Minimally-invasive treatments for benign thyroid nodules: a Delphi-based consensus statement from the Italian minimally-invasive treatments of the thyroid (MITT) group

作者：Enrico Papini, Claudio Maurizio Pacella, Luigi Solbiati, Gaetano Achille, Daniele Barbaro, Stella Bernardi, Vito Cantisani, Roberto Cesareo, Arturo Chiti, Luca Cozzaglio, Anna Crescenzi, Francesco De Cobelli, Maurilio Deandrea, Laura Fugazzola, Giovanni Gambelunghe, Roberto Garberoglio, Gioacchino Giugliano, Livio Luzi, Roberto Negro, Luca Persani, Bruno Raggiunti, Francesco Sardanelli, Ettore Cesare Seregni, Martina Sollini, Stefano Spiezia, Fulvio Stacul, Dominique Van Doorne, Luca Maria Sconfienza, Giovanni Mauri · 发表于：International Journal of Hyperthermia · 年份：2019 · DOI：10.1080/02656736.2019.1575482 · 被引用次数：196 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Thyroid and Parathyroid Surgery、Head and Neck Anomalies

Benign thyroid nodules are a common clinical occurrence and usually do not require treatment unless symptomatic. During the last years, ultrasound-guided minimally invasive treatments (MIT) gained an increasing role in the management of nodules causing local symptoms. In February 2018, the Italian MIT Thyroid Group was founded to create a permanent cooperation between Italian and international physicians dedicated to clinical research and assistance on MIT for thyroid nodules. The group drafted this list of statements based on literature review and consensus opinion of interdisciplinary experts to facilitate the diffusion and the appropriate use of MIT of thyroid nodules in clinical practice. (#1) Predominantly cystic/cystic symptomatic nodules should first undergo US-guided aspiration; ethanol injection should be performed if relapsing (level of evidence [LoE]: ethanol is superior to simple aspiration = 2); (#2) In symptomatic cystic nodules, thermal ablation is an option when symptoms persist after ethanol ablation (LoE = 4); (#3) Double cytological benignity confirmation is needed before thermal ablation (LoE = 2); (#4) Single cytological sample is adequate in ultrasound low risk (EU-TIRADS ≤3) and in autonomously functioning nodules (LoE = 2); (#5) Thermal ablation may be proposed as first-line treatment for solid, symptomatic, nonfunctioning, benign nodules (LoE = 2); (#6) Thermal ablation may be used for dominant lesions in nonfunctioning multinodular goiter in patients...