Endocrine Abstracts

Objectives: To define sonographic and color Doppler peculiarities of thyroid nodules influencing the efficacy and follow-up principles of percutaneous laser ablation (PLA).

Methods: Three hundred forty-five thyroid nodules were treated with 1–3 PLA sessions and subsequently sonographically examined every three months within one year. Indication for PLA was increase sizes of nodules. All nodes were benign according to FNAB.

Results: The best results after PLA were achieved in solitary solid nodules 20 mm or smaller with low vascularity of peripheral or combined pattern. Effectiveness depended on the size of the nodules. Big nodules and hypervascular nodules needed more PLA sessions with increased laser power supply. The nodules with calcification, avascular regions of extremely high or low US-density and big fluid collections showed poor volume regression. Nodules having high density according to US elastography worse decreased. Homogenous surrounding tissue US-pattern allows faster nodule volume decrease comparatively to autoimmune thyroiditis. In 72% nodules reduced their volume more than to two times and 24% disappeared. Avascular and hypoechoic nodules in four week period after PLA show further volume regression; persisting vascularization suggests a second PLA session.

Conclusions: US- guided PLA is effective in benign thyroid nodules and may be alternative to conservative methods. Grey-scale and color Doppler sonography is the leading follow-up modality for patients after PLA. The best period of control for effectiveness of treatment was ninth month after PLA