Thyroid Research Thyroid Research Archive Nodular Goiter

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.