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Endocrine Abstracts (2024) 101 PS2-17-06 | DOI: 10.1530/endoabs.101.PS2-17-06

ETA2024 Poster Presentations Non-surgical treatment (10 abstracts)

Proficiency in performing radiofrequency ablation procedure for non-functioning benign thyroid nodules: a qualitative rather than quantitative matter

Spyridon Chytiris 1 , Marsida Teliti 2 , Laura Croce 3 , Francesca Coperchini 3 , Beatrice Grillini 4 , Matteo Cerutti 4 , Rodolfo Fonte 5 , Flavia Magri 6 & Mario Rotondi 7


1Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri Irccs, 27100, Pavia, Italy., Pavia, Italy; 2Ics Maugeri, University of Pavia, Department of Internal Medicine and Therapeutics, Pavia, Italy; 3University of Pavia, Department of Internal Medicine and Therapeutics, Italy; 4Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Italy; 5Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri Irccs, 27100, Pavia, Italy.; 6F Maugeri Istituto Scientifico, Pavia, Italy; 7Unit of Internal Medicine and Endocrinology, Ics Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, University of Pavia, Unit of Internal Medicine and Endocrinology, Ics Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, University of Pavia, Italy, University of Pavia and Fondazione Mugeri, Pavia, Pavia, Italy


Objective: Radiofrequency ablation (RFA) is an emerging non-surgical treatment for benign thyroid nodules (BTN). Despite its proven safety profile, data on the learning curve (LC) required to achieve proficiency are still lacking.

Materials and methods: The first 179 RFA procedures performed by a single operator in patients with non-functioning BTN were retrospectively analyzed. Six-month nodule volume reduction rate (VRR) ≥ 50% was regarded as reflection of proficiency. Multiple linear regression analysis has been performed to determine the relationship between the VRR and clinical variables. Cumulative sum (CUSUM) charts were plotted to assess LCs for all consecutive procedures and in relation to basal nodule size. In details, Group 1 (G1): 57 patients with small nodules (<10 ml); Group 2 (G2): 87 patients with intermediate nodules (10 – 25 ml); Group 3 (G3): 35 patients with large size (> 25 ml).

Results: LC of all 179 procedures showed 3 phases: initial learning (1-39 procedures); consolidation (40-145 procedures); and experienced period (146-179 procedures). For G1 and G2 proficiency is achieved starting from the 10th procedure within the group (or 37th considering consecutively all procedures) and from the 59th procedure within the group (or 116th considering consecutively all procedures), respectively. LC of G3 did not detect operator proficiency.

Conclusion: Specific LCs exist concerning the basal size of the nodule treated with RFA. In nodules with baseline volume > 25 ml suboptimal VRR has to be expected. Previously achieved experience on small-intermediate nodules does not seem to provide advantages in terms of higher VRR in the treatment of large nodules. Other potential and non-modifiable factors likely play a key role in the final volume reduction independently from the increased skill of the operator.

Volume 101

46th Annual Meeting of the European Thyroid Association (ETA) 2024

European Thyroid Association 

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