Abstract：
BACKGROUND: Recently, locoregional treatment with ultrasound-guided radiofrequency has been proposed as a new, effective, and safe procedure for low-risk papillary thyroid microcarcinoma (PTC < 1 cm), not eligible or recruitable for surgery. Until now, the gold standard has been the surgery and then the active surveillance.
OBJECTIVE: The aim of the study is to present our experience of ultrasound-guidedthermoablation, a procedure performed before demolitive surgery and post-active surveillance. It is a non-invasive treatment that does not require general anesthesia, with a low risk of complications, hypothyroidism, and hypoparathyroidism.
METHODS: All nodules described on ultrasound showed a volumetric increase (follow-up from 12 to 36 months). The cytological examination in all cases showed TIR 4b and TIR 5 papillary microcarcinoma. All the patients were offered the possibility of radiofrequency thermoablation; they were all informed and gave their consent. 18G active tip electrode needles 7 or 10 mm (Amica Gen HS) were used with the moving shot method under local anesthesia in a day hospital setting. No severe complications were reported.
RESULTS: Contrast-Enhanced Ultrasonography (CEUS) with SonoVue (CEUS Sonovue) was performed post-procedure and then at 1, 3, 6, and 12 months, which documented complete revascularization and progressive volumetric reduction of the treated area.
CONCLUSIONS: Our experience has confirmed that radiofrequency ablation can effectively eliminate small papillary thyroid carcinomas with fewer complications. In our opinion, it is a valid alternative for the treatment of low-risk and indolent papillary thyroid microcarcinomas, even in the absence of surgical contraindications.
OBJECTIVE: The aim of the study is to present our experience of ultrasound-guidedthermoablation, a procedure performed before demolitive surgery and post-active surveillance. It is a non-invasive treatment that does not require general anesthesia, with a low risk of complications, hypothyroidism, and hypoparathyroidism.
METHODS: All nodules described on ultrasound showed a volumetric increase (follow-up from 12 to 36 months). The cytological examination in all cases showed TIR 4b and TIR 5 papillary microcarcinoma. All the patients were offered the possibility of radiofrequency thermoablation; they were all informed and gave their consent. 18G active tip electrode needles 7 or 10 mm (Amica Gen HS) were used with the moving shot method under local anesthesia in a day hospital setting. No severe complications were reported.
RESULTS: Contrast-Enhanced Ultrasonography (CEUS) with SonoVue (CEUS Sonovue) was performed post-procedure and then at 1, 3, 6, and 12 months, which documented complete revascularization and progressive volumetric reduction of the treated area.
CONCLUSIONS: Our experience has confirmed that radiofrequency ablation can effectively eliminate small papillary thyroid carcinomas with fewer complications. In our opinion, it is a valid alternative for the treatment of low-risk and indolent papillary thyroid microcarcinomas, even in the absence of surgical contraindications.
摘要：
背景：最近，超声引导射频局部治疗被认为是一种新的,有效,低危甲状腺乳头状微小癌（PTC<1cm）的安全手术，没有资格或可招募的手术。直到现在,黄金标准是手术，然后是主动监测。
目的：本研究的目的是介绍我们的超声引导热消融的经验，拆除手术前和主动监测后执行的程序。它是一种不需要全身麻醉的非侵入性治疗，并发症的风险很低，甲状腺功能减退,和甲状旁腺功能减退.
方法：超声上描述的所有结节均显示体积增加（随访12至36个月）。所有病例的细胞学检查均显示TIR4b和TIR5乳头状微小癌。为所有患者提供了射频热消融的可能性；他们都被告知并同意。在日间医院环境中，在局部麻醉下，将18G有源尖端电极针7或10mm（AmicaGenHS）与移动射击方法一起使用。无严重并发症报告。
结果：术后进行超声造影（CEUS）与SonoVue（CEUSSonovue），然后在1、3、6和12个月进行，记录了治疗区域的完全血运重建和进行性体积减少。
结论：我们的经验证实，射频消融可以有效消除甲状腺小乳头状癌，并发症少。在我们看来,它是治疗低风险和惰性甲状腺乳头状微小癌的有效替代方法，即使没有手术禁忌症。
目的：本研究的目的是介绍我们的超声引导热消融的经验，拆除手术前和主动监测后执行的程序。它是一种不需要全身麻醉的非侵入性治疗，并发症的风险很低，甲状腺功能减退,和甲状旁腺功能减退.
方法：超声上描述的所有结节均显示体积增加（随访12至36个月）。所有病例的细胞学检查均显示TIR4b和TIR5乳头状微小癌。为所有患者提供了射频热消融的可能性；他们都被告知并同意。在日间医院环境中，在局部麻醉下，将18G有源尖端电极针7或10mm（AmicaGenHS）与移动射击方法一起使用。无严重并发症报告。
结果：术后进行超声造影（CEUS）与SonoVue（CEUSSonovue），然后在1、3、6和12个月进行，记录了治疗区域的完全血运重建和进行性体积减少。
结论：我们的经验证实，射频消融可以有效消除甲状腺小乳头状癌，并发症少。在我们看来,它是治疗低风险和惰性甲状腺乳头状微小癌的有效替代方法，即使没有手术禁忌症。
