PMID- 31461356
OWN - NLM
STAT- MEDLINE
DCOM- 20200211
LR  - 20210204
IS  - 1530-891X (Print)
IS  - 1530-891X (Linking)
VI  - 26
IP  - 1
DP  - 2020 Jan
TI  - VASCULARITY-TARGETED PERCUTANEOUS ETHANOL INJECTION OF TOXIC THYROID ADENOMAS: 
      OUTCOMES OF A FEASIBILITY STUDY PERFORMED IN THE USA.
PG  - 22-29
LID - 10.4158/EP-2019-0329 [doi]
AB  - Objective: The recommended treatment options for toxic adenoma (TA) in the USA 
      are radioactive iodine ablation and surgical resection, with continued 
      observation for pre-toxic adenoma (PTA). Percutaneous ethanol ablation (PEI) has 
      proven efficacy in the treatment of TA and is widely available in Europe but not 
      in the USA. Methods: Retrospective analysis was performed of all patients who 
      underwent PEI for TA/PTA at the University of Utah, from January 2010 to 2018. 
      Ultrasound-guided PEI, with injections targeting power Doppler-mapped blood 
      vessels within the adenomas, was conducted. Functionality was confirmed using 
      thyroid scintigraphy prior to PEI. Results: Eighteen adults (15 female) underwent 
      PEI. Mean age was 41 +/- 13.7 years. Baseline thyroid-stimulating hormone (TSH) was 
      suppressed (0.06 +/- 0.09 mU/L), with normal free thyroxine (FT4) 1.43 +/- 0.39 
      ng/dL. Median nodule volume was 5.7 cm(3) (interquartile range [IQR], 4.8 to 7.7 
      cm(3)). Seventy-eight percent (n = 14) underwent two or less PEI sessions. Median 
      volume of ethanol used was 0.46 mL/mL nodule volume (IQR, 0.3 to 0.6 mL). There 
      was a significant increase in TSH concentrations within the first 3 months after 
      PEI (0.06 +/- 0.09 mU/L vs. 1.22 +/- 1.88 mU/L; P = .02), with a concomitant 
      significant decrease in FT4 concentrations (1.43 +/- 0.39 ng/day vs. 1.13 +/- 0.25 
      ng/day; P<.01). Significant nodular volume reduction was observed following PEI 
      (median 5.7 cm(3) [IQR 4.8-7.7 cm(3)] vs. 2.5 cm(3) [IQR 2.0-7.8 cm(3)]; P<.01). 
      Conclusion: Vascularity-targeted PEI is safe and effective for treating PTA and 
      TA. This unique approach required lower injected alcohol volume and fewer 
      injections for therapeutic success. Abbreviations: ATA = American Thyroid 
      Association; FT4 = free thyroxine; IQR = interquartile range; PD = power Doppler; 
      PEI = percutaneous ethanol injection; PTA = pre-toxic adenoma; RAI = radioactive 
      iodine ablation; RFA = radiofrequency ablation; TA = toxic adenoma; TT3 = total 
      triiodothyronine; US = ultrasound.
FAU - Sharma, Anu
AU  - Sharma A
FAU - Abraham, Dev
AU  - Abraham D
LA  - eng
PT  - Journal Article
DEP - 20190828
PL  - United States
TA  - Endocr Pract
JT  - Endocrine practice : official journal of the American College of Endocrinology 
      and the American Association of Clinical Endocrinologists
JID - 9607439
RN  - 0 (Iodine Radioisotopes)
RN  - 3K9958V90M (Ethanol)
SB  - IM
MH  - Adult
MH  - Ethanol
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - Iodine Radioisotopes
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - *Thyroid Neoplasms
MH  - *Thyroid Nodule
MH  - Treatment Outcome
EDAT- 2019/08/29 06:00
MHDA- 2020/02/12 06:00
CRDT- 2019/08/29 06:00
PHST- 2019/08/29 06:00 [pubmed]
PHST- 2020/02/12 06:00 [medline]
PHST- 2019/08/29 06:00 [entrez]
AID - S1530-891X(20)35077-1 [pii]
AID - 10.4158/EP-2019-0329 [doi]
PST - ppublish
SO  - Endocr Pract. 2020 Jan;26(1):22-29. doi: 10.4158/EP-2019-0329. Epub 2019 Aug 28.