The Importance of Nodule Size in the Management of Ruptured Thyroid Nodule After Radiofrequency Ablation: A Retrospective Study and Literature Review
BackgroundNodule rupture is a relatively uncommon yet severe complication of radiofrequency ablation (RFA). When nodule rupture occurs, determining suitable therapeutic management is a critical issue. A study herein aimed to identify the predictive factors affecting the management of post-RFA nodule...
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| Format: | Article |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2021.776919/full |
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| author | Wen-Chieh Chen Sheng-Dean Luo Wei-Chih Chen Chen-Kai Chou Yen-Hsiang Chang Kai-Lun Cheng Kai-Lun Cheng Wei-Che Lin |
| author_facet | Wen-Chieh Chen Sheng-Dean Luo Wei-Chih Chen Chen-Kai Chou Yen-Hsiang Chang Kai-Lun Cheng Kai-Lun Cheng Wei-Che Lin |
| author_sort | Wen-Chieh Chen |
| collection | DOAJ |
| description | BackgroundNodule rupture is a relatively uncommon yet severe complication of radiofrequency ablation (RFA). When nodule rupture occurs, determining suitable therapeutic management is a critical issue. A study herein aimed to identify the predictive factors affecting the management of post-RFA nodule rupture.MethodsPost-RFA nodule rupture data of 9 patients were enrolled from 2 medical centers. A literature investigation was performed, uncovering nodule rupture data of 17 patients. A total of 26 patients were analyzed and divided into two groups, categorized as patients requiring either invasive or conservative therapeutic management. Data including initial symptoms, imaging, therapeutic management, and prognosis were reviewed and compared between the two groups.ResultsSignificant differences in nodule diameter, and the ablation time of the course prior to rupture (RUP time) were noted between the two groups (p = 0.045 and 0.008, respectively). Logistic regression analysis indicated the initial nodule diameter and RUP time significantly affected the requirement of invasive treatment (OR 1.99 and 1.11, respectively). Considering practicality, when a nodule with an initial maximum diameter of >4.5cm ruptured, invasive management was suggested (sensitivity 69% and specificity 79%).ConclusionThough nodule ruptures can be managed conservatively, a ruptured nodule with an initial maximum diameter of >4.5cm may require invasive management. Understanding the significant clinical and imaging features will help physicians make an appropriate risk assessment to determine the correct treatment in a timely manner. |
| first_indexed | 2024-12-18T02:18:21Z |
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| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-18T02:18:21Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-32dcf08fed2742c1a332fd1cec7d93502022-12-21T21:24:20ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922021-11-011210.3389/fendo.2021.776919776919The Importance of Nodule Size in the Management of Ruptured Thyroid Nodule After Radiofrequency Ablation: A Retrospective Study and Literature ReviewWen-Chieh Chen0Sheng-Dean Luo1Wei-Chih Chen2Chen-Kai Chou3Yen-Hsiang Chang4Kai-Lun Cheng5Kai-Lun Cheng6Wei-Che Lin7Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Medical Imaging, Chung Shan Medical University Hospital, Taichung, TaiwanSchool of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, TaiwanDepartment of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, TaiwanBackgroundNodule rupture is a relatively uncommon yet severe complication of radiofrequency ablation (RFA). When nodule rupture occurs, determining suitable therapeutic management is a critical issue. A study herein aimed to identify the predictive factors affecting the management of post-RFA nodule rupture.MethodsPost-RFA nodule rupture data of 9 patients were enrolled from 2 medical centers. A literature investigation was performed, uncovering nodule rupture data of 17 patients. A total of 26 patients were analyzed and divided into two groups, categorized as patients requiring either invasive or conservative therapeutic management. Data including initial symptoms, imaging, therapeutic management, and prognosis were reviewed and compared between the two groups.ResultsSignificant differences in nodule diameter, and the ablation time of the course prior to rupture (RUP time) were noted between the two groups (p = 0.045 and 0.008, respectively). Logistic regression analysis indicated the initial nodule diameter and RUP time significantly affected the requirement of invasive treatment (OR 1.99 and 1.11, respectively). Considering practicality, when a nodule with an initial maximum diameter of >4.5cm ruptured, invasive management was suggested (sensitivity 69% and specificity 79%).ConclusionThough nodule ruptures can be managed conservatively, a ruptured nodule with an initial maximum diameter of >4.5cm may require invasive management. Understanding the significant clinical and imaging features will help physicians make an appropriate risk assessment to determine the correct treatment in a timely manner.https://www.frontiersin.org/articles/10.3389/fendo.2021.776919/fullthyroid noduleultrasoundradiofrequency ablationcomplicationnodule rupture |
| spellingShingle | Wen-Chieh Chen Sheng-Dean Luo Wei-Chih Chen Chen-Kai Chou Yen-Hsiang Chang Kai-Lun Cheng Kai-Lun Cheng Wei-Che Lin The Importance of Nodule Size in the Management of Ruptured Thyroid Nodule After Radiofrequency Ablation: A Retrospective Study and Literature Review Frontiers in Endocrinology thyroid nodule ultrasound radiofrequency ablation complication nodule rupture |
| title | The Importance of Nodule Size in the Management of Ruptured Thyroid Nodule After Radiofrequency Ablation: A Retrospective Study and Literature Review |
| title_full | The Importance of Nodule Size in the Management of Ruptured Thyroid Nodule After Radiofrequency Ablation: A Retrospective Study and Literature Review |
| title_fullStr | The Importance of Nodule Size in the Management of Ruptured Thyroid Nodule After Radiofrequency Ablation: A Retrospective Study and Literature Review |
| title_full_unstemmed | The Importance of Nodule Size in the Management of Ruptured Thyroid Nodule After Radiofrequency Ablation: A Retrospective Study and Literature Review |
| title_short | The Importance of Nodule Size in the Management of Ruptured Thyroid Nodule After Radiofrequency Ablation: A Retrospective Study and Literature Review |
| title_sort | importance of nodule size in the management of ruptured thyroid nodule after radiofrequency ablation a retrospective study and literature review |
| topic | thyroid nodule ultrasound radiofrequency ablation complication nodule rupture |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2021.776919/full |
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