Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Endocrine
Published in: Endocrine 2/2018

01-11-2018 | Meta-Analysis

Efficacy and safety of cooled and uncooled microwave ablation for the treatment of benign thyroid nodules: a systematic review and meta-analysis

Authors: Bo-wen Zheng, Jin-fen Wang, Jin-xiu Ju, Tao Wu, Ge Tong, Jie Ren

Published in: Endocrine | Issue 2/2018

Login to get access

Abstract

Purpose

To evaluate the effectiveness and safety of microwave ablation (MWA), including cooled MWA (cMWA) and uncooled MWA (uMWA), for the treatment of benign thyroid nodules (BTNs).

Methods

The databases of MEDLINE, EMBASE and Cochrane library were searched up to 3 Jun, 2018. In this meta-analysis, data of volume reduction rates (VRRs) at the 3-, 6- and 12-month follow-up, and complications are obtained to evaluate the effectiveness and safety of cMWA and uMWA for the treatment of BTNs.

Results

Nine studies involving 1461 patients with 1845 BTNs were included. The pooled VRR at the 3-month follow-up after MWA therapy reached 54.3% (95% CI: 45.3–63.3%, I2 = 97.6%), 73.5% (95% CI: 66.7–80.3%, I2 = 94.9%) at the 6-month follow-up, and 88.6% (95% CI: 84.9–92.4%, I2 = 92.7%) at the 12-month follow-up. The pooled proportions of overall, major and minor complications were 52.4% (95% CI: 29.8–74.9%; I2 = 99.5%), 4.8% (95% CI: 2.7–7.0%; I2 = 55.9%) and 48.3% (95% CI: 31.2–65.4%; I2 = 99.7%). Both cMWA and uMWA achieved similar pooled VRR at the 3-month follow-up (58.4 vs 45.3%, P = 0.07) and pooled proportion of major complications (4.9 vs 5.0%, P = 0.49), while uMWA had higher pooled proportions of overall and minor complications than cMWA (97.8 vs 29.7%, P < 0.01; 97.8 vs 21.0%, P < 0.01), with more patients suffering pain and skin burn after uMWA (100 vs 5.5%, P < 0.01; 47.2 vs 0.2%, P < 0.01).

Conclusion

MWA is an effective treatment modality for BTNs. When considering the patient’s comfort, cMWA would be a more preferable procedure with less complications.
Literature
1.
H. Gharib, E. Papini, R. Paschke, D.S. Duick, R. Valcavi, L. Hegedus, P. Vitti, American association of clinical endocrinologists, associazione medici endocrinologi, and European thyroid association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. J. Endocrinol. Invest. 33, 1–50 (2010)CrossRef
2.
H. Gharib, L. Hegedus, C.M. Pacella, J.H. Baek, E. Papini, Clinical review: Nonsurgical, image-guided, minimally invasive therapy for thyroid nodules. J. Clin. Endocrinol. Metab. 98, 3949–3957 (2013)CrossRef
3.
J.J. Sancho, R. Prieto, J.P. Duenas, C. Ribera, J. Ripolles, A. Larrad, A. Sitges-Serra, A randomized trial of hemithyroidectomy versus Dunhill for the surgical management of asymmetrical multinodular goiter. Ann. Surg. 256, 846–842 (2012)CrossRef
4.
L. Rosato, N. Avenia, P. Bernante, M. De Palma, G. Gulino, P.G. Nasi, M.R. Pelizzo, L. Pezzullo, Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J. Surg. 28, 271–276 (2004)CrossRef
5.
R. Cesareo, A. Palermo, V. Pasqualini, R. Cianni, G. Gaspa, S. Manfrini, C.M. Pacella, Radiofrequency ablation for the management of thyroid nodules: A critical appraisal of the literature. Clin. Endocrinol. 87, 639–648 (2017)CrossRef
6.
E. Papini, R. Gugliemi, C.M. Pacella, Laser, radiofrequency, and ethanol ablation for the management of thyroid nodules. Curr. Opin. Endocrinol. Diabetes Obes. 23, 400–406 (2016)CrossRef
7.
M.K. Shahrzad, Laser thermal ablation of thyroid benign nodules. J. Lasers Med. Sci. 6, 151–156 (2015)CrossRef
8.
A.P. Mainini, C. Monaco, L.C. Pescatori, C. De Angelis, F. Sardanelli, L.M. Sconfienza, G. Mauri, Image-guided thermal ablation of benign thyroid nodules. J. Ultrasound 20, 11–22 (2017)CrossRef
9.
Y.L. Yang, C.Z. Chen, X.H. Zhang, Microwave ablation of benign thyroid nodules. Future Oncol. 10, 1007–1014 (2014)CrossRef
10.
P. Liang, Y. Wang, X. Yu, B. Dong, Malignant liver tumors: Treatment with percutaneous microwave ablation—complications among cohort of 1136 patients. Radiology 251, 933–940 (2009)CrossRef
11.
W. Wu, X. Gong, Q. Zhou, X. Chen, X. Chen, B. Shi, US-guided percutaneous microwave ablation for the treatment of benign thyroid nodules. Endocr. J. 64, 1079–1085 (2017)CrossRef
12.
Y.J. Liu, L.X. Qian, D. Liu, J.F. Zhao, Ultrasound-guided microwave ablation in the treatment of benign thyroid nodules in 435 patients. Exp. Biol. Med. 242, 1515–1523 (2017)CrossRef
13.
Z. Cheng, Y. Che, S. Yu, S. Wang, D. Teng, H. Xu, J. Li, D. Sun, Z. Han, P. Liang, US-guided percutaneous radiofrequency versus microwave ablation for benign thyroid nodules: A prospective multicenter study. Sci. Rep. 7, 9554 (2017)CrossRef
14.
F. Morelli, A. Sacrini, G. Pompili, A. Borelli, S. Panella, A. Masu, L. De Pasquale, R. Giacchero, G. Carrafiello, Microwave ablation for thyroid nodules: A new string to the bow for percutaneous treatments? Gland Surg. 5, 553–558 (2016)CrossRef
15.
J. Yu, P. Liang, Status and advancement of microwave ablation in China. Int. J. Hyperthermia 33, 278–287 (2017)CrossRef
16.
S.P. Hozo, B. Djulbegovic, I. Hozo, Estimating the mean and variance from the median, range, and the size of a sample. BMC Med. Res. Methodol. 5, 13 (2005)CrossRef
17.
D.R. Burke, C.A. Lewis, J.F. Cardella, S.J. Citron, A.T. Drooz, Z.J. Haskal, J.W. Husted, T.C. McCowan, A. Van Moore, S.B. Oglevie, D. Sacks, J.B. Spies, R.B. Towbin, C.W. Bakal, Quality improvement guidelines for percutaneous transhepatic cholangiography and biliary drainage. J. Vasc. Interv. Radiol. 14, S243–246 (2003)CrossRef
18.
C.A. Lewis, T.E. Allen, D.R. Burke, J.F. Cardella, S.J. Citron, P.E. Cole, A.T. Drooz, E.A. Drucker, Z.J. Haskal, L.G. Martin, A. Van Moore, C.D. Neithamer, S.B. Oglevie, K.S. Rholl, A.C. Roberts, D. Sacks, O. Sanchez, A. Venbrux, C.W. Bakal, Quality improvement guidelines for central venous access. The standards of practice committee of the society of cardiovascular and interventional radiology. J. Vasc. Interv. Radiol. 8, 475–479 (1997)CrossRef
19.
I. J. Nixon, P. Angelos, A. R. Shaha, A. Rinaldo, M. D. Williams, A. Ferlito, Image-guided chemical and thermal ablations for thyroid disease: Review of efficacy and complications. Head Neck (2018)
20.
O. Dent, Methodological index for non-randomized studies. ANZ J. Surg. 73, 675–676 (2003)CrossRef
21.
J. Higgins, S. Green, Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. Updated March 2011. Accessed 15 Aug 2015
22.
M. Egger, G. Davey Smith, M. Schneider, C. Minder, Bias in meta-analysis detected by a simple, graphical test. BMJ 315, 629–634 (1997)CrossRef
23.
Y. Korkusuz, K. Kohlhase, D. Groner, C. Erbelding, W. Luboldt, C. Happel, S. Ahmad, T.J. Vogl, F. Gruenwald, Microwave ablation of symptomatic benign thyroid nodules: Energy requirement per ml volume reduction. RoFo 188, 1054–1060 (2016)CrossRef
24.
B. Wang, Z. Y. Han, J. Yu, Z. Cheng, F. Liu, X. L. Yu, C. Chen, J. Liu, P. Liang, Factors related to recurrence of the benign non-functioning thyroid nodules after percutaneous microwave ablation. Int. J. Hyperthermia 33, 459–464 (2017)CrossRef
25.
W.W. Yue, S.R. Wang, F. Lu, L.P. Sun, L.H. Guo, Y.L. Zhang, X.L. Li, H.X. Xu, Radiofrequency ablation vs. microwave ablation for patients with benign thyroid nodules: A propensity score matching study. Endocrine 55, 485–495 (2017)CrossRef
26.
H. Korkusuz, C. Happel, K. Heck, H. Ackermann, F. Grunwald, Percutaneous thermal microwave ablation of thyroid nodules. Preparation, feasibility, efficiency. Nuklearmedizin 53, 123–130 (2014)CrossRef
27.
Y. Wei, L. Qian, J. B. Liu, Y. Liu, Sonographic measurement of thyroid nodule changes after microwave ablation: relationship between multiple parameters. Int. J. Hyperthermia 34, 660–668 (2018)CrossRef
28.
W. Wu, X. Gong, Q. Zhou, X. Chen, X. Chen, Ultrasound-guided percutaneous microwave ablation for solid benign thyroid nodules: Comparison of MWA versus control group. Int. J. Endocrinol. 2017, 9724090 (2017)PubMedPubMedCentral
29.
Y. Korkusuz, D. Groner, N. Raczynski, O. Relin, Y. Kingeter, F. Grunwald, C. Happel, Thermal ablation of thyroid nodules: Are radiofrequency ablation, microwave ablation and high intensity focused ultrasound equally safe and effective methods? Eur. Radiol. 28, 929–935 (2018)CrossRef
30.
B. Feng, P. Liang, Z. Cheng, X. Yu, J. Yu, Z. Han, F. Liu, Ultrasound-guided percutaneous microwave ablation of benign thyroid nodules: experimental and clinical studies. Eur. J. Endocrinol. 166, 1031–1037 (2012)CrossRef
31.
K. Heck, C. Happel, F. Grunwald, H. Korkusuz, Percutaneous microwave ablation of thyroid nodules: Effects on thyroid function and antibodies. Int. J. Hyperth. 31, 560–567 (2015)CrossRef
32.
O.M. Mader, N.F. Tanha, A. Mader, C. Happel, Y. Korkusuz, F. Grunwald, Comparative study evaluating the efficiency of cooled and uncooled single-treatment MWA in thyroid nodules after a 3-month follow up. Eur. J. Radiol. Open 4, 4–8 (2017)CrossRef
33.
W. Yue, S. Wang, B. Wang, Q. Xu, S. Yu, Z. Yonglin, X. Wang, Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: safety and imaging follow-up in 222 patients. Eur. J. Radiol. 82, e11–16 (2013)CrossRef
34.
H. Korkusuz, F. Nimsdorf, C. Happel, H. Ackermann, F. Grunwald, Percutaneous microwave ablation of benign thyroid nodules. Functional imaging in comparison to nodular volume reduction at a 3-month follow-up. Nuklearmedizin 54, 13–19 (2015)CrossRef
35.
X. Zhi, N. Zhao, Y. Liu, J. B. Liu, C. Teng, L. Qian, Microwave ablation compared to thyroidectomy to treat benign thyroid nodules. Int. J. Hyperthermia 34, 644–652 (2018)CrossRef
36.
C.L. Brace, Radiofrequency and microwave ablation of the liver, lung, kidney, and bone: What are the differences? Curr. Probl. Diagn. Radiol. 38, 135–143 (2009)CrossRef
37.
Y. Korkusuz, O.M. Mader, W. Kromen, C. Happel, S. Ahmad, D. Groner, M. Koca, A. Mader, F. Grunwald, H. Korkusuz, Cooled microwave ablation of thyroid nodules: Initial experience. Eur. J. Radiol. 85, 2127–2132 (2016)CrossRef
38.
E.J. Ha, J.H. Baek, K.W. Kim, J. Pyo, J.H. Lee, S.H. Baek, H. Dossing, L. Hegedus, Comparative efficacy of radiofrequency and laser ablation for the treatment of benign thyroid nodules: systematic review including traditional pooling and bayesian network meta-analysis. J. Clin. Endocrinol. Metab. 100, 1903–1911 (2015)CrossRef
39.
M. Ahmed, C.L. Brace, F.T. Lee Jr., S.N. Goldberg, Principles of and advances in percutaneous ablation. Radiology 258, 351–369 (2011)CrossRef
40.
E.M. Knavel, C.L. Brace, Tumor ablation: Common modalities and general practices. Tech. Vasc. Interv. Radiol. 16, 192–200 (2013)CrossRef
41.
J.H. Shin, J.H. Baek, E.J. Ha, J.H. Lee, Radiofrequency ablation of thyroid nodules: basic principles and clinical application. Int. J. Endocrinol. 2012, 919650 (2012)CrossRef
42.
R. Cesareo, V. Pasqualini, C. Simeoni, M. Sacchi, E. Saralli, G. Campagna, R. Cianni, Prospective study of effectiveness of ultrasound-guided radiofrequency ablation versus control group in patients affected by benign thyroid nodules. J. Clin. Endocrinol. Metab. 100, 460–466 (2015)CrossRef
43.
S.L. Jung, J.H. Baek, J.H. Lee, Y.K. Shong, J.Y. Sung, K.S. Kim, D. Lee, J.H. Kim, S.M. Baek, J.S. Sim, D.G. Na, Efficacy and safety of radiofrequency ablation for benign thyroid nodules: A prospective multicenter study. Korean J. Radiol. 19, 167–174 (2018)CrossRef
44.
J.H. Baek, J.H. Lee, J.Y. Sung, J.I. Bae, K.T. Kim, J. Sim, S.M. Baek, Y.S. Kim, J.H. Shin, J.S. Park, D.W. Kim, J.H. Kim, E.K. Kim, S.L. Jung, D.G. Na, Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study. Radiology 262, 335–342 (2012)CrossRef
45.
C. Kim, J.H. Lee, Y.J. Choi, W.B. Kim, T.Y. Sung, J.H. Baek, Complications encountered in ultrasonography-guided radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers. Eur. Radiol. 27, 3128–3137 (2017)CrossRef
46.
W.K. Jeong, J.H. Baek, H. Rhim, Y.S. Kim, M.S. Kwak, H.J. Jeong, D. Lee, Radiofrequency ablation of benign thyroid nodules: Safety and imaging follow-up in 236 patients. Eur. Radiol. 18, 1244–1250 (2008)CrossRef
47.
J.F. Wang, T. Wu, K.P. Hu, W. Xu, B.W. Zheng, G. Tong, Z.C. Yao, B. Liu, J. Ren, Complications followingradiofrequency ablation of benign thyroid nodules: A systematic review. Chin. Med. J. (Engl.) 130, 1361–1370 (2017)CrossRef
48.
R. Cervelli, S. Mazzeo, L. De Napoli, A. Boccuzzi, B. Pontillo-Contillo, G. Materazzi, P. Miccoli, R. Cioni, D. Caramella, Radiofrequency ablation in the treatment of benign thyroid nodules: An efficient and safe alternative to surgery. J. Vasc. Interv. Radiol. 28, 1400–1408 (2017)CrossRef
49.
Y. Sun, Y. Wang, X. Ni, Y. Gao, Q. Shao, L. Liu, P. Liang, Comparison of ablation zone between 915- and 2,450-MHz cooled-shaft microwave antenna: Results in in vivo porcine livers. AJR Am. J. Roentgenol. 192, 511–514 (2009)CrossRef
50.
N. He, W. Wang, Z. Ji, C. Li, B. Huang, Microwave ablation: an experimental comparative study on internally cooled antenna versus non-internally cooled antenna in liver models. Acad. Radiol. 17, 894–899 (2010)CrossRef
Metadata
Title
Efficacy and safety of cooled and uncooled microwave ablation for the treatment of benign thyroid nodules: a systematic review and meta-analysis
Authors
Bo-wen Zheng
Jin-fen Wang
Jin-xiu Ju
Tao Wu
Ge Tong
Jie Ren
Publication date
01-11-2018
Publisher
Springer US
Published in
Endocrine / Issue 2/2018
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-018-1693-2

Other articles of this Issue 2/2018

Endocrine 2/2018 Go to the issue

Original Article

Effect of timing of levothyroxine administration on the treatment of hypothyroidism: a three-period crossover randomized study

Endocrine Surgery

The role of E and N-cadherin in the postoperative course of gonadotroph pituitary tumours

Original Article

Efficacy and safety of long-acting pasireotide in patients with somatostatin-resistant acromegaly: a multicenter study

Original Article

Temporal relationship of sleep apnea and acromegaly: a nationwide study

Endocrine imaging

Severe Graves’ Orbitopathy occurring in a patient with thyroid hemiagenesis

Original Article

New modified Friedewald formulae for estimating low-density lipoprotein cholesterol according to triglyceride levels: extraction and validation
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits