Purpose: To define indications and the efficacy of percutaneous laser ablation (PLA).
Materials and Methods: US-guided PLA was performed in 566 thyroid nodules (1-6 sessions with output power 2.5-4W for 42-620 seconds). Follow-up period was up to 6 years.
Results: The best results were achieved in solitary solid nodules less than 2.0 cm in size with sufficiently homogenous echostructure, low or moderate vascularity of peripheral or combined pattern. Homogenous structure of the surrounding tissue allows faster nodule volume decrease ending with a smaller "scar" achieved by fewer PLA sessions. Treatment of hypervascular nodules is less effective and needs more PLA sessions. PLA is not proved to be effective in calcificated nodules and nodules with avascular regions of extremely high or low US density. Approximately 30-40% patients with nodular goiter have indications to PLA. Among them 72% nodules reduce their volume two or more times and 24% disappear. The nodules appearing hypoechoic and partly or completely avascular in 4 weeks time after PLA session show further volume regression. The nodules with persisting vascularization do not decrease and should be subject to a second PLA session.
Conclusion: US-guided PLA is an effective treatment modality for decreasing benign thyroid nodules volume. Gray scale sonography and color Doppler imaging should be used to achieve the best results.