Endocrine Abstracts

Purpose: Our purpose was to evaluate the safety and effectiveness of a virtual needle tracking system for US-guided percutaneous RFA of benign thyroid nodules (BTN) as compared to standard RFA.

Method and materials: A STARmed (Korea) 18G bipolar RF electrode was used to perform the BTN ablation procedures. A US machine (LOGIQ E9, GE Healthcare) with a low magnetic field generator was used; electromagnetic sensors, calculating their mutual position, were set on the US probe and on the needle bottom (VirtuTRAX, CIVCO); the system shows the expected path of the needle and its tip position. US-guided RFA were made with a in-plane approach on 23 patients (18F; 57±14) with BTN, randomized in two groups: 13 (group A) were treated with RFA using the Virtual Tracker, 10 (group B) without it. A contrast-enhanced US follow-up was performed after one week in order to have a precise assessment of the area of necrosis in each patient.

Results: In all 23 cases a wide area of nodule ablation was safely obtained. The positioning system accurately guided the needle tip inside the target and allowed for a correct treatment of the lesions with RF. A significant increase of the area of necrosis after RFA was found in group A compared to group B (P<0.01). No periprocedural complications occured.

Conclusion: The Virtual tracker allows to easily perform nodules RFA with US-guided approach, providing the clear visualization of the virtual needle tip and shaft, even if the real needle is not visible due to the ablation artifact. The excellent level of safety provided by the virtual tracker allows to perform RFA with high confidence achieving a shortening of the learning curve and granting a significant increase in the nodule area of ablation.