Comparison of the Retention and Aspiration Techniques in Ultrasound-Guided Ethanol Ablation of Thyroid Cystic Nodules

Abstract Background Ethanol ablation (EA) is the first-line of therapy for relapsing symptomatic cystic thyroid nodules in most guidelines; however there is no consensus regarding the procedure details. Two techniques have been described for EA of thyroid cystic nodules; the retention technique and the aspiration technique. There are conflicting data regarding the superiority of one technique over the other. Aim of the Work to compare between the retention technique and the aspiration technique in treating cystic and predominantly cystic thyroid nodules. Patients and Methods 20 patients with mean age of 35.3±15.2 years having thyroid cysts or predominantly cystic nodules were treated using ethanol ablation. 10 patients were treated using retention technique, the other 10 patients were treated using aspiration technique. Results 15 patients (75%) were females, while 5 patients (25%) were males. Pure cystic nodules were 9 (45%), while 11 (55 %) patients had predominantly cystic nodules. The median nodule initial volume was 26 cc (14.23-38.45). The 6 month VRR was 81% (60-88), with overall success rate (VRR≥ 50%) of 85 %. No statistically significant difference was found between the retention and aspiration techniques as regards the 6-month VRR (P = 0.62), success rate (P = 0.76), symptom score (P = 0.63), cosmetic score (P = 0.455), or procedural pain (P = 0.43). Conclusion Retention and aspiration techniques show the same efficacy and safety in treating pure cystic and predominantly cystic thyroid nodules.