Clinical Outcomes of Thermal Ablation Re-Treatment of Benign Thyroid Nodules: A Multicenter Study from the Italian Minimally Invasive Treatments of the Thyroid Group

Dr. Giovanni Mauri, a recognized radiologist and interventional radiologist at the European Institute of Oncology in Milan, Italy, holds a notable position in the medical field. His educational background is rooted in the University of Milan School of Medicine, where he graduated in 2007 and completed his Board Certification in Radiology by 2012. His expertise was further developed through fellowships at St George’s Hospital, University of London, and Brigham and Women’s Hospital, Harvard Medical School in Boston.

Throughout his career, Dr. Mauri has been involved in various capacities as a Consultant Radiologist, contributing significantly to the advancement of interventional radiology, especially in thyroid disease treatment through image-guided biopsies and ablations. His academic contributions include 67 peer-reviewed publications, participation in over 100 national and international meetings, and co-authorship of five book chapters. Dr. Mauri is also an Adjunct Professor at the University of Milan, where he is involved in teaching courses related to basic sciences and pathogenesis and diagnostics.

His commitment to the medical community extends beyond clinical and research activities, as he serves on the editorial boards and as a reviewer for multiple peer-reviewed journals. Dr. Mauri’s innovative work in thyroid ablation techniques has significantly influenced the approach to treating thyroid diseases, promoting less invasive treatments that benefit patients.

Additionally, Dr. Mauri’s achievements have been recognized on a global scale, including being named in the top 2% of scientists by Stanford University. This acknowledgment highlights his significant impact and contributions to the field of radiology and interventional radiology, especially in the development and application of minimally invasive procedures for thyroid diseases.

For more detailed insights into Dr. Giovanni Mauri’s work and his contributions to medical science, references can be found through the European Institute of Oncology’s profile and academic publications.


Abstract

Background: Thermal ablation (TA) is an established therapeutic option alternative to surgery in patients with solid benign thyroid nodules causing local symptoms. However, a variable part of thyroid nodules remain viable after these nonsurgical treatments, and as many as 15% of nodules treated with TA may require a second treatment over time. This study aimed to evaluate the outcomes of TA re-treatment on symptomatic benign thyroid nodules where the volume decreased by <50% after the first procedure ( = technique inefficacy). Methods: We performed a multicenter retrospective cohort study including patients who underwent re-treatment with TA for benign thyroid nodules, whose volume decreased by <50% after initial treatment. The primary aim was to evaluate volume and volume reduction ratio (VRR) over time and compare the 6- and 12-month VRR after first versus second treatment. The secondary aim was to identify protective or risk factors for technique inefficacy, regrowth, and further treatments, expressed as adjusted hazard ratios (HRs) and confidence interval [CI], after adjustment for sex, age, nodule volume, structure and function, nodule regrowth or symptom relapse, technique used and if the same technique was used for the first and second TA and time between them. Results: We included 135 patients. Re-treatment led to VRR of 50% and 52.2% after 6 and 12 months. VRR after re-treatment was greater than after first treatment in small and medium size nodules (<30 mL), while there were no differences for large nodules (>30 mL). After re-treatment technique inefficacy rate was 51.9%, regrowth rate was 12.6%, and further treatment rate was 15.6%. Radiofrequency ablation (RFA) was protective toward technique inefficacy (HR = 0.40 [CI 0.24-0.65]) and need of further treatments (HR = 0.30 [CI 0.12-0.76]). Large nodule volume (>30 mL) was associated with increased risk of re-treatment (HR = 4.52 [CI 1.38-14.82]). Conclusions: This is the first study evaluating the outcomes of re-treatment on symptomatic benign thyroid nodules with a VRR <50% after the initial TA treatment. Best results were seen in small and medium nodules (<30 mL) and after RFA. Prospective confirmatory studies are needed.

Keywords: laser; radiofrequency ablation; re-treatment; second treatment; thermal ablation; thyroid nodules.

Read more by clicking here.

This news powered by RFAMD media services