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Radiofrequency Ablation Therapy(RFA)

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Presentation on theme: "Radiofrequency Ablation Therapy(RFA)"— Presentation transcript:

1 Radiofrequency Ablation Therapy(RFA)
Treatment of Benign Thyroid Mass 대림성모병원 영상의학과 백 정환

2 Treatment of Benign Thyroid Nodule
Drug medication : Thyroid hormone – TSH suppression Ethanol injection Laser Ablation : heat New Method : RFA

3 RFA : Basic Concept 전류의 저항을 이용하여 바늘 끝에서 열을 생성 Tumor necrosis

4 RFA : Current Application
Liver mass : Hepatoma, Metastasis Huge symptomatic cyst(liver, kidney) Bone, Lung, Breast, Kidney mass Disc, BPH, Anal incontinence

5 Cool-tip RF System Generator Pump – cooling system Electrode : Needle

6 Cool-tip RF System Thin needle : No scar

7 Material (I) 2002. 6 – 2004. 7 148명 200개의 tumor
M : F = 16 : 132 (나이 15-71세) Biopsy proven benign tumor Tumor volume : (6.83)cc

8 Material (II) 대상 환자 증상 : 통증, 이물감, 압박감 Cosmetic Problem 환자가 원하는 경우
Cancer phobia

9 Method Supine position Local anesthesia
No pain control during procedure Localization of needle in the mass 전체 mass가 echogenic 하게 변하게

10 Follow-up U/S : Echogenecity and doppler signal Repeat RFA
: Tumor size 가 줄지 않는 경우 Doppler signal 이 남아 있는 경우

11 Result 평균 부피감소율 (73.2%) 50% 이상 부피 감소 : 90% (180/200)
90% 이상 부피 감소 : 36% (72/200) 100% 소실 : 10% (20/200)

12 Complications Nerve Injury(Voice change) Pain 영구적인 부작용(-)
: 2 예 (1주, 2개월에 complete recovery) Pain : 대부분의 환자가 먹는 진통제로 잘 조절 영구적인 부작용(-)

13 Solid Thyroid Mass F/26 Known thyroid mass with discomfort
4.6cm sized solid hypervascular mass 9 months after RFA(2.4cm)

14 Solid and Cystic Mass(I)
F/36 Neck swelling and discomfort for 1 years Complete ablation state 11 months after RFA (4.2cm  2.1cm)

15 Gross and Microscopic Pathology

16

17 Cystic thyroid mass F/21 No response to medication for 6 months
2.4cm sized hemorrhagic mass 5 months after RFA (7mm)

18 Complete Ablation state of thyroid mass
10 months after RFA (3mm) 18months after RFA (0mm)

19 Solid and Cystic Mass(I)
F/32 Known thyroid nodule with cancer phobia 1.4cm sized solid and cystic nodule

20 Complete Ablation state of thyroid mass
3 months after RFA (5mm) 7 months after RFA (0mm)

21 Special Type of Thyroid Mass : Colloid Cyst
M/28 left neck swelling and pain 3rd RFAT state(7months, 8mm) 4.6cm sized colloid cyst 3rd RFA state(7months, 8mm)

22 Conclusion(I) 고주파 열치료는 여러 양성, 악성 종양에 세계적으로 널리 이용되는 치료법
본원에서 2년 6개월 전 갑상선의 양성 종양에 처음 치료 시작 후 추적한 결과 좋은 효과를 보입니다.

23 Conclusion(II) 그러나 더 오랜 기간의 추적검사를 거쳐 안정성이 입증되어야 할 숙제를 안고 있습니다.


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