Laser coagulation
therapy for patients with benign solitary thyroid nodules
(March 2003)
The background of the study. Patients
with benign solitary thyroid nodules may be treated with thyroxine
or by surgery, or they may not be treated. In this study, the efficacy
of thermal coagulation using a laser for reducing the size of these
nodules was evaluated.
How the study was done. The laser-treatment
group consisted of 16 adults with a single palpable thyroid nodule.
All the patients had symptoms caused by the nodule, and most thought
their nodule was unsightly. The control group consisted of 15 adults
with smaller nodules who had no symptoms and had declined treatment.
The laser treatment consisted of insertion of a needle into the
center of the nodule under local anesthesia and with ultrasound
guidance; then a laser fiber was inserted through the needle into
the nodule. Power was delivered for 490 seconds. The treatment resulted
in the appearance of an irregular echogenic area surrounding the
laser fiber. The patients were evaluated by measurements of nodule
volume by ultrasonography and assessment of pressure symptoms and
reports of cosmetic problems for up to six months.
The results of the study. The mean
nodule volume in the laser-treatment group decreased from 10 ml
(range, 2 to 26) to 5 ml (range, 1 to 21) at six months, a decrease
of 50 percent (P<0.001). The patients' pressure symptoms decreased
substantially, and they thought their cosmetic appearance improved.
The procedure caused only slight, transient discomfort. In contrast,
the nodule volume in the control group increased by 25 percent.
The conclusions of the study. Laser
coagulation may result in a substantial reduction in nodule volume
in patients with benign solitary thyroid nodules.
The original article. Dossing H,
Bennedbaek FN, Karstrup S, Hegedus L. Benign solitary solid cold
thyroid nodules: US-guided interstitial laser photocoagulation-initial
experience. Radiology 2002;225:53-7.
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