대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제84권5호
  • /
  • Pages.1009-1016
  • /
  • 2023
  • /
  • 1738-2637(pISSN)
  • /
  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

국내의 갑상선 고주파 절제술에 대한 교육: 현황 및 미래 전망

Training of Radiofrequency Ablation for Thyroid Nodules in Korea: Current and Future Perspective

  • 안혜신 (중앙대학교 의과대학 중앙대학교병원 영상의학과) ;
  • 정소령 (가톨릭대학교 의과대학 여의도성모병원 영상의학과) ;
  • 백정환 (울산대학교 의과대학 서울아산병원 영상의학과) ;
  • 성진용 (대림성모병원 영상의학과, 갑상선센터) ;
  • 김지훈 (서울대학교 의과대학 서울대학교병원 영상의학과)
  • Hye Shin Ahn (Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine) ;
  • So Lyung Jung (Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jung Hwan Baek (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Jin Yong Sung (Department of Radiology and Thyroid Center, Daerim St. Mary's Hospital) ;
  • Ji-hoon Kim (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine)
  • 투고 : 2023.06.19
  • 심사 : 2023.09.16
  • 발행 : 2023.09.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

고주파 절제술(radiofrequency ablation)은 미세 침습 치료술의 한 방법으로 양성 갑상선 결절과 갑상선 재발암 환자에서 수술적 치료를 대신하여 이용되고 있다. 국내에서는 2002년 세계 최초로 갑상선 결절에 대한 고주파 절제술을 시작하여, 2008년에는 대규모 연구 결과를 발표하였다. 2009년 대한갑상선영상의학회(Korean Society of Thyroid Radiology)는 고주파 절제술에 대한 첫 권고안을 만들었으며, 2012년과 2018년에 이를 개정하였다. 대한갑상선영상의학회의 지침서는 갑상선 결절의 고주파 절제술에 대한 세계 최초의 지침서로 국내 및 국외에서 갑상선 고주파 절제술을 시행하는 시술자들을 위한 지침이 되었다. 이 지침서들은 한국 및 전 세계 여러 나라에서 고주파 절제술의 확립 및 확산에 크게 기여하였다. 또한 대한 갑상선영상의학회는 2015년부터 참가자 수준에 맞춘 고주파 절제술의 심화 실습 과정을 진행하고 있다. 본 종설에서는 대한갑상선영상의학회에서 실시한 고주파 절제술 교육의 역사를 소개하고, 고주파 절제술의 학습 곡선 및 현재 한국에서의 교육 프로그램을 기술한 후 앞으로 나아갈 방향을 제시해보고자 한다.

Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. In Korea, RFA for thyroid nodules was first performed in 2002, and a large population study was published in 2008. The Task Force Committee of the Korean Society of Thyroid Radiology (KSThR) developed its first recommendations for RFA in 2009, which were revised in 2012 and 2018. The KSThR guideline was the first guideline for RFA of thyroid nodules worldwide and has become a guideline for physicians to perform thyroid RFA in Korea and other countries around the world. These guidelines have contributed significantly to the establishment and widespread use of RFA worldwide. In addition, since 2015, the KSThR has conducted intensive hands-on courses depending on the level of the participants. In this article, the authors introduce the history of eduction for RFA conducted by the KSThR and describe the learning curve of RFA and current training programs in Korea, along with future directions for training programs.

키워드

참고문헌

  1. Deandrea M, Limone P, Basso E, Mormile A, Ragazzoni F, Gamarra E, et al. US-guided percutaneous radiofrequency thermal ablation for the treatment of solid benign hyperfunctioning or compressive thyroid nodules. Ultrasound Med Biol 2008;34:784-791 
  2. Jeong WK, Baek JH, Rhim H, Kim YS, Kwak MS, Jeong HJ, et al. Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol 2008;18:1244-1250 
  3. Kim YS, Rhim H, Tae K, Park DW, Kim ST. Radiofrequency ablation of benign cold thyroid nodules: initial clinical experience. Thyroid 2006;16:361-367 
  4. Spiezia S, Garberoglio R, Milone F, Ramundo V, Caiazzo C, Assanti AP, et al. Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid 2009;19:219-225 
  5. Baek JH, Jeong HJ, Kim YS, Kwak MS, Lee D. Radiofrequency ablation for an autonomously functioning thyroid nodule. Thyroid 2008;18:675-676 
  6. Baek JH, Kim YS, Lee D, Huh JY, Lee JH. Benign predominantly solid thyroid nodules: prospective study of efficacy of sonographically guided radiofrequency ablation versus control condition. AJR Am J Roentgenol 2010;194:1137-1142 
  7. Sung JY, Kim YS, Choi H, Lee JH, Baek JH. Optimum first-line treatment technique for benign cystic thyroid nodules: ethanol ablation or radiofrequency ablation? AJR Am J Roentgenol 2011;196:W210-W214 
  8. Jung SL, Baek JH, Lee JH, Shong YK, Sung JY, Kim KS, et al. Efficacy and safety of radiofrequency ablation for benign thyroid nodules: a prospective multicenter study. Korean J Radiol 2018;19:167-174 
  9. Mauri G, Hegedus L, Bandula S, Cazzato RL, Czarniecka A, Dudeck O, et al. European Thyroid Association and Cardiovascular and Interventional Radiological Society of Europe 2021 clinical practice guideline for the use of minimally invasive treatments in malignant thyroid lesions. Eur Thyroid J 2021;10:185-197 
  10. Orloff LA, Noel JE, Stack BC Jr, Russell MD, Angelos P, Baek JH, et al. Radiofrequency ablation and related ultrasound-guided ablation technologies for treatment of benign and malignant thyroid disease: an international multidisciplinary consensus statement of the American Head and Neck Society Endocrine Surgery Section with the Asia Pacific Society of Thyroid Surgery, Associazione Medici Endocrinologi, British Association of Endocrine and Thyroid Surgeons, European Thyroid Association, Italian Society of Endocrine Surgery Units, Korean Society of Thyroid Radiology, Latin American Thyroid Society, and Thyroid Nodules Therapies Association. Head Neck 2022;44:633-660 
  11. Kim JH, Baek JH, Lim HK, Ahn HS, Baek SM, Choi YJ, et al. 2017 thyroid radiofrequency ablation guideline: Korean Society of Thyroid Radiology. Korean J Radiol 2018;19:632-655 
  12. Park YJ, Lee EK, Song YS, Kang SH, Koo BS, Kim SW, et al. 2023 Korean Thyroid Association management guidelines for patients with thyroid nodules. Int J Thyroidol 2023;16:1-31 
  13. Baek JH, Na DG, Lee JH, Jung SL, Sung JY, Sim JS. Korean Society of Thyroid Radiology recommendations for radiofrequency ablation of thyroid nodules. Seoul: Korean Society of Thyroid Radiology 2009 
  14. Na DG, Lee JH, Jung SL, Kim JH, Sung JY, Shin JH, et al. Radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: consensus statement and recommendations. Korean J Radiol 2012;13:117-125 
  15. Papini E, Monpeyssen H, Frasoldati A, Hegedus L. 2020 European Thyroid Association clinical practice guideline for the use of image-guided ablation in benign thyroid nodules. Eur Thyroid J 2020;9:172-185 
  16. Dobnig H, Amrein K. Monopolar radiofrequency ablation of thyroid nodules: a prospective Austrian single-center study. Thyroid 2018;28:472-480 
  17. Deandrea M, Sung JY, Limone P, Mormile A, Garino F, Ragazzoni F, et al. Efficacy and safety of radiofrequency ablation versus observation for nonfunctioning benign thyroid nodules: a randomized controlled international collaborative trial. Thyroid 2015;25:890-896 
  18. Russ G, Ben Hamou A, Poiree S, Ghander C, Menegaux F, Leenhardt L, et al. Learning curve for radiofrequency ablation of benign thyroid nodules. Int J Hyperthermia 2021;38:55-64 
  19. Sim JS, Baek JH, Cho W. Initial ablation ratio: quantitative value predicting the therapeutic success of thyroid radiofrequency ablation. Thyroid 2018;28:1443-1449 
  20. Kuo CY, Liu CL, Tsai CH, Cheng SP. Learning curve analysis of radiofrequency ablation for benign thyroid nodules. Int J Hyperthermia 2021;38:1536-1540 
  21. Bom WJ, Joosten FBM, van Borren MMGJ, Bom EP, van Eekeren RRJP, de Boer H. Radiofrequency ablation for symptomatic, non-functioning, thyroid nodules: a single-center learning curve. Endocr Connect 2022;11:e210304 
  22. Baek JH, Lee JH, Sung JY, Bae JI, Kim KT, Sim J, et al. Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study. Radiology 2012;262:335-342 
  23. Chung SR, Suh CH, Baek JH, Park HS, Choi YJ, Lee JH. Safety of radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: a systematic review and meta-analysis. Int J Hyperthermia 2017;33:920-930 
  24. Park HS, Baek JH, Park AW, Chung SR, Choi YJ, Lee JH. Thyroid radiofrequency ablation: updates on innovative devices and techniques. Korean J Radiol 2017;18:615-623 
  25. Uppot RN, Laguna B, McCarthy CJ, De Novi G, Phelps A, Siegel E, et al. Implementing virtual and augmented reality tools for radiology education and training, communication, and clinical care. Radiology 2019;291:570-580 
  26. Dawson SL, Kaufman JA, Meglin D. An interactive virtual reality/simulator trainer for interventional radiology. J Vasc Interv Radio 1996;7:374