Safety and Efficacy of Radiofrequency Ablation for Nonfunctioning Benign Thyroid Nodules in Children and Adolescents in 14 Patients over a 10-Year Period

Abstract

Purpose: To evaluate the efficacy and safety of radiofrequency (RF) ablation for nonfunctioning benign thyroid nodules in children and adolescents. Materials and Methods: Fourteen pediatric patients (10 female, 4 male; mean age 15.7 +/- 2.3 years, range 12-19 years) with nonfunctioning benign thyroid nodules (mean longest diameter 3.7 +/- 1.1 cm, range 2.0-5.6 cm) treated with the use of RF ablation from 2005 to 2015 were evaluated. The inclusion criteria for RF ablation therapy were (i) age <20 years, (ii) benign cytological confirmation by >= 2 separate fine-needle aspiration or core needle biopsies, (iii) pressure symptoms or cosmetic problems caused by thyroid nodules, (iv) absence of any suspicious feature as determined with the use of ultrasound (US), (v) normal serum levels of thyroid hormone and thyrotropin, and (vi) follow-up of >6 months. RF ablation was performed with the use of an RF generator and an 18-gauge internally cooled electrode. RF ablation was performed under local anesthesia without conscious sedation or general anesthesia. Changes in nodules on follow-up US, changes in symptomatic and cosmetic scores, and complications arising during or after RF ablation were evaluated. Results: Mean follow-up period was 36.9 +/- 21.7 months (range 6-69 months). At last follow-up visits, mean longest nodule diameter and volume had decreased significantly (3.7 +/- 1.1 cm vs 1.4 +/- 0.9 cm and 14.6 +/- 13.3 mL vs 1.7 +/- 4.4 mL; P < 0.001). Both cosmetic and compressive symptoms significantly improved (3.8 +/- 0.6 vs 1.4 +/- 0.6 and 3.4 +/- 1.0 vs 0.1 +/- 0.4; P < 0.001). The mean number of ablation sessions was 2.1 +/- 1.2 (range 1-5 sessions) and no major complication was encountered during or after RF ablation. Conclusions: RF ablation might be a safe and effective treatment modality for nonfunctioning benign thyroid nodules in children and adolescents.