Effectiveness of Percutaneous Ethanol Injection in Nodular Diseases of the Thyroid Gland

10-Year Follow-Up

Mayra Espenbetova, PhD, MD; Kuralay Amrenova, PhD, MD; Zhanar Zhumanbayeva, MD; Zhanar Zamanbekova, PhD, MD; Oxana Yurkovskaya, PhD, MD; Gulnar Shalgumbayeva, PhD, MD; Azhar Dyussupova, PhD, MD; Onala Telford, MD; Natalya Glushkova, PhD, MD


Endocr Pract. 2018;24(11):982-987. 

In This Article

Abstract and Introduction


Objective: Percutaneous ethanol injection (PEI) of thyroid cysts is not considered to be the standard of care in Kazakhstan, although thyroid nodules are highly prevalent. Patients with cystic nodules >3 cm typically undergo surgery with high rate of disability due to postsurgical hypothyroidism. Adoption of PEI as a standard of care will help reduce the number of unnecessary surgical interventions. The objective of this study was to assess effectiveness of PEI in patients with thyroid cysts and colloid nodules with 10 years of follow-up.

Methods: A total of 257 patients were treated with PEI and have been followed for 10 ± 1.2 years. All patients had baseline labs (thyroid-stimulating hormone [TSH] and free thyroxine [FT4] levels) and ultrasonography prior to the procedure. The Short Form Health Survey (SF-36) assessing quality of life (QoL) was performed 12 months after the last PEI procedure.

Results: At baseline, all patients had normal levels of FT4 and TSH that remained within normal limits throughout the follow-up period. Ultrasound evaluation performed over 3 months after PEI demonstrated significant volumetric reduction from 18.4 to 0.2 mL (P<.001) in cystic nodules and from 10.2 to 1.1 cm3 (P<.001) in colloid nodules. Patients who underwent the procedure had better SF-36 survey scores compared to their baseline QoL scores.

Conclusion: PEI for cystic and colloid thyroid nodules could be considered as an effective and safe procedure. It enables up to a 100% reduction of nodule volume and has a low rate of adverse effects.