

The authors wish to thank all subjects who participated in this study. The authors would also like to thank their colleagues at Kaohsiung Chang Gung Memorial Hospital.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article. The raw data are available from the corresponding author, upon reasonable request.