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Larijani B, Pajouhi M, Ghanaati H, Bastanhagh MH, Abbasvandi F, Firooznia K, Shirzad M, Amini MR, Sarai M, Abbasvandi N, Baradar-Jalili R. Treatment of hyperfunctioning thyroid nodules by percutaneous ethanol injection. BMC Endocr Disord 2002; 2:3. [PMID: 12470301 PMCID: PMC140013 DOI: 10.1186/1472-6823-2-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2002] [Accepted: 12/06/2002] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND: Autonomous thyroid nodules can be treated by a variety of methods. We assessed the efficacy of percutaneous ethanol injection in treating autonomous thyroid nodules. METHODS: 35 patients diagnosed by technetium-99 scanning with hyperfunctioning nodules and suppressed sensitive TSH (sTSH) were given sterile ethanol injections under ultrasound guidance. 29 patients had clinical and biochemical hyperthyroidism. The other 6 had sub-clinical hyperthyroidism with suppressed sTSH levels (<0.24 &mgr;IU/ml) and normal thyroid hormone levels. Ethanol injections were performed once every 1-4 weeks. Ethanol injections were stopped when serum T3, T4 and sTSH levels had returned to normal, or else injections could no longer be performed because significant side effects. Patients were followed up at 3, 6 and, in 15 patients, 24 months after the last injection. RESULTS: Average pre-treatment nodule volume [18.2 PlusMinus; 12.7 ml] decreased to 5.7 PlusMinus; 4.6 ml at 6 months follow-up [P < 0.001]. All patients had normal thyroid hormone levels at 3 and 6 months follow-up [P < 0.001 relative to baseline]. sTSH levels increased from 0.09 PlusMinus; 0.02 &mgr;IU/ml to 0.65 PlusMinus; 0.8 &mgr;IU/ml at the end of therapy [P < 0.05]. Only 3 patients had persistent sTSH suppression at 6 months post-therapy. T4 and sTSH did not change significantly between 6 months and 2 years [P > 0.05]. Ethanol injections were well tolerated by the patients, with only 2 cases of transient dysphonia. CONCLUSION: Our findings indicate that ethanol injection is an alternative to surgery or radioactive iodine in the treatment of autonomous thyroid nodules.
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Affiliation(s)
- Bagher Larijani
- Endocrinology & Metabolism Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Pajouhi
- Endocrinology & Metabolism Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Ghanaati
- Medical Imaging Centre, Imam Khomeini University Hospital, Tehran, Iran
| | | | - Fereshteh Abbasvandi
- Endocrinology & Metabolism Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Firooznia
- Medical Imaging Centre, Imam Khomeini University Hospital, Tehran, Iran
| | - Mahmood Shirzad
- Endocrinology & Metabolism Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Amini
- Endocrinology & Metabolism Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Sarai
- Endocrinology & Metabolism Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasreen Abbasvandi
- Endocrinology & Metabolism Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Baradar-Jalili
- Endocrinology & Metabolism Research Centre, Tehran University of Medical Sciences, Tehran, Iran
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