PDF(Pubmed)
Abstract：
BACKGROUND: Benign thyroid nodules (BTNs) represent a prevalent clinical challenge globally, with various ultrasound-guided ablation techniques developed for their management. Despite the availability of these methods, a comprehensive evaluation to identify the most effective technique remains absent. This study endeavors to bridge this knowledge gap through a network meta-analysis (NMA), aiming to enhance the understanding of the comparative effectiveness of different ultrasound-guided ablation methods in treating BTNs.
METHODS: We comprehensively searched PubMed, Embase, Cochrane, Web of Science, Ovid, SCOPUS, and ProQuest for studies involving 16 ablation methods, control groups, and head-to-head trials. NMA was utilized to evaluate methods based on the percentage change in nodule volume, symptom score, and cosmetic score. This study is registered in INPLASY (registration number 202260061).
RESULTS: Among 35 eligible studies involving 5655 patients, NMA indicated that RFA2 (radiofrequency ablation, 2 sessions) exhibited the best outcomes at 6 months for percentage change in BTN volume (SUCRA value 74.6), closely followed by RFA (SUCRA value 73.7). At 12 months, RFA was identified as the most effective (SUCRA value 81.3). Subgroup analysis showed RFA2 as the most effective for solid nodule volume reduction at 6 months (SUCRA value 75.6), and polidocanol ablation for cystic nodules (SUCRA value 66.5).
CONCLUSIONS: Various ablation methods are effective in treating BTNs, with RFA showing notable advantages. RFA with 2 sessions is particularly optimal for solid BTNs, while polidocanol ablation stands out for cystic nodules.
METHODS: We comprehensively searched PubMed, Embase, Cochrane, Web of Science, Ovid, SCOPUS, and ProQuest for studies involving 16 ablation methods, control groups, and head-to-head trials. NMA was utilized to evaluate methods based on the percentage change in nodule volume, symptom score, and cosmetic score. This study is registered in INPLASY (registration number 202260061).
RESULTS: Among 35 eligible studies involving 5655 patients, NMA indicated that RFA2 (radiofrequency ablation, 2 sessions) exhibited the best outcomes at 6 months for percentage change in BTN volume (SUCRA value 74.6), closely followed by RFA (SUCRA value 73.7). At 12 months, RFA was identified as the most effective (SUCRA value 81.3). Subgroup analysis showed RFA2 as the most effective for solid nodule volume reduction at 6 months (SUCRA value 75.6), and polidocanol ablation for cystic nodules (SUCRA value 66.5).
CONCLUSIONS: Various ablation methods are effective in treating BTNs, with RFA showing notable advantages. RFA with 2 sessions is particularly optimal for solid BTNs, while polidocanol ablation stands out for cystic nodules.
摘要：
背景：良性甲状腺结节（BTN）是全球普遍存在的临床挑战，为其管理开发了各种超声引导消融技术。尽管这些方法可用，一个全面的评估，以确定最有效的技术仍然缺乏。本研究试图通过网络荟萃分析(NMA)弥合这一知识差距，旨在增强对不同超声引导消融方法治疗BTN的比较有效性的理解。
方法：我们全面搜索了PubMed，Embase,科克伦,WebofScience,奥维德,Scopus,和ProQuest涉及16种消融方法的研究，控制组,和正面交锋的试验.NMA用于评估基于结节体积百分比变化的方法，症状评分,和化妆品得分。本研究在INPLASY（注册号202260061）注册。
结果：在涉及5655名患者的35项符合条件的研究中，NMA表明RFA2(射频消融，2次会议)在6个月时表现出最佳的BTN体积百分比变化结果(SUCRA值74.6)，紧随其后的是RFA(SUCRA值73.7)。12个月时,RFA被确定为最有效(SUCRA值81.3)。亚组分析显示，在6个月时，RFA2对实体结节体积减少最有效（SUCRA值75.6），和脊髓灰质炎消融治疗囊性结节（SUCRA值66.5）。
结论：各种消融方法均可有效治疗BTN，RFA显示出显著的优势。具有2个会话的RFA对于可靠的BTN特别理想，而polidocanol消融在囊性结节中脱颖而出。
方法：我们全面搜索了PubMed，Embase,科克伦,WebofScience,奥维德,Scopus,和ProQuest涉及16种消融方法的研究，控制组,和正面交锋的试验.NMA用于评估基于结节体积百分比变化的方法，症状评分,和化妆品得分。本研究在INPLASY（注册号202260061）注册。
结果：在涉及5655名患者的35项符合条件的研究中，NMA表明RFA2(射频消融，2次会议)在6个月时表现出最佳的BTN体积百分比变化结果(SUCRA值74.6)，紧随其后的是RFA(SUCRA值73.7)。12个月时,RFA被确定为最有效(SUCRA值81.3)。亚组分析显示，在6个月时，RFA2对实体结节体积减少最有效（SUCRA值75.6），和脊髓灰质炎消融治疗囊性结节（SUCRA值66.5）。
结论：各种消融方法均可有效治疗BTN，RFA显示出显著的优势。具有2个会话的RFA对于可靠的BTN特别理想，而polidocanol消融在囊性结节中脱颖而出。
