Abstract:
Thyroid cancer is the most common endocrine malignancy, and its incidence is increasing, driven in part by the advent of ultrasound, and subsequent increased detection of small, early thyroid cancers. Yet even for small tumors, thyroidectomy with lymph node dissection remains standard of care. Specific to well-differentiated thyroid cancer, surgery has come under scrutiny as a possible overtreatment, in light of stable and favorable survival rates even as guidelines have allowed fewer radical resections and lymph node dissections over time. Moreover, thyroid cancer unfortunately has a known recurrence rate regardless of therapy, and surgical re-intervention for local structural recurrence is eventually limited by scar. Radioactive iodine therapy, another accepted treatment, is minimally invasive but can only treat patients with iodine-avid tumors. For all of these reasons, image-guided thermal ablation has emerged as a valuable complementary tool as a thyroid-sparing, parathyroid-sparing, voice-sparing, repeatable, minimally invasive outpatient focal therapy for both primary and recurrent well-differentiated thyroid cancers. However, the data are still evolving, and this represents a new patient cohort for some interventional radiologists. Therefore, the goal of this review is to discuss the technique and evidence for ablation of patients with thyroid cancer.
摘要:
甲状腺癌是最常见的内分泌恶性肿瘤,它的发病率在增加,部分原因是超声波的出现,随后增加了对小的检测,早期甲状腺癌.然而,即使是小肿瘤,甲状腺切除术和淋巴结清扫仍是标准护理。特异于高分化甲状腺癌,手术作为可能的过度治疗而受到审查,鉴于稳定和有利的生存率,即使指南允许随着时间的推移减少根治性切除和淋巴结清扫。此外,不幸的是,无论治疗方法如何,甲状腺癌都有已知的复发率,局部结构性复发的手术再干预最终受到瘢痕的限制。放射性碘治疗,另一种公认的治疗方法,是微创的,但只能治疗富含碘的肿瘤患者。由于所有这些原因,图像引导热消融已经成为一种有价值的补充工具,作为甲状腺保护,保留甲状旁腺,保留声音,可重复,原发性和复发性高分化甲状腺癌的微创门诊局部治疗.然而,数据仍在发展,对于一些介入放射科医生来说,这代表了一个新的患者队列。因此,本综述的目的是讨论甲状腺癌患者消融的技术和证据。