Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(3):417-421 | DOI: 10.5507/bp.2014.009

Ultrasound-guided percutaneous ethanol injection of small and medium-sized thyroid cysts with relatively small amounts of ethanol

Milan Halenka, David Karasek, Zdenek Frysak
Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
Corresponding autor: Milan Halenka, e-mail: milan.halenka@fnol.cz

Background: Ultrasound-guided percutaneous ethanol injection (US-guided PEI) is used in patients with recurring symptomatic thyroid cysts in whom simple drainage was not successful. It is an alternative non-surgical approach in patients refusing or at risk during surgery.

Methods and Results: US-guided PEI was performed in 33 patients, with a success rate of 100% and significantly decreased cyst volume after 1, 3 and 6 months after the last PEI compared with the initial volume. The mean number of PEI procedures was 1.5±0.7 with a mean 96% ethanol volume of 2.4±1.2 mL. In the entire group, the initial cyst volume was significantly reduced to the final volume at 6 months after PEI (10.82±5.03 mL vs. 0.78±0.84 mL; P<0.001). Also in all patients, mean volume reduction rates were significantly increased (P<0.001) at check-ups at 1 month (83.1±8.1%), 3 months (89.9±6.3%) and 6 months (92.6±6.4%). In case of medium-sized cysts, more PEI procedures were needed than in small cysts (1.1±0.4 vs. 2.0±0.5). The total amount of 96% ethanol was equal to 22.7±7.9% of the initial cyst volume.

Conclusion: Our experiences confirm that small and medium-sized cysts may be successfully treated with relatively small amounts of ethanol. In case of medium-sized cysts, more PEI procedures were needed. Final reduction of complex cysts was achieved later. Apart from temporary localized pain, no serious complications were observed in most cases.

Keywords: thyroid cyst, ultrasound-guided percutaneous ethanol injection, volume reduction rate

Received: October 3, 2013; Accepted: January 23, 2014; Prepublished online: February 20, 2014; Published: September 30, 2015  Show citation

ACS AIP APA ASA Harvard Chicago IEEE ISO690 MLA NLM Turabian Vancouver
Halenka, M., Karasek, D., & Frysak, Z. (2015). Ultrasound-guided percutaneous ethanol injection of small and medium-sized thyroid cysts with relatively small amounts of ethanol. Biomedical papers, 159(3), 417-421. doi: 10.5507/bp.2014.009
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Welker MJ, Orlov D. Thyroid nodules. Am Fam Physician 2003;67(3):559-66. Go to PubMed...
    2. McHenry CR, Slusarczyk SJ, Khiyami A. Recommendations for management of cystic thyroid disease. Surgery 1999;126(6):1167-71. Go to original source... Go to PubMed...
    3. Alexander EK, Heering JP, Benson CB, Frates MC, Doubilet PM, Cibas ES, Marqusee E. Assessment of nondiagnostic ultrasound-guided fine needle aspirations of thyroid nodules. Clin Endocrinol Metab 2002;87(11):4924-7. Go to original source...
    4. Kim JH, Lee HK, Lee JH, Ahn IM, Choi CG. Efficacy of sonographically guided percutaneous ethanol injection for treatment of thyroid cysts versus solid thyroid nodules. AJR Am J Roentgenol 2003;180(6):1723-6. Go to original source... Go to PubMed...
    5. Cho YS, Lee HK, Ahn IM, Lim SM, Kim DH, Choi CG, Suh DC. Sonographically guided ethanol sclerotherapy for benign thyroid cysts: results in 22 patients. AJR Am J Roentgenol 2000;174(1):213-6. Go to original source... Go to PubMed...
    6. Sheppard MC, Franklyn JA. Management of the single thyroid nodule. Clin Endocrinol 1992;37(5):398-401. Go to original source... Go to PubMed...
    7. Yasuda K, Ozaki O, Sugino K, Yamashita T, Toshima K, Ito K, Harada T. Treatment of cystic lesions of the thyroid by ethanol instillation. World J Surg 1992;16(5):958-61. Go to original source... Go to PubMed...
    8. Bennedbaek FN, Hegedüs L. Treatment of recurrent thyroid cysts with ethanol: a randomized double-blind controlled trial. J Clin Endocrinol Metab 2003;88(12):5773-7. Go to original source... Go to PubMed...
    9. Zingrillo M, Torlontano M, Ghiggi MR, D'Aloiso L, Nirchio V, Bisceglia M, Liuzzi A. Percutaneous ethanol injection of large thyroid cystic nodules. Thyroid 1996;6(5):403-8. Go to original source... Go to PubMed...
    10. Lee SJ, Ahn IM. Effectiveness of percutaneous ethanol injection therapy in benign nodular and cystic thyroid diseases: long-term follow-up experience. Endocr J 2005;52(4):455-62. Go to original source... Go to PubMed...
    11. Del Prete S, Caraglia M, Russo D, Vitale G, Giuberti G, Marra M, D'Alessandro AM, Lupoli G, Addeo R, Facchini G, Rossiello R, Abbruzzese A, Capasso E. Percutaneous ethanol injection efficacy in the treatment of large symptomatic thyroid cystic nodules: ten-year follow-up of a large series. Thyroid 2002;12(9):815-21. Go to original source... Go to PubMed...
    12. Ziele¼nik W, Kawczyk-Krupka A, Barlik MP, Cebula W, Sieroñ A. Modified percutaneous ethanol injection in the treatment of viscous cystic thyroid nodules. Thyroid 2005;15(7):683-6. Go to original source... Go to PubMed...
    13. Gharib H, Hegedüs L, Pacella CM, Baek JH, Papini E. Clinical review: Nonsurgical, image-guided, minimally invasive therapy for thyroid nodules. J Clin Endocrinol Metab 2013;98(10):3949-57. Go to original source... Go to PubMed...
    14. Kim DW, Rho MH, Kim HJ, Kwon JS, Sung YS, Lee SW. Percutaneous ethanol injection for benign cystic thyroid nodules: is aspiration of ethanol-mixed fluid advantageous? Am J Neuroradiol 2005;26(8):2122-7.
    15. Sung JY, Baek JH, Kim YS, Jeong HJ, Kwak MS, Lee D, Moon WJ. One-step ethanol ablation of viscous cystic thyroid nodules. Am J Roentgenol. 2008;191(6):1730-3. Go to original source... Go to PubMed...
    16. Zingrillo M, Torlontano M, Chiarella R, Ghiggi MR, Nirchio V, Bisceglia M, Trischitta V. Percutaneous ethanol injection may be a definitive treatment for symptomatic thyroid cystic nodules not treatable by surgery: five-year follow-up study. Thyroid 1999;9(8):763-7. Go to original source... Go to PubMed...
    17. Monzani F, Lippi F, Goletti O, Del Guerra P, Caraccio N, Lippolis PV, Baschieri L, Pinchera A. Percutaneous aspiration and ethanol sclerotherapy for thyroid cysts. J Clin Endocrinol Metab 1994;78(3):800-2. Go to original source...
    18. Kim YJ, Baek JH, Ha EJ, Lim HK, Lee JH, Sung JY, Kim JK, Kim TY, Kim WB, Shong YK. Cystic versus predominantly cystic thyroid nodules: efficacy of ethanol ablation and analysis of related factors. Eur Radiol 2012;22(7):1573-8. Go to original source... Go to PubMed...
    19. Jayesh SR, Mehta P, Cherian MP, Ilayaraja V, Gupta P, Venkatesh K. Efficacy and safety of USG-guided ethanol sclerotherapy in cystic thyroid nodules. Indian J Radiol Imaging 2009;19(3):199-202. Go to original source... Go to PubMed...
    20. Valcavi R, Frasoldati A. Ultrasound-guided percutaneous ethanol injection therapy in thyroid cystic nodules. Endocr Pract 2004;10(3):269-75. Go to original source... Go to PubMed...
    21. Verde G, Papini E, Pacella CM, Gallotti C, Delpiano S, Strada S, Fabbrini R, Bizzarri G, Rinaldi R, Panunzi C. Ultrasound guided percutaneous ethanol injection in the treatment of cystic thyroid nodules. Clin Endocrinol 1994;41(6):719-24. Go to original source... Go to PubMed...
    22. Antonelli A, Campatelli A, Di Vito A, Alberti B, Baldi V, Salvioni G, Fallahi P, Baschieri L. Comparison between ethanol sclerotherapy and emptying with injection of saline in treatment of thyroid cysts. Clin Investig 1994;72(12):971-4. Go to original source... Go to PubMed...
    23. Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L, Vitti P; AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and EuropeanThyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract 2010;16 Suppl 1:1-43. Go to original source... Go to PubMed...

    Return to the content