Purpose : Among patients diagnosed with benign thyroid nodule, those experiencing aesthetic problems, discomfort of neck or anxiety for malignant changes are being recently treated through RFA or EI. This study researches the subjects, treatment effects & safety of each treatment method.
Subject and method : Out of the 75 patients, 36 patients had received RFA whereas 39 had received EI from October 2009 to June 2011. All surgeries were implemented 1~2 times. Follow-up ultrasound was conducted 1~22 months after the surgery to compare the decrease in nodule volume & aesthetic changes based on the final examination results. Furthermore, ultrasound images were used to classify nodules as Cystic, Solid or Complex. To examine changes in the size of the nodule, this study used Formula (1), & to calculate the decrease rate of volume before and after surgery, Formula (2) was used for comparison. Aesthetic score was measured on a scale of 1~4 points by examining the aesthetic problem & the palpable degree of nodule. The effectiveness of treatment was calculated by the ratio of patients that presented at least 50% decrease in nodule volume through surgery.
Formula 1. Volume = major axis x minor axis x height (π/6)
Formula 2. Volume decrease rate = decreased volume (volume before treatment - final volume after treatment) x 100/volume before treatment
Results : Out of the 36 patients that underwent RFA, 29 were women & 7 were men. The average age of patients was 46. The nature of the nodule was classified as the following: 23 solid nodules & 13 complex nodules. The average volume before surgery was 23.95ml & the average volume was decreased to 11.51ml after surgery. Final surgery results presented the average decrease rate of nodule volume as 56%. Aesthetic score was decreased from 2.33 to 1.52 & the effectiveness of treatment was presented as 72.2%.Out of the 39 patients that underwent EI, 32 were women & 7 were men. The average age of patients was 42. The nature of the nodule was classified as the following: 34 cystic nodules & 5 complex nodules. The average volume before surgery was 18ml & the average volume was decreased to 4.9ml after surgery. Final surgery results presented the average decrease rate of nodule volume as 69.1%. Aesthetic score was decreased from 2.89 to 1.56 and the effectiveness of treatment was presented as 82.05%.
Conclusion : RFA & EI methods are used to treat benign nodules of the thyroid gland. The preference for these treatment methods differ according to the nature of the nodule & the effect of treatment in comparison to the surgical cost. EI is preferred for nodules with many cystic portions whereas RFA is preferred for nodules with many solid portions. Complex nodules are first treated through EI & followed by the RFA. Both surgical methods are regarded effective treatment methods as they present significant changes in the decrease of nodule volume, alleviate symptoms & improve aesthetic changes by leaving no scars.
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