Endocrine Abstracts

The objective was to evaluate the short-term results of the laser interstitial thermotherapy (LITT) application in the treatment of patients with nodular goiter and cytology TBSRTC IV category.

Materials and methods: In 2021-2023, ultrasound-guided LITT was performed on 21 patients with nodular goiter and cytology TBSRTC IV. Laser type - GaAlAs Diode Laser (VELAS II-30F). The wavelength was 1064 nm, and the emission mode - continuous. Power at the 1st session was 3.4 (3.3; 3.5) W, at the 2nd - 3.4 (3.4; 3.45) W, P = 0.58. The energy at the 1st session was 510.0 (352.0; 784.5) J, the 2nd - 408 (258, 770.5) J, P = 0.31. Twenty-six LITT sessions were performed: Group I (n =12) - 1 session, Group II (n =6) - 2 sessions. Volume-reduction rate (VRR) and cytological smears at control TFNAB were evaluated. A positive result has been considered at VRR ± 70.0% and the absence of atypia in control smears. The average follow-up period was 4.0 (3.0; 6.3) months.

The results VRR after 1 LITT session ranged from 12.4% to 99.10%, after the 2^nd LITT session at 1^st control - min. - 85.7%, max. - 100.0%, at the 2^nd control – 96.55%. The frequency of patients with VRR ± 70.0% in Group I was 75.0%, and in Group II – 100.0%, P = 0.52. Binary logistic regression analysis did not reveal a statistically significant relationship between the frequency of VRR ± 70.0% and the number of sessions or energy delivered to the node, P = 0.34. After LITT at control TFNAB in Group I, the frequency of TBSRTC IV was 20% (n =1), and TBSRTC II – 80.0% (n =4). In group II, TBSRTC IV – 40.0% (n =2), TBSRTC III – 40.0% (n =2), and TBSRTC II – 20.0% (n =1). The study groups did not differ statistically significantly in the frequency of TBSRTC II, III, and IV after LITT, P = 0.13. The average values of DAP-IV activity before LITT in patients of Group I was 6.0 (3.25, 8.0), after LITT – 0.0 (0.0, 3.5), P = 0.068. In Group II, DAP-IV before LITT was 0.0 (0.0; 6.5), and after LITT – 3.0 (1.5; 6.0), P = 0.581.

Conclusions: Laser interstitial thermotherapy can be an effective method of treatment for patients with nodular goiter and a cytology TBSRTC IV. However, to obtain more valid results, a study should be conducted on a larger sample. The research proceeds.