Ultrasound-guided radiofrequency ablation for papillary thyroid microcarcinoma: a retrospective analysis of 198 patients

Figures & data

Figure 1. Consort 2010 flow diagram.

Table 1. Characteristics of nodules proved to be PTMC under US or CEUS.

Characteristics	Nodules, n (%)
Echogenicity
Hypoechoic	195 (95.6%)
Isoechoic	8 (3.9%)
Hyperechogenic	1 (0.5%)
Composition
Solid	204 (100%)
Calcification
Punctate echogenic foci	38 (18.6%)
Macrocalcification	58 (28.4%)
No calcification	108 (52.9%)
Vascularity
Yes	113 (55.4%)
No	91 (44.6%)
Hashimoto thyroiditis
Yes	36 (17.6%)
No	168 (82.4%)
CEUS
Low	167 (81.9%)
Iso-enhancement	28 (13.7%)
High	9 (4.4%)

Figure 2. The preoperative and postoperative pathological images of the patient. (A) PTC was diagnosed by preoperative biopsy pathology; (B) degenerative changes were revealed in postoperative biopsy pathology.

Figure 3. Preoperative imaging and CEUS imaging immediately after RFA. (A) Preoperative CEUS imaging showing the hypoechoic nodule was low-enhanced; (B) CEUS imaging immediately after RFA revealed a non-enhanced area of 1.6 cm × 1.4 cm ×1.2 cm in the ablated area.

Figure 4. Post-operative CEUS images during follow-up. (A) the non-enhanced area was 1.4cmx1.3cmx1.1cm 1 month after RFA; (B) the non-enhanced area was 0.9cmx0.9cmx0.8cm 3 months after RFA; (C) the non-enhanced area was 0.2cmx0.3cmx0.3cm 18 months after RFA (VRR was 99%).

Table 2. Changes of volume and VRR after RFA in the follow-ups.

Follow-up time points	Volume (mm^3)		p	VRR (%)		p
	Mean ± SD	Range	.000*	Mean ± SD	Range	.000*
1st month	241.7 ± 298.3	9.4–2585.3	.000#	73.9 ± 13.7	14–100	.000#
3rd month	89.8 ± 147.2	0.0–1256.0	.000#	90.5 ± 8.2	54–100	.000#
6th month	37.6 ± 87.2	0.0–673.5	.000#	96.1 ± 5.9	44–100	.000#
12th month	13.6 ± 59.8	0.0–544.3	.000#	98.8 ± 3.2	74–100	.000#
18th month	2.4 ± 14.4	0.0–167.5	.001#	99.6 ± 1.9	86–100	.000#
24th month	0.2 ± 2.0	0.0–23.5	.015#	99.8 ± 1.0	90–100	.005#

*means the difference of the volume or VRR in different time points compared using Analysis of variance for repeated measurement of general lineal model.

#means the difference of volume or VRR compared with that of last time point (for example, Volume of 3rd month postoperatively versus that of 1st month postoperatively).

Gharib H, Papini E, Garber JR, Nodules AAATFoT, et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules–2016 Update. Endocr Pract. 2016;22(Supplement 1):1–639.

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