Skip to main content
Download PDF

Comparison of the effectiveness of lauromacrogol injection for ablation and microwave ablation in the treatment of predominantly cystic thyroid nodules: a multicentre study

BMC Cancer volume 23, Article number: 785 (2023) Cite this article

Abstract

Purpose

To compare the therapeutic efficacy and safety of microwave ablation (MWA) and lauromacrogol injection for ablation (LIA) for benign predominantly cystic thyroid nodules.

Materials and methods

In this retrospective study, 85 patients with predominantly cystic thyroid nodules (PCTNs) who underwent microwave ablation (MWA) or lauromacrogol injection for ablation (LIA) between June 2019 and August 2022 at three hospitals were included in our research. Forty-six patients were treated with microwave ablation, and thirty-nine patients were treated with lauromacrogol injection for ablation. The baseline characteristics, nodal volume, volume reduction rate (VRR), and incidence of postoperative complications were compared between these two groups.

Results

After treatment, there were significant differences in the thyroid nodule volume and the volume reduction rate (VRR) at different follow-up times between the groups (p < 0.001). There were no significant differences in the nodal volume or the volume reduction rate (VRR) between the MWA group and the LIA group at 1, 3, 6, and 12 months (p > 0.05). Of note, no serious intraoperative or postoperative complications occurred in the corresponding group.

Conclusion

MWA and LIA are very effective and safe strategies for the treatment of predominantly cystic thyroid nodules. However, LIA is more advantageous in that it is less expensive and has a shorter length of hospital stay than MWA.

Peer Review reports

Introduction

In recent decades, the advancement of imaging technology, particularly the use of high-resolution ultrasound (US), has improved the diagnosis of thyroid nodules (TNs) [1,2,3]. According to a large body of evidence, approximately 15–30% of thyroid nodules in adults are diagnosed as cystic or mainly cystic nodules (50% cystic components) [3,4,5,6]. Most of these nodules are large and cause a choking sensation when swallowing and a sensation of a foreign body in the throat [7,8,9]. Due to their rapid growth and large size, the nodules may compress important anatomical structures such as the trachea, oesophagus, and large blood vessels in the neck [8, 10, 11].

Traditionally, surgery is the main treatment for predominantly cystic thyroid nodules (PCTNs) despite its disadvantages such as scarring, nerve damage, and the risk of hypothyroidism [12,13,14]. In recent years, some minimally invasive approaches, including physical and chemical ablation therapy, have been widely adopted for the treatment of predominantly cystic thyroid nodules [8, 15, 16]. Chemical ablation, with either absolute ethanol or lauromacrogol, is often used for simple cystic thyroid nodules [17, 18]. However, absolute ethanol is well diffused, easily spilled, and difficult to control in ablation. Lauromacrogol (polyoxyethylene lauryl ether) is a sclerosing agent with a local anaesthetic effect. It has been reported that lauromacrogol has barely any effect on many organs with large benign cystic lesions, such as the liver, kidney, and pancreas [19]. Therefore, many clinicians have devoted themselves to exploring the use of lauromacrogol as an alternative to ethanol ablation in the treatment of benign cystic thyroid nodules [20]. In addition to chemical ablation, thermal ablation has been widely used as an effective surgical treatment in clinical practice. It has high feasibility and low complication rate [21]. In recent years, microwave ablation has been shown to be a promising and safe new method for the treatment of thyroid nodules including those with predominantly cystic thyroid nodules [22].

However, there are few studies comparing the efficacy of microwave ablation and lauromacrogol injection for ablation in the treatment of predominantly cystic thyroid nodules. This study aims to compare the efficacy of MWA and LIA in the treatment of predominantly cystic thyroid nodules, and it is hoped that the study will provide more effective information for clinical decision-making and the selection of patients with predominantly cystic thyroid nodules.

Materials and methods

This study was a retrospective study that was approved by the Ethics Committee of the Affiliated Hospital of Jiangsu University (SWYXLL20190225–2). Informed consent was not required for the review of ultrasound images and medical records. To ensure uniformity among the three study centres, the data were analysed and processed by personnel who strictly followed the inclusion and exclusion criteria of the study. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline for observational studies [23].

Patients

Before each procedure, all the patients who were scheduled for ultrasound-guided fine-needle aspiration (FNA), MWA or LIA provided written informed consent.

Inclusion criteria: patients who were older than 18 years of age; patients with preoperative ultrasound images showing predominantly cystic thyroid nodules (PCTNs, 50% < cystic component < 90% ); patients with thyroid nodules without signs of malignancy (each nodule underwent at least two fine-needle aspiration cytology (FNAC) examinations to rule out the possibility of malignancy and ultrasound suggests no suspicious ultrasound features such as calcification, poorly defined borders, aspect ratios > 1 and so on); patients with relevant laboratory test results (including routine blood tests, coagulation tests, and thyroid function tests) within the normal range; and patients with thyroid gland disease who had not undergone any previous surgical treatment (including surgical intervention or chemical or physical ablation).

The exclusion criteria were as follows: patients with a malignant tumour confirmed by fine needle aspiration cytology; patients with malignant ultrasound features of thyroid nodules (calcification, poorly defined borders, aspect ratios > 1 and so on); patients with an abnormal coagulation function; and patients with serious primary illnesses such as comorbidities or other serious infectious diseases.

Group criteria

According to the need of the study, whether it was the MWA group or the LIA group, we divided the patients into two groups based on the size of the thyroid initial volume. Patients with smaller thyroid volume were group A (volume < 10 ml) and patients with larger thyroid volume were group B (volume ≥ 10 ml).

Preablation evaluation

Before the operation, the patients underwent relevant tests. (1) Laboratory tests included routine blood tests, blood coagulation tests, and thyroid function tests. (2) The pathological results of ultrasound-guided fine needle aspiration cytology were benign. (3) The thyroid nodules were examined via ultrasound, and the location and volume of the nodules, the proportion of cystic components, and the blood flow in and around the nodules were evaluated in detail.

Ablation procedure

All ablation procedures were performed by sonographers with more than 10 years of experience in performing ultrasound intervention.

The microwave ablation (MWA) procedure: The patient was placed in the supine position with the neck fully exposed. The patient was then routinely disinfected and covered with towels. According to the location of the lesion, 2% lidocaine was used for local infiltration anaesthesia. An 18G puncture needle was placed into the cystic part of the nodule, and as much cystic fluid as possible was extracted. Under the guidance of ultrasound, a 2% lidocaine injection and a 0.9% sodium chloride injection were mixed 1:1, and local infiltration anaesthesia was administered in the space between the anterior thyroid capsule and the anterior cervical muscle group. To prevent causing a thermal burn injury to the normal tissues during the operation, 0.9% sodium chloride was injected in the local gap to form a liquid isolation zone. Then, the microwave ablation needle was inserted into the thyroid nodules according to the predesigned puncture path, and ablation was performed by a continuous moving method, with a power of 30–40 W, from deep to shallow, from the lower pole to the upper pole, layer by layer, until the whole nodule was ablated. If necessary, contrast-enhanced ultrasound should be used to determine the extent of ablation for lesions to prevent residual lesions and additional organ damage.

The Lauromacrogol injection for ablation (LIA) procedure: The patient was positioned supine so that the neck was slightly extended. Routine disinfection and draping were performed before local anaesthesia was administered. Under ultrasound guidance, an 18G puncture needle was inserted into the centre of the cystic dark area, and all the cystic fluid was extracted. A 0.9% sodium chloride injection or a small amount of alcohol or lauromacrogol was used for multiple flushing (the specific volume of liquid to be replaced was calculated according to the volume of the nodule and the proportion of cystic part), and then, lauromacrogol was injected.

Follow-up and assessments

Postoperative complications such as intraoperative bleeding and organ damage and postoperative complications such as infection and abnormal voice were recorded in a timely manner. Thyroid ultrasound was performed at 1, 3, 6, and 12 months after thyroid treatment and every 6 months thereafter, and contrast-enhanced ultrasound was performed if necessary. The size of the nodules was observed, and the volume of the nodules was measured (V = πabc/6, where a is the maximum diameter, and b and c are the other two perpendicular diameters) [24].The volume reduction rate (VRR) was calculated at different time points. VRR= (initial volume-final volume) ×100/initial volume [25].

Statistical analysis

Statistical analysis of the data was performed using SPSS (IBM SPSS 26.0). The continuous data were expressed as the means ± standard deviations (Χ ± SD). Independent samples t-tests were used to compare the changes in nodule volume and rate of volume reduction before and after treatment, provided that normality of the data was ensured. The intergroup comparison of counting data was conducted by χ2 test. All P values were two-sided, and P < 0.05 indicated that the difference was statistically significant.

Results

A total of 85 patients participated in our retrospective research, including 46 patients in the MWA group and 39 in the LIA group. After following the strict inclusion criteria, 85 patients with 85 nodules were included in the research (Fig. 1).

Fig. 1
figure 1

Flowchart of the patient enrollment process

Full size image

Baseline characteristics of the patients

There were 4 males and 42 females in the MWA group. The youngest patient was 24 years old, the oldest was 79. The mean age was 50.30 ± 14.07 years. In another group, there were 8 males and 31 females. The youngest patient was 24 years old, and the oldest patient was 72 years old. The mean age was 49.79 ± 13.14 years. In the MWA group, the volume of the nodules was 2.67–33.40 ml before treatment, with an average of 11.03 ± 7.16 ml. The volume of nodules in the LIA group before treatment was 2.53–28.33 ml, with an average of 11.41 ± 6.53 ml. Before treatment, there were no significant differences in sex, age, long diameter of nodules, initial volume, or location between the two groups (all P > 0.05). (Table 1)

Table 1 Baseline characteristics of the patients with predominant cystic thyroid nodules
Full size table

Comparison of the volume and VRR between the two groups

The mean nodal volume in the MWA group before treatment was 11.03 ± 7.16 ml, 2.80 ± 2.31 ml at 6 months and 1.14 ± 1.31 ml at 12 months. The estimated mean VRR at 1, 3, 6, and 12 months was 59.9%, 73.2%, 82.3%, and 88.9%, respectively. In comparison, the mean nodal volume in the LIA group was 11.41 ± 6.53 ml before treatment, 3.15 ± 2.55 ml at 6 months, and 1.23 ± 1.16 ml at the 12-month follow-up. The estimated mean VRRs at 1, 3, 6, and 12 months were 60.9%, 73.4%, 82.5%, and 89.4%, respectively (Fig. 2). In both the MWA group and the LIA group, the nodule volumes at different time points after operation were significantly reduced compared with those before operation (P < 0.001), and postoperative VRR increased significantly with the extension of postoperative follow-up time (P < 0.001). When comparing the reduction in the mean nodule volume after MWA and LIA, no significant difference was found between these two groups (p > 0.05). (Table 2).

Fig. 2
figure 2

The VRRs of PTNs after MWA or LIA at the postoperative follow-ups. (VRR, volume reduction rate; MWA, microwave ablation; LIA, lauromacrogol injection for ablation; mon, months)

Full size image
Table 2 Comparison of the Volume and VRR Between the Two Groups
Full size table

Comparison of treatment effects of thyroid nodules of different sizes

The subgroup study showed that in the MWA group, there was no significant difference between group A and group B in terms of mean VRR at 1 month, 3 months, 6 months and 12 months after ablation (all p > 0.05). Whereas in LIA group, there was no significant difference in VRR between group A and group B at 1 month, 3 months, 6 months and 12 months after ablation (all p > 0.05) (Table 3).

Table 3 VRR in different subgroups of thyroid nodules
Full size table

Comparison of the clinical characteristics between the two groups

The mean number of hospital days in the MWA group was 1.09 ± 0.28, and the average cost of hospitalization was 11.21 ± 0.77 K. The mean number of hospital days in the LIA group was 0.26 ± 0.44, and the average cost of hospitalization was 5.40 ± 0.50 K. In general, there was a significant difference in the length of stay and the cost of hospitalization. (Table 4)

Safety evaluation

None of the patients had any major complications during or after the therapeutic procedure, such as vocal cord destruction, skin infection or scarring, or damage to the trachea or oesophagus. Three patients in the MWA group experienced minor complications, while 2 patients in the LIA group experienced minor complications; all cases of complications resolved within 3 months. (Table 4)

Table 4 Comparison of the clinical characteristics between the two groups
Full size table

Discussion

The rapid development of ultrasound equipment has led to an increasing number of thyroid nodes, mostly benign, being found in daily examinations [2, 26, 27]. For predominantly cystic thyroid nodules, surgery is accepted as the preferred therapeutic option, especially when there is tracheal or oesophageal compression or protrusion from the skin [12, 28]. However, surgery usually has several negative effects, including intraoperative nerve paralysis or injury, postoperative neck haematoma formation, wound infection, and the need for life-long medication therapy after thyroidectomy [29, 30]. In recent years, several minimally invasive methods, such as percutaneous ethanol injection (PEI), lauromacrogol injection for ablation (LIA), microwave ablation (MWA), and radiofrequency ablation (RFA), have been widely used in the treatment of benign thyroid nodules [31,32,33,34].

The safety and efficacy of these methods have been previously reported. However, there have been few systematic comparative studies on whether one of these ablation methods is superior to others. Hence, this study is a primary and retrospective analysis comparing MWA and LIA in terms of their effectiveness and safety in the treatment of predominantly cystic thyroid nodules. This study is expected to provide patients with thyroid nodules and clinicals with more information for clinical decision-making.

In recent decades, lauromacrogol sclerotherapy has played an increasingly important role in the treatment of other benign diseases. Lauromacrogol has been previously used in the treatment of gastrointestinal bleeding and haemorrhoids, resulting in good therapeutic effects [35, 36].Further research has proven its great potential in the treatment of cysts. It was first used in the treatment of hepatic cysts [37]. In the past 10 years, several studies have shown that lauromacrogol treatment is more advantageous in terms of efficacy, incidence of complications and cost than traditional liquid sclerotherapy. It has been clinically accepted and used in the treatment of benign cystic thyroid nodules [38]. Lauromacrogol is a liquid sclerosing agent that is injected to treat the relevant disease by producing inflammation and fibrosis in the thyroid tissue [39]. It has also been shown that lauromacrogol can be safely used without causing peri-thyroidal adhesions or altering thyroid function [39]. In the YiJie Dong study [40], 142 benign cystic thyroid nodules in 137 patients were treated with LIA after cytological confirmation of benignancy. At the 12-month postoperative follow-up, the mean size of the thyroid nodules decreased from 18.4 ml to 3.6 ml. Treatment was considered effective with a VRR > 50%, and the treatment success rate was 73.2% (104/142). Another study [41] demonstrated that the volume of 158 cystic or predominantly cystic thyroid nodules in 143 patients were reduced from an initial volume of 15.6 ml to a mean volume of 0.6 ml at the 12-month postoperative follow-up. At the 12-month postoperative follow-up, the volume of all the nodules were reduced by > 70%. Both studies showed that lauromacrogol injection for ablation (LIA) is a safe and effective treatment for predominantly cystic thyroids. Our study had similar findings, with thyroid nodules shrinking from 15 ml before ablation to 12 ml 12 months after the procedure, with a volume reduction rate (VRR) of 75%.

A minimally invasive procedure used for the treatment of benign thyroid nodules is microwave ablation. This novel treatment technique is a safe and effective treatment for benign thyroid nodules and recurrent thyroid cancer. In the Yue et al. study [42]. A total of 474 benign thyroid nodules in 435 patients were treated with ultrasound-guided MWA, and the overall VRR of the thyroid nodules after 6 months of follow-up was 65%, with a VRR of cystic nodules being 83%, which is consistent with the VRR of nodules being 82.3% in our study. This suggests that MWA is safe and effective for the treatment of a predominantly cystic thyroid. Of course, previous studies have also shown that MWA can be used for the treatment of other types of thyroid nodules, such as solid or purely cystic nodules.

In the past, a team studied the factors affecting the effectiveness of the treatment, and they suggested that the initial volume might affect the effectiveness of the treatment [43]. Therefore, we studied initial volume as a criterion for grouping. After our study, we found that there was no statistically significant difference between the VRR of group A and group B in both MWA and LIA groups at 1 month, 3 months, 6 months, and 12 months after ablation (all p > 0.05), which ultimately confirms that the initial volume of the thyroid nodule does not affect the effectiveness of treatment. Our study’s findings were inconsistent with theirs, and we believe that the initial volume of thyroid nodules in the two groups at the time of their study was inconsistent, leading to a bias in their results. We strictly controlled the initial volume of thyroid nodules in both groups in our study.

There is no consensus on the best treatment choices for cystic solid nodules, and guidelines do not give a higher recommendation for LIA or MWA. This study shows that the advantages of LIA are the ease of treatment and the cheap total cost of therapy, but the advantages of MWA are the superior treatment outcomes. LIA is an excellent therapy choice for people who desire to shorten their recovery time or lower their treatment costs. However, some studies have found that due to circumstances such as the nodule’s high parenchymal content or the patient’s high blood supply status, partial resorption or even recurrence of the nodule may occur [40]. As a result, if one desires a better outcome and is willing to tolerate a large amount of therapy and a longer treatment duration, MWA would be an excellent treatment option. Therefore, we need to make better clinical choices based on the patient’s general condition and diagnostic needs.

Our study still had several limitations. (1) This study was a retrospective study with potential selective bias. When selecting subjects for the study, they may have been included or excluded due to human factors, which may have affected the results of the study. Future studies need to collect more patient information and develop more stringent inclusion and exclusion criteria. (2) The relatively small sample size of this study may lead to biased results and requires further validation in a randomized clinical trial with a large sample size. (3) Non-comparative and non-homogeneous statistical analyses are also a limitation, and the findings were confirmed by rigorous experimental grouping in future prospective multicentre studies.

Conclusion

In our research, both MWA and LIA were therapeutically effective and safe in treating predominantly cystic thyroid nodules. MWA or LIA can effectively reduce the thyroid nodule volume and improve the patients’ clinical symptoms. LIA can shorten the length of hospital stay and reduce the overall cost. Hence, based on the patient’s general condition, we must perform a thorough assessment and select the best course of action.

Data Availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Chen L, Sun P, Hao Q, Yin W, Xu B, Ma C, Stemmer A, Fu C, Wang M, Lu J. Diffusion-weighted MRI in the evaluation of the thyroid nodule: comparison between integrated-shimming EPI and conventional 3D-shimming EPI techniques. Oncotarget. 2018;9(40):26209–16.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Wheeler MH. Management of the solitary thyroid nodule. J R Soc Med. 1988;81(8):437–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Mauri G, Pacella CM, Papini E, Solbiati L, Goldberg SN, Ahmed M, Sconfienza LM. Image-guided thyroid ablation: proposal for standardization of terminology and reporting criteria. Thyroid: Official Journal of the American Thyroid Association. 2019;29(5):611–8.

    Article  PubMed  Google Scholar 

  4. Chen Z, Xu W, Huang Y, Jin X, Deng J, Zhu S, Liu H, Zhang S, Yu Y. Associations of noniodized salt and thyroid nodule among the chinese population: a large cross-sectional study. Am J Clin Nutr. 2013;98(3):684–92.

    Article  CAS  PubMed  Google Scholar 

  5. Miller JM, Zafar SU, Karo JJ. The cystic thyroid nodule. Recognition and management. Radiology. 1974;110(2):257–61.

    Article  CAS  PubMed  Google Scholar 

  6. Choi WJ, Baek JH, Choi YJ, Lee JH, Ha EJ, Lee WC, Lim HK, Kim WB. Management of cystic or predominantly cystic thyroid nodules: role of simple aspiration of internal fluid. Endocr Res. 2015;40(4):215–9.

    Article  PubMed  Google Scholar 

  7. Ferreira MC, Piaia C, Cadore AC. Percutaneous ethanol injection versus conservative treatment for benign cystic and mixed thyroid nodules. Arch Endocrinol Metab. 2016;60(3):211–6.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Døssing H, Bennedbæk FN, Hegedüs L. Long-term outcome following laser therapy of benign cystic-solid thyroid nodules. Endocr Connections. 2019;8(7):846–52.

    Article  Google Scholar 

  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: Official Journal of the American Thyroid Association. 1996;6(5):403–8.

    Article  CAS  PubMed  Google Scholar 

  10. Weiss RE, Lado-Abeal J. Thyroid nodules: diagnosis and therapy. Curr Opin Oncol. 2002;14(1):46–52.

    Article  PubMed  Google Scholar 

  11. Alexander EK, Hurwitz S, Heering JP, Benson CB, Frates MC, Doubilet PM, Cibas ES, Larsen PR, Marqusee E. Natural history of benign solid and cystic thyroid nodules. Ann Intern Med. 2003;138(4):315–8.

    Article  PubMed  Google Scholar 

  12. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M et al. 2015 american thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid Cancer: the american thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid Cancer. Thyroid: Official Journal of the American Thyroid Association 2016, 26(1).

  13. Durante C, Grani G, Lamartina L, Filetti S, Mandel SJ, Cooper DS. The diagnosis and management of thyroid nodules: a review. JAMA. 2018;319(9):914–24.

    Article  PubMed  Google Scholar 

  14. Eng CY, Quraishi MS, Bradley PJ. Management of thyroid nodules in adult patients. Head Neck Oncol. 2010;2:11.

    Article  PubMed  PubMed Central  Google Scholar 

  15. 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.

    Article  CAS  PubMed  Google Scholar 

  16. Sung JY, Baek JH, Kim KS, Lee D, Yoo H, Kim JK, Park SH. Single-session treatment of benign cystic thyroid nodules with ethanol versus radiofrequency ablation: a prospective randomized study. Radiology. 2013;269(1):293–300.

    Article  PubMed  Google Scholar 

  17. Nixon IJ, Angelos P, Shaha AR, Rinaldo A, Williams MD, Ferlito A. Image-guided chemical and thermal ablations for thyroid disease: review of efficacy and complications. Head Neck. 2018;40(9):2103–15.

    Article  PubMed  Google Scholar 

  18. He L, Zhao W, Xia Z, Su A, Li Z, Zhu J. Comparative efficacy of different ultrasound-guided ablation for the treatment of benign thyroid nodules: systematic review and network meta-analysis of randomized controlled trials. PLoS ONE. 2021;16(1):e0243864.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Linghu E, Du C, Chai N, Li H, Wang Z, Sun Y, Xu W, Guo X, Ning B, Sun L, et al. A prospective study on the safety and effectiveness of using lauromacrogol for ablation of pancreatic cystic neoplasms with the aid of EUS. Gastrointest Endosc. 2017;86(5):872–80.

    Article  PubMed  Google Scholar 

  20. Xiang J, Linghu E, Chai N. Case of large intra-esophageal bronchogenic cyst treated with lauromacrogol ablation. Dig Endosc. 2020;32(3):435.

    Article  PubMed  Google Scholar 

  21. Du J-R, Li W-H, Quan C-H, Wang H, Teng D-K. Long-term outcome of microwave ablation for benign thyroid nodules: over 48-month follow-up study. Front Endocrinol (Lausanne). 2022;13:941137.

    Article  PubMed  Google Scholar 

  22. Fu Q-Q, Kang S, Wu C-P, Wang S-Y, Liu Y-Y, Tian J-W, Jiang S-Q. A study on the efficacy of microwave ablation for benign thyroid nodules and related influencing factors. Int J Hyperthermia. 2021;38(1):1469–75.

    Article  CAS  PubMed  Google Scholar 

  23. Lobascio P, Laforgia R, Novelli E, Perrone F, Di Salvo M, Pezzolla A, Trompetto M, Gallo G. Short-term results of sclerotherapy with 3% polidocanol foam for symptomatic second- and third-degree hemorrhoidal disease. J Invest Surg. 2021;34(10):1059–65.

    Article  PubMed  Google Scholar 

  24. Jeong WK, Baek JH, Rhim H, Kim YS, Kwak MS, Jeong HJ, Lee D. Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol. 2008;18(6):1244–50.

    Article  PubMed  Google Scholar 

  25. Luo F, Huang L, Gong X, Han Z, Liu F, Cheng Z, Dou J, Yu X, Liang P, Yu J. Microwave ablation of benign thyroid nodules: 3-year follow-up outcomes. Head Neck. 2021;43(11):3437–47.

    Article  PubMed  Google Scholar 

  26. Yang H, Chen Y, Chen B, Zhao S, Zhang Z, Wang K, Chen Z, Feng H, An M. Ablating aspiration needle tract prior to microwave ablation can improve therapeutic outcomes for predominantly cystic thyroid nodules. Front Endocrinol (Lausanne). 2021;12:752822.

    Article  PubMed  Google Scholar 

  27. Alexander EK, Cibas ES. Diagnosis of thyroid nodules. Lancet Diabetes Endocrinol. 2022;10(7):533–9.

    Article  PubMed  Google Scholar 

  28. McHenry CR, Slusarczyk SJ, Khiyami A. Recommendations for management of cystic thyroid disease. Surgery 1999, 126(6).

  29. Papini E, Pacella CM, Solbiati LA, Achille G, Barbaro D, Bernardi S, Cantisani V, Cesareo R, Chiti A, Cozzaglio L, et al. Minimally-invasive treatments for benign thyroid nodules: a Delphi-based consensus statement from the italian minimally-invasive treatments of the thyroid (MITT) group. Int J Hyperthermia. 2019;36(1):376–82.

    Article  PubMed  Google Scholar 

  30. Zhang Z, Lin N. Clinical diagnostic value of American College of Radiology thyroid imaging report and data system in different kinds of thyroid nodules. BMC Endocr Disord. 2022;22(1):145.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Dong S, Sun L, Xu J, Han Z, Liu J. Intracystic hemorrhage and its management during Ultrasound-Guided percutaneous microwave ablation for cystic thyroid nodules. Front Endocrinol (Lausanne). 2020;11:477.

    Article  PubMed  Google Scholar 

  32. Wu W, Gong X, Zhou Q, Chen X, Chen X. Ultrasound-guided percutaneous microwave ablation for solid benign thyroid nodules: comparison of MWA versus Control Group. Int J Endocrinol. 2017;2017:9724090.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Bandeira-Echtler E, Bergerhoff K, Richter B. Levothyroxine or minimally invasive therapies for benign thyroid nodules. Cochrane Database Syst Rev. 2014;2014(6):CD004098.

    PubMed  PubMed Central  Google Scholar 

  34. Xia B, Yu B, Wang X, Ma Y, Liu F, Gong Y, Zou X, Lei J, Su A, Wei T, et al. Conspicuousness and recurrence related factors of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules. BMC Surg. 2021;21(1):317.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Gallo G, Pietroletti R, Novelli E, Sturiale A, Tutino R, Lobascio P, Laforgia R, Moggia E, Pozzo M, Roveroni M, et al. A multicentre, open-label, single-arm phase II trial of the efficacy and safety of sclerotherapy using 3% polidocanol foam to treat second-degree haemorrhoids (SCLEROFOAM). Tech Coloproctol. 2022;26(8):627–36.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Fonseca MM, Mocelin FJ, Grill MH, Gianesini S, Miyake K, Argenta R, Pereira AH. Nd:yag laser combined with injection sclerotherapy in the treatment of reticular veins and telangiectasias (CLaCS method): a triple-blind randomized clinical trial comparing two sclerosing agents associated with same laser patterns. Phlebology. 2023;38(3):165–71.

    Article  PubMed  Google Scholar 

  37. Itou C, Koizumi J, Hashimoto T, Myojin K, Kagawa T, Mine T, Imai Y. Foam sclerotherapy for a symptomatic hepatic cyst: a preliminary report. Cardiovasc Intervent Radiol. 2014;37(3):800–4.

    Article  PubMed  Google Scholar 

  38. Gaballa D, Moyer M. Thoughts of the safety and efficacy of EUS-guided cyst ablation with the use of lauromacrogol. Gastrointest Endosc. 2018;87(5):1367.

    Article  PubMed  Google Scholar 

  39. Idiz UO, Aysan E, Can I, Buyukpinarbasili N, Yardimci EY, Bektasoglu H. The effects of lauromacrogol on thyroid tissue in rabbits. Is this a safe option for the treatment of nodular thyroid disease? Ann Ital Chir. 2016;87:192–7.

    PubMed  Google Scholar 

  40. Dong YJ, Liu ZH, Zhou JQ, Zhan WW. Efficacy of Lauromacrogol injection for ablation of Benign predominantly cystic thyroid nodules and related factors: a prospective study. Korean J Radiol. 2022;23(4):479–87.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Gong X, Zhou Q, Wang F, Wu W, Chen X. Efficacy and safety of Ultrasound-Guided Percutaneous Polidocanol Sclerotherapy in Benign cystic thyroid nodules: preliminary results. Int J Endocrinol. 2017;2017:8043429.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Liu Y-J, Qian L-X, Liu D, Zhao J-F. Ultrasound-guided microwave ablation in the treatment of benign thyroid nodules in 435 patients. Exp Biol Med (Maywood). 2017;242(15):1515–23.

    Article  CAS  PubMed  Google Scholar 

  43. Zhang Y, Chu X, Liu Y, Zhao Y, Han X, Hu X, Xiang P, Chen G, Liu C, Xu S. The influence of nodule size on clinical efficacy of ethanol ablation and microwave ablation on cystic or predominantly cystic thyroid nodules. Endocr Connections 2022, 11(11).

Download references

Acknowledgements

We are grateful to all the teams and patients who took part in this research.

Funding

This work was supported by the Medical Education Collaborative Innovation Fund of Jiangsu University (JDY2022002), the Fifth Phase “169 Project” Scientific Research Project of Zhenjiang City (YLJ201931), the Social Development Program of Zhenjiang City (SH2022066), and the Kunshan Social Development Science and Technology Project (KSF2021131).

Author information

Authors and Affiliations

  1. Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, Zhenjiang, 212000, China

    Xin Min, Zheng Zhang, Yanwei Chen, Shuangshuang Zhao, Jingwen Ge, Huajiao Zhao, Yun Cai & Baoding Chen

  2. Department of Medical Ultrasound, Changzhou First People’s Hospital and The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China

    Hui Chen

  3. Department of Medical Ultrasound, The First People’s Hospital of Kunshan Affiliated to Jiangsu University, Kunshan, 215132, China

    Jun Shao

  4. Department of Medical Ultrasound, The Fifth People’s Hospital of Wuxi, The Medical School of Jiangnan University, Wuxi, 214000, Jiangsu, China

    Yanfei Jing

Authors
  1. Xin Min
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zheng Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yanwei Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shuangshuang Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jingwen Ge
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Huajiao Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yun Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hui Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jun Shao
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yanfei Jing
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Baoding Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

XM participated in the data collection. The manuscript was written and edited by XM. BC, HC and JS carried out the procedure. The manuscript was reviewed by YJ, ZZ, Ya.C, SZ, JG, HZ and Yu.C. All the authors reviewed and approved the article for submission.

Corresponding author

Correspondence to Baoding Chen.

Ethics declarations

Ethics approval and consent to participate

This study design followed the international regulations of The Declaration of Helsinki. Our research was approved by the Ethical Committee of the Affiliated Hospital of Jiangsu University (SWYXLL20190225-2), and written informed consent was obtained from the participants.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Min, X., Zhang, Z., Chen, Y. et al. Comparison of the effectiveness of lauromacrogol injection for ablation and microwave ablation in the treatment of predominantly cystic thyroid nodules: a multicentre study. BMC Cancer 23, 785 (2023). https://doi.org/10.1186/s12885-023-11301-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12885-023-11301-7

Keywords

BMC Cancer

ISSN: 1471-2407

Contact us