Very good news…it seems that Bethesda 4 thyroid nodule is a candidate for thermalablation! It may be that the international guidelines have been recently updated, could anyone explain with the EBM support? Has this this personal approach been approved by IRB? In literature some pilot studies X Li 2021, J Jang 2022, consider it only for ineligible patients to surgery or that refuse surgery. Patients with Bethesda 4 and suspicious ultrasound features for malignancy should be actively treated with surgery.
I presented my talk on the ablation of thyroid nodules at the European Congress of Interventional Radiology (CIRSE), held in Lisbon, Portugal, from September 14-17. I had the opportunity to share the latest findings from the literature, as well as my own approach, particularly on the subject of thermal ablation in Bethesda 3 and 4 thyroid nodules, which has been a highly debated topic recently. I would like to thank the CIRSE scientific committee for their kind invitation.
The evidence based medicine has a lot of grades It begins with expert opinion and then case series then RCT then metanalysis of RCT and this is the highest evidence We can’t accept any expert opinion or case series if we have metaanlysis of RCT against thermal ablation of such cases (and to my knowledge it’s not present) and if there such please share with us to learn from it The recommendation against ablation is based mainly on expert opinion and small trials also In international conferences if any one have IRB approval and informed written consent from the patients and all sequences is clear for the patients why not to illustrate his work? Professor Bülent Çekiç talk wasn’t a guidelines nor recommendation to ablate all cases of Bethesda 4 it’s just case series in its in the beginning of the EBM and finally guidelines were written to the best of evidence at time of writing and of course if a lot of trials is coming the guidelines will change in the future
Assoc. Professor İnterventional Radiology
3moDear Dr. Spieza, thank you for sharing my LinkedIn post, 'Save your Thyroid,' on your page. First of all, I recommend that you carefully review the studies available on PubMed regarding thermal ablation in Bethesda 4 thyroid nodules, and I suggest you listen to my entire presentation on the CIRSE website. It appears that you have not thoroughly reviewed the literature, nor have you watched my presentation. Conferences are platforms where everyone shares the latest publications and ideas reciprocally. Unfortunately, this is not possible on social media. I hope we have the chance to discuss this topic face-to-face at a scientific meeting in the future. I wish you success in your professional career.