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ABSTRACT
Recently, percutaneous ethanol injection therapy (PEIT) has been used as an alternative to surgery and radioiodine for the management of autonomously functioning thyroid nodules. Here we report our experience on the efficacy and complications of PEIT on toxic thyroid nodules in two years follow-up. In 26 patients with autonomously functioning thyroid nodules, the levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyrotropin (TSH), ultrasound and scintigraphic evaluation of thyroid gland before, 6 and 24 months after ethanol injection were determined. PEIT was performed after excluding malignancy by fineneedle aspiration biopsy. Each patient underwent 3-8 sessions (mean 4 ± 1) of PEIT, with an injection of 1.5-8.0 (mean 3.76 ± 1.67) mL total amount of ethanol. Results: Mean nodule volume reduced from 5.5 ± 6.1mL to 2.8 ± 3.8mL 6 months after therapy (p=0.0001) and to 2.6 ± 4.1mL (p=0.001) 24 months after therapy at ultrasound evaluation. Nodule volumes showed a significant shrinkage 6 and 24 months after therapy (92.3% and 90.0%, respectively). During follow-up, hyperfunctioning nodule became cold in 11 (42.3%) and relatively active in 7 (26.9%) of patients at scintigraphy. TSH levels increased to normal levels in 17 (65.4%), and persisted below normal levels in 9 (34.6%) patients. Injections were well tolerated by all patients. Treatment did not cause considerable side effects. PEIT can be considered as practical, effective and cost-effective treatment as an alternative method to surgery and radioiodine without any severe complication particularly hypothyroidism for benign toxic nodules.
Recently, percutaneous ethanol injection therapy (PEIT) has been used as an alternative to surgery and radioiodine for the management of autonomously functioning thyroid nodules. Here we report our experience on the efficacy and complications of PEIT on toxic thyroid nodules in two years follow-up. In 26 patients with autonomously functioning thyroid nodules, the levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyrotropin (TSH), ultrasound and scintigraphic evaluation of thyroid gland before, 6 and 24 months after ethanol injection were determined. PEIT was performed after excluding malignancy by fineneedle aspiration biopsy. Each patient underwent 3-8 sessions (mean 4 ± 1) of PEIT, with an injection of 1.5-8.0 (mean 3.76 ± 1.67) mL total amount of ethanol. Results: Mean nodule volume reduced from 5.5 ± 6.1mL to 2.8 ± 3.8mL 6 months after therapy (p=0.0001) and to 2.6 ± 4.1mL (p=0.001) 24 months after therapy at ultrasound evaluation. Nodule volumes showed a significant shrinkage 6 and 24 months after therapy (92.3% and 90.0%, respectively). During follow-up, hyperfunctioning nodule became cold in 11 (42.3%) and relatively active in 7 (26.9%) of patients at scintigraphy. TSH levels increased to normal levels in 17 (65.4%), and persisted below normal levels in 9 (34.6%) patients. Injections were well tolerated by all patients. Treatment did not cause considerable side effects. PEIT can be considered as practical, effective and cost-effective treatment as an alternative method to surgery and radioiodine without any severe complication particularly hypothyroidism for benign toxic nodules.