Benign solitary solid cold thyroid nodules: US-guided interstitial laser photocoagulation--initial experience.

PURPOSE To evaluate the effects of ultrasonography (US)-guided interstitial laser photocoagulation (ILP) on the volume of benign solitary solid cold thyroid nodules and any nodule-related symptoms. MATERIALS AND METHODS ILP was performed in 16 patients with normal thyroid function and a solid benign thyroid nodule. None of the patients had uptake on a radionuclide scan. Patients underwent one ILP session. A needle was positioned in the thyroid nodule with US guidance, and the laser fiber was placed in the lumen of the needle. Patients were treated for 287-1,200 seconds with an output power of 1-3 W. ILP was performed with continuous US guidance and terminated when the echogenic changes were stationary. Thyroid nodule volume and thyroid function were evaluated before and 1, 3, and 6 months after treatment. During the same period, 15 untreated patients (control group) were followed up to evaluate the size of the untreated thyroid nodule. RESULTS In the 16 patients treated with ILP, the mean thyroid nodule volume decreased from 10 to 5.4 mL (P <.001) after 6 months. The median energy given was 761 J. There was no relationship between the dose of thermal energy given and nodule reduction. Pressure symptoms were significantly reduced (P =.0002) after 6 months. The treatment was well-tolerated in all patients. No significant change in thyroid nodule volume was seen in the control group. CONCLUSION US-guided ILP could become a useful nonsurgical alternative in the treatment of the benign solitary solid cold thyroid nodule in patients who cannot or will not undergo surgery.