Dr.Guttler’s Thyroid Patient Blog Post: PET/CT to Prevent unnecessary Surgery in Follicular Neoplasm with Low PET/CT SUV.

Dr.Guttler’s Thyroid Patient Blog Post: PET/CT to Prevent unnecessary Surgery in Follicular Neoplasm with Low PET/CT SUV.

Dr.Guttler’s Thyroid Patient Blog Post: PET/CT to Prevent unnecessary Surgery in Follicular Neoplasm with Low PET/CT SUV.

Dr.Guttler’s Comments:

1.28/86 had PET/CT.

2. 6/28 had high SUV> 5 were sent to surgey.

3.22/28 had low SUV <5 were treated with RFA.

4. 74% volume reduction by 12 months.

5. 1/22 had temporary vocal cord paralysis recovered by 3 months.

6. By using PET/CT,  select patients with low SUV follicular neoplasm could have RFA  which offers a safe and feasible alternative treatment option for patients unsuitable or unwilling to undergo surgery.

7. I use PET/CT for help in  finding low risk patients for RFA.

8. Call me at 310-393-8860 or email to thyroid.manager@thyroid.com.

Ask for Alicia

Dr.G.

RFA of follicular neoplasm with low SUV  with results before and after RFA.

Before and after RFA for low SUV Follicular neoplasm.

Radiofrequency ablation for treatment of thyroid follicular neoplasm with low SUV in PET/CT study

International J. Hyperthermia 2021 (38) 1 963-969

 

Objectives

To evaluate the feasibility of radiofrequency ablation (RFA) on follicular neoplasm with low standard uptake value (SUV) in a Positron emission tomography (PET/CT) study.

Methods

From January 2018 to July 2019, 86 consecutive patients were diagnosed with follicular neoplasm. Of the patients, 28 with PET/CT scans were enrolled in this study. All patients received ultrasound, fine/core needle aspiration, and PET/CT scan prior to treatment. In accordance with previous studies, we recommended 6 patients who had follicular neoplasm with SUVmax ≥5 undergo surgical resection due to an elevated suspicion of malignancy. For 22 patients SUVmax <5, RFA was performed using the moving shot technique. Ultrasound was performed 6 to 12 months after each procedure.

Results

Statistically significant volume reductions during follow-up between values prior to RFA and 12 months post RFA were demonstrated (12.6 ± 20.9 vs. 2.4 ± 3.0 cm3, p < 0.001). Volume reduction ratios at 6–12 months (mean: 10.1 months) after RFA were 73.3% ± 17.7%. One patient presented with vocal cord palsy and recovered within 3 months after RFA. No postprocedural hypothyroidism occurred in the RFA patients.

Conclusions

By using PET/CT, we can select patients with low SUV follicular neoplasm. RFA offers a safe and feasible alternative treatment option for patients unsuitable or unwilling to undergo surgery.

  • KEY POINTS

  • By using positron emission tomography-computed tomography, we can distinguish low SUV follicular neoplasm for radiofrequency ablation.

  • For low SUV follicular neoplasm, RF ablation offers a safe and effective alternative treatment option for patients unsuitable or unwilling to undergo surgery.

 

 

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