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    Microwave ablation of autonomously functioning thyroid nodules: a comparative study with radioactive iodine therapy on the functional treatment success
    (Via Medica, 2021) Erturk, Mehmet Sercan; Cekic, Bulent; Celik, Mehmet; Uguz, Isil Demiray
    Introduction: The objective of this study was to compare the efficiency of microwave ablation (MWA) and radioactive iodine (RAI) in the treatment of toxic adenoma (TA), and to investigate the functional treatment success of the used modalities for its remission. Material and methods: Treatment outcomes - thyroid hormone levels and nodule characteristics - of 30 patients (23:7 F:M; 52.77 +/- 11.13 years) treated by MWA were compared with the those of 35 patients (24:11 F:M; 61.43 +/- 12.60 years) treated by RAI. The baseline characteristics of TAs, which are gender and pre volume, were analogous and did not show any statistical significance (p > 0.05). Thyroid hormone levels of patients treated with two different methods were measured after 9 months, and the obtained results were compared. Results: Although there was no statistically significant difference in the nodule volume (p > 0.05), there was a greater volume reduction rate (VRR%) in the group treated with MWA rather than RAI (p < 0.05) at the end of the follow-up. In the MWA group, there was a higher increase in FT3 than in the RAI group (p < 0.05). Furthermore, no statistically significant difference in TSH (p = 0.124) and FT4 (p = 0.144) levels of the patients as treatment outcomes was observed. The therapeutic success was accomplished in 18/30 (60%) of the MWA group and in 24/35 (68.6%) of the RAI group. Conclusions: Therapeutic success of MWA and RAI did not show any statistically significant difference (p = 0.471). However, the development of hypothyroidism in 7 of 35 patients treated with RAI was observed. On the other hand, no case of post-treatment hypothyroidism was observed in patients treated with MWA. In this regard, MWA could be a great alternative to RAI due to its advantages in terms of non-exposure to radiation and lower risk of post-treatment hypothyroidism.
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    Microwave Ablation of Benign Thyroid Nodules: Effects on Systemic Inflammatory Response
    (Coll Physicians & Surgeons Pakistan, 2020) Erturk, Mehmet Sercan; Cekic, Bulent; Celik, Mehmet
    Objective: To explore the alterations of neutrophil-to-lymphocyte ratio (NLR) as a systemic inflammatory marker after microwave ablation for benign thyroid nodules. Study Design: A descriptive study. Place and Duration of Study: Department of Radiology, Antalya Training and Research Hospital, from December 2018 to June 2019. Methodology: Demographic data of the patients, ultrasonographic features of the nodules, thyroid function tests of the patients, leukocyte, neutrophil, lymphocyte values, and thyroid nodule volumes of the patients before and after the procedure were recorded. NLR and volume reduction ratio (VRR %) of 35 patients with thyroid nodules were compared before and after microwave ablation therapy of the thyroid nodules. Results: The nodule volume decreased from 23.89 +/- 15.44 cc to 11.57 +/- 8.65 cc at two months and to 7.79 +/- 5.74 cc at six months. The VRR% increased from 38.65 +/- 16.82 to 63.16 +/- 14.19 at three months and to 68.29 +/- 11.80 at six months. The mean value of NLR decreased from 2.28 +/- 0.86 to 1.78 +/- 0.54. ROC curve analysis suggested that the optimum pre-NLR cut-off point for 50% VRR success was 2.50 with the specifity and sensitivity of 0.67 and 0.50. Conclusion: After ultrasound-guided microwave ablation of benign thyroid module, VRR percentage increased significantly, while the inflammatory marker NLR value decreased.
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    Microwave ablation of symptomatic benign thyroid nodules: Short- and long-term effects on thyroid function tests, thyroglobulin and thyroid autoantibodies
    (Wiley, 2021) Erturk, Mehmet Sercan; Cekic, Bulent; Celik, Mehmet; Ucar, Havva
    Objective Microwave ablation therapy has been attracting great attention due to its advantages such as low complication rate, good cosmetic results and effective nodule shrinking. Although the effect of thermal ablation therapy on the nodule volume reduction rate has been shown several studies, a limited number of papers have been reported for the effects of microwave ablation (MWA) on thyroid function tests. The aim of this study was to investigate the short- and long-term effects of MWA therapy on thyroid function tests (TFTs), thyroglobulin (Tg) and thyroid autoantibodies in euthyroid patients. Design, patients and measurements Demographic data of the patients, TFTs, Tg, thyroid autoantibodies and thyroid volume of the nodules were recorded before the procedure and follow-up. Any differences in serum thyroid hormone levels were investigated in pre-, post- and 6-month follow-up periods before and after MWA. Results The difference between all thyroid hormone levels at pre MWA and 24 h after MWA was statistically significant (p < .001). FT3 (4.62) pmol/L and FT4 (10.81) pmol/L median levels increased significantly (p < .001), while thyrotropin (TSH) levels decreased at 24 h after MWA (p < .001). Thyroid antibodies levels were not statistically different at 6-month (p > .05), whereas Tg levels decreased (p < .001) compared to pre MWA. Conclusions While no significant effect was observed at 6 month, the effect of MWA on thyroid function tests was prominent at 24 h.