A Single Session Of Laser Ablation For Toxic Thyroid Nodules: Three-Year Follow-Up Results

Purpose: To confirm the effectiveness of laser ablation on toxic nodules in a large population with three years of follow-up.Material and methods: Between 2009 and 2014, we treated 82 patients with hyperthyroidism related to the presence of a toxic nodular goitre. Patients were pre-treated pharmacologically with methimazole prior to single session of laser ablation (LA) and then followed up every 3months with FT4 and TSH blood tests as well as ultrasound examination of the nodules treated.Results: All patients responded to the treatment. The median nodule volume decreased from 12ml (range 5-118ml) to 5ml (range 1.2-40ml) after three years (p<0.001). The percentage of patients who discontinued methimazole therapy was reduced by increasing the initial volume of the toxic nodule. In nodules with a volume less than 5ml, all patients were able to suspend methimazole; this percentage was reduced to 90.2% in nodules with a volume between 5 and 15ml, 61.1% in those with volume 15-25ml and only 28.5% in nodules larger than 25ml. We had no major complications but only moderate pain and fever in the evening, a few hours after ablation therapy in 10% of treated patients.Conclusions: Single session of LA of toxic thyroid nodules is effective and safe, especially in nodules with a volume under 15ml.