Thyroid Nodule Clinical Trial
Official title:
Effect of Ultrasound Guided Laser Ablation Therapy on Symptomatic Benign Thyroid Nodules
Verified date | May 2024 |
Source | Mercy Research |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This is a prospective trial to evaluate the effects of laser ablation on symptomatic benign thyroid nodules. The study is designed to assess the clinical efficacy, safety, tolerability and impact on symptoms of single ultrasound guided laser ablation treatment of symptomatic benign thyroid nodules. Approximately 20 subjects will undergo laser ablation of symptomatic benign nodules.
Status | Completed |
Enrollment | 10 |
Est. completion date | September 28, 2023 |
Est. primary completion date | September 28, 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 90 Years |
Eligibility | Inclusion Criteria: - Males or females, Age =18 years - Thyroid Stimulating Hormone (TSH) within normal limits - Presence of thyroid nodule >29 mm and =60 mm in the longest dimension on ultrasound imaging - Symptoms from thyroid nodule - tightness or pressure in neck, neck tenderness, neck pain, difficulty swallowing, voice changes, shortness of breath or cosmetic disfigurement - Solid thyroid nodule with less than 20% cystic component - Cytological benign nodule proven by previous biopsy within 2 years - Ability to place the laser tip inside the nodule and to keep vital structures (i.e. trachea and esophagus) outside the zone of injury. To achieve this safe zone, we will leave a minimum of 17 mm distance between the fiber tip anterior to the vital structures and 10 mm from the fiber tip in all other dimensions. - Not on anticoagulants or anticoagulants stopped for appropriate amount of time based on the pharmacology of the drug - Ability to understand and willingness to provide informed consent Exclusion Criteria: - Pregnancy - Diagnosis of Hyperthyroidism - Malignant thyroid nodule - Egg shell or coarse calcification in the thyroid nodule - Patient on anticoagulation which cannot be stopped due to medical reasons - Coagulopathy - Thyroid nodules in contact with trachea, esophagus or major blood vessels - Prior neck surgery - Prior radiation to head and neck - Previous radioactive iodine treatment - Current iodine supplementation - Current anti-thyroid medication - Biotin supplementation within 2 days prior to enrollment - Allergy to Ethyl chloride spray or lidocaine - Physical and psychological conditions that prevent safe administration of the procedure as determined by the investigator - Adults not able to consent - Prisoners - Individuals who cannot read and understand English |
Country | Name | City | State |
---|---|---|---|
United States | Mercy Clinic Endocrinology - Smith Glynn Callaway | Springfield | Missouri |
Lead Sponsor | Collaborator |
---|---|
Johnson Thomas | Mercy Research |
United States,
Pacella CM, Mauri G, Achille G, Barbaro D, Bizzarri G, De Feo P, Di Stasio E, Esposito R, Gambelunghe G, Misischi I, Raggiunti B, Rago T, Patelli GL, D'Este S, Vitti P, Papini E. Outcomes and Risk Factors for Complications of Laser Ablation for Thyroid Nodules: A Multicenter Study on 1531 Patients. J Clin Endocrinol Metab. 2015 Oct;100(10):3903-10. doi: 10.1210/jc.2015-1964. Epub 2015 Aug 14. — View Citation
Pacella CM, Mauri G, Cesareo R, Paqualini V, Cianni R, De Feo P, Gambelunghe G, Raggiunti B, Tina D, Deandrea M, Limone PP, Mormile A, Giusti M, Oddo S, Achille G, Di Stasio E, Misischi I, Papini E. A comparison of laser with radiofrequency ablation for the treatment of benign thyroid nodules: a propensity score matching analysis. Int J Hyperthermia. 2017 Dec;33(8):911-919. doi: 10.1080/02656736.2017.1332395. Epub 2017 Jun 12. — View Citation
Papini E, Rago T, Gambelunghe G, Valcavi R, Bizzarri G, Vitti P, De Feo P, Riganti F, Misischi I, Di Stasio E, Pacella CM. Long-term efficacy of ultrasound-guided laser ablation for benign solid thyroid nodules. Results of a three-year multicenter prospective randomized trial. J Clin Endocrinol Metab. 2014 Oct;99(10):3653-9. doi: 10.1210/jc.2014-1826. Epub 2014 Jul 22. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Change in Radiographic Volume of Thyroid Nodule From Baseline at 3, 6 and 12 Months After Laser Ablation | Percentage change from baseline volume will be calculated at 3, 6 and 12 months after laser treatment. | 12 months | |
Primary | Change in the Thyroid Function After Laser Treatment Assessed by the Measurement of TSH and Free T4 at 3, 6 and 12 Months After Laser Ablation | Number of patients who develops hypo or hyperthyroidism 3,6 and 12 months after laser treatment. | 12 months | |
Primary | Change in Doppler Grade at 3, 6, and 12 Months After Laser Ablation | Number of patients who had changes in blood flow inside the thyroid nodule as evidenced by change in Doppler grade. | 12 months | |
Primary | Change in Thyroid Antibody Levels 3,6 and 12 Months After Laser Ablation | Number of patients who develops new thyroid antibodies 3,6, and 12 months after laser ablation | 12 months | |
Primary | Cosmetic Assessment at 3,6 and 12 Months and Immediately After Laser Ablation Measured Using a Numerical Scale | Patients perceived cosmetic appearance will be measured using a numerical scale at baseline, immediately after procedure and then at 3, 6 and 12 months after procedure using following question. On a scale from 0 to 10, how much does your thyroid nodule affect your appearance? 0 being the best outcome and 10 being the worst outcome. | 3 months, 6 months, and 12 months after procedure | |
Secondary | Reported Pain Score on the Numerical Scale Immediately Post Procedure. | Change in pain will be measured using a numerical scale at baseline, immediately post procedure and 3 months after procedure using the following question. Rate your pain on a scale from 0 to 10 where 0 is no pain and 10 is the worst pain possible. | Immediately post-procedure | |
Secondary | Tolerability of Ultrasound Guided Percutaneous Laser Ablation for Treatment of Symptomatic Benign Thyroid Nodules as Reported Through a Questionnaire After the Procedure. | Participants will be asked to answer the following questionnaire after the procedure.
How likely is it that you would have the laser ablation procedure again? 1 = Very Likely 2 = Somewhat Likely 3 = Not Likely |
Post-procedure on the day of procedure | |
Secondary | Number of Participants With Treatment Related Adverse Events as Assessed by CTCAE v4.0 | Treatment related adverse events will be captured using CTCAE v4,0 format | 1 year | |
Secondary | Reported Pain Score on the Numerical Scale 3 Months Post Procedure. | Change in pain will be measured using a numerical scale at baseline, immediately post procedure and 3 months after procedure using the following question. Rate your pain on a scale from 0 to 10 where 0 is no pain and 10 is the worst pain possible. | 3 months | |
Secondary | Tolerability of Ultrasound Guided Percutaneous Laser Ablation for Treatment of Symptomatic Benign Thyroid Nodules as Reported Through a Questionnaire After the Procedure. | Participants will be asked to answer the following questionnaire after the procedure.
How satisfied were you with the length of the laser ablation procedure? 1= Satisfied 2 = Neither 3 = Dissatisfied |
Post-procedure on day of procedure | |
Secondary | Tolerability of Ultrasound Guided Percutaneous Laser Ablation for Treatment of Symptomatic Benign Thyroid Nodules as Reported Through a Questionnaire After the Procedure. | Participants will be asked to answer the following questionnaire after the procedure.
How much discomfort did you have with the laser ablation procedure? 1= Less than I thought 2 = About what I thought 3 = More than I thought |
Post-procedure on day of procedure |
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