DataSheet1_Efficacy of echolaser smart interface-guided laser ablation in volume reduction of symptomatic benign thyroid nodules.pdf

BackgroundThe management of benign symptomatic thyroid nodules until recent years has been limited to surgery, radioactive iodine treatment, or surveillance which is associated with the burden of morbidity of complications or symptom non-relief as well as cost. Laser ablation has emerged as a minimally invasive alternative, this uses laser energy to thermally ablate nodule tissue, leading to volume reduction and symptom relief. Long-term treatment response data is growing but remains limited in the United States. Our study aims to quantify the effectiveness of laser ablation in reducing the volume of thyroid nodules over a 12 to 18-month period.
Materials and methodsRetrospective review of data was conducted for 63 adults with cytologically benign, solid symptomatic thyroid nodules ranging from 1.333 cm3 to 103.794 cm3 in volume. Ultrasound-guided laser thermal ablation was performed on all nodules using EchoLaser X4 Smart Interface device with 1064 nm diode laser to deliver total ablation energy (joules), calculated per device guidelines. Serial sonographic volume measurements were conducted 1 month, 3 -6 months, 6 - 12 months, and 12 to 18 months post-ablation intervals.
ResultsStudy cohort was comprised of 63 thyroid nodules. reduction in nodule volume increased progressively over time, with median reductions of 46.05% [STD 21.8] at 1 month, 60.33% [STD 20.1] at 3-6 months, 68.69% [STD 18.8] at 6-12 months, and 64.04% [STD 19.27] at 12-18 months. A total of 62, 56, 42, and 17 nodules had available data for analysis at these respective intervals.
ConclusionThis study demonstrated a marked progressive reduction of thyroid nodule volume following ablation. The treatment appears to be consistently effective in reducing symptoms across a wide range of nodule sizes, although the degree of volume reduction varies. The results of our study underscore the potential of laser ablation as a viable treatment option for thyroid nodules, with a sustained reduction in nodule volume observed over an extended post-procedure period.

【背景】直到近年来，有症状的良性甲状腺结节的临床管理手段仍局限于手术、放射性碘治疗或随访观察，但上述方式均存在并发症发病负担、症状未缓解以及医疗成本高昂的问题。激光消融作为一种微创替代疗法应运而生，其通过激光能量对结节组织实施热消融，可实现结节体积缩小与症状缓解。目前该疗法的长期治疗响应数据正逐步积累，但在美国地区仍较为有限。本研究旨在量化12至18个月随访周期内，激光消融缩小甲状腺结节体积的临床有效性。【材料与方法】本研究对63例经细胞学证实为良性的实性有症状甲状腺结节患者的临床资料进行回顾性分析，纳入研究的结节体积介于1.333 cm³至103.794 cm³之间。所有结节均采用搭载1064 nm二极管激光器的EchoLaser X4智能界面设备，按照设备操作指南计算总消融能量（焦耳），并在超声引导下完成激光热消融术。分别于消融术后1个月、3~6个月、6~12个月及12~18个月四个时间节点开展系列超声体积测量。【结果】本研究队列共纳入63枚甲状腺结节。结节体积随随访时间推移呈进行性缩小：术后1个月时中位体积缩减率为46.05%（标准差Standard Deviation，STD 21.8），3~6个月时为60.33%（STD 20.1），6~12个月时为68.69%（STD 18.8），12~18个月时为64.04%（STD 19.27）。在上述四个时间节点可获得有效分析数据的结节数分别为62枚、56枚、42枚及17枚。【结论】本研究证实，甲状腺结节在激光消融术后体积呈显著进行性缩小。尽管不同结节的体积缩减程度存在个体差异，但该疗法在广泛结节尺寸范围内均能持续有效缓解相关症状。本研究结果凸显了激光消融作为甲状腺结节可行治疗方案的潜力，术后长期随访可见结节体积持续缩减。