Radiofrequency ablation for treatment of thyroid follicular neoplasm with low SUV in PET/CT study

• Main Authors: Wei-Che Lin, Yu-Cheng Tung, Yen-Hsiang Chang, Sheng-Dean Luo, Pi-Ling Chiang, Shun Chen Huang, Wei-Chih Chen, Chen-Kai Chou, Yan-Ye Su, Wen-Chieh Chen, Shun-Yu Chi, Jung Hwan Baek
• Format: Article
• Language: English
• Published: Taylor & Francis Group 2021-01-01
• Series: International Journal of Hyperthermia
• Subjects: thyroid gland; follicular neoplasm; ultrasound; f-18 fdg pet/ct; ablation technique
• Online Access: http://dx.doi.org/10.1080/02656736.2021.1912414
• ISSN: 0265-6736; 1464-5157

Objectives To evaluate the feasibility of radiofrequency ablation (RFA) on follicular neoplasm with low standard uptake value (SUV) in a Positron emission tomography (PET/CT) study. Methods From January 2018 to July 2019, 86 consecutive patients were diagnosed with follicular neoplasm. Of the patients, 28 with PET/CT scans were enrolled in this study. All patients received ultrasound, fine/core needle aspiration, and PET/CT scan prior to treatment. In accordance with previous studies, we recommended 6 patients who had follicular neoplasm with SUVmax ≥5 undergo surgical resection due to an elevated suspicion of malignancy. For 22 patients SUVmax <5, RFA was performed using the moving shot technique. Ultrasound was performed 6 to 12 months after each procedure. Results Statistically significant volume reductions during follow-up between values prior to RFA and 12 months post RFA were demonstrated (12.6 ± 20.9 vs. 2.4 ± 3.0 cm3, p < 0.001). Volume reduction ratios at 6–12 months (mean: 10.1 months) after RFA were 73.3% ± 17.7%. One patient presented with vocal cord palsy and recovered within 3 months after RFA. No postprocedural hypothyroidism occurred in the RFA patients. Conclusions By using PET/CT, we can select patients with low SUV follicular neoplasm. RFA offers a safe and feasible alternative treatment option for patients unsuitable or unwilling to undergo surgery.KEY POINTS By using positron emission tomography-computed tomography, we can distinguish low SUV follicular neoplasm for radiofrequency ablation. For low SUV follicular neoplasm, RF ablation offers a safe and effective alternative treatment option for patients unsuitable or unwilling to undergo surgery.