Percutaneous ethanol injection shrinks benign cystic thyroid nodules

Treatment with percutaneous ethanol injection (PEI) appears to produce marked reductions in the volume of benign cystic thyroid nodules, with the reduction evident at 6 months post-treatment and stable over time, according to the results of a meta-analysis.

Researchers performed a systematic review and searched multiple online databases for studies reporting data on volume reduction rate, compressive symptoms, and cosmetic concerns among individuals treated with PEI for benign cystic thyroid nodules. Associated complications were also assessed.

Nine studies were included in the meta-analysis, four of which were retrospective cohorts, one was a prospective cohort, and one a randomized controlled study. Participants were mostly euthyroid outpatients with a benign cystic or predominantly cystic thyroid nodule, causing compressive symptoms or cosmetic concerns. Overall, 1,667 nodules (mean volume at baseline 18 ml) were treated with PEI.

Pooled data showed that volume reduction rates were 77 percent at 6 months, 81 percent at 12 months, 72 percent at 24 months, 68 percent at 36 months, 74 percent at 60 months, and 69 percent at 120 months.

Furthermore, PEI treatment led to significant decreases in the compressive symptoms and cosmetic concerns. None of the patients developed permanent complications.

The findings suggest that PEI therapy is effective in reducing nodule size, with effects stable for up to 10 years. Therefore, PEI should be considered an effective and safe strategy in patients with recurrent symptomatic cystic or predominantly cystic thyroid nodules.