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Peer-reviewedCC BY 4.0Journal of Endocrinological Investigation

Short- and mid-term efficacy of percutaneous ethanol injection in cystic and predominantly cystic thyroid nodules: systematic review and meta-analysis

  • Sium Wolde Sellasie1,2
  • Maurilio Deandrea3
  • Stefano Amendola1
  • Tommaso Piticchio4
  • Luigi Uccioli1
  • Pierpaolo Trimboli5,6
6 affiliations
  1. 1Division of Endocrinology and Diabetes, Department of Surgical Sciences, CTO Andrea Alesini Hospital, University of Rome Tor Vergata, Rome, 00133 Italy
  2. 2School of Applied Medical‑Surgical Sciences, University of Rome Tor Vergata, Rome, 00133 Italy
  3. 3UO Endocrinologia, Diabetologia e Malattie del metabolismo, AO Ordine Mauriziano, Torino, 101128 Italy
  4. 4Department of Medicine and Surgery, Kore University of Enna, Enna, Italy
  5. 5Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
  6. 6Clinic for Endocrinology and Diabetology, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
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Abstract

Objective: To evaluate the short- and mid-term volume reduction rate(VRR) after percutaneous ethanol injection(PEI), at 1,3 and 6 months, in patients with cystic or predominantly cystic thyroid nodules(CNs/pCNs, respectively), conducting a systematic review and meta-analysis of published data on VRR outcomes across these intervals.

Design and methods: A systematic search of articles published up to October 30,2025 identified studies reporting PEI treatment for CNs/pCNs.Characteristics of the study design, CNs/pCNs cohorts, and outcomes of interest(VRR at 1,3 and 6 months of follow up)were extracted.Statistical analysis included a random-effects meta-analysis, assessment of heterogeneity with use of the I2 statistic, and meta-regression and subgroup analyses to explore potential sources of heterogeneity.

Results: Six studies comprising 431 CNs/pCNs were included.The pooled VRRs at 1,3 and 6 months post-PEI were 85.18%(95% CI: 80.72–89.64),91.50%(95% CI: 88.88–94.12) and 93.11%(95% CI: 90.91–95.31),respectively. Stratifying by nodule cystic composition, the VRR at consecutive follow-up time points was significantly different between the 1- and 3-month intervals in both subgroups [CN: VRRs at 1, 3 and 6 months were 91.16% (88.38–93.93), 95.69% (94.16–97.22) and 96.02% (94.16–97.87), respectively; pCN: VRRs at 1,3 and 6 months were respectively 80.19% (77.04–83.33), 87.08% (84.95–89.2) and 90.01%(88.83–91.19)].A secondary meta-regression analysis with baseline mean volume as covariate demonstrated a significant inverse association with VRR at 1 and 3 months in pCN(p = 0.02).

Conclusion: By providing pooled VRRs for the short- and mid-term follow-up, this meta-analysis should be regarded as an initial step, paving the way for larger, high-quality studies aimed at standardizing the PEI procedure and supporting its incorporation into future dedicated guidelines.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s40618-026-02927-y.

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Cite

BibTeXRIS
BibTeX
@article{sellasie2026short,
  title = {{Short- and mid-term efficacy of percutaneous ethanol injection in cystic and predominantly cystic thyroid nodules: systematic review and meta-analysis}},
  author = {Sium Wolde Sellasie and Maurilio Deandrea and Stefano Amendola and Tommaso Piticchio and Luigi Uccioli and Pierpaolo Trimboli},
  journal = {Journal of Endocrinological Investigation},
  year = {2026},
  month = jun,
  doi = {10.1007/s40618-026-02927-y},
  url = {https://doi.org/10.1007/s40618-026-02927-y},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Short- and mid-term efficacy of percutaneous ethanol injection in cystic and predominantly cystic thyroid nodules: systematic review and meta-analysis
AU  - Sium Wolde Sellasie
AU  - Maurilio Deandrea
AU  - Stefano Amendola
AU  - Tommaso Piticchio
AU  - Luigi Uccioli
AU  - Pierpaolo Trimboli
PY  - 2026
DA  - 2026/06/16
JO  - Journal of Endocrinological Investigation
DO  - 10.1007/s40618-026-02927-y
UR  - https://doi.org/10.1007/s40618-026-02927-y
AB  - Objective: To evaluate the short- and mid-term volume reduction rate(VRR) after percutaneous ethanol injection(PEI), at 1,3 and 6 months, in patients with cystic or predominantly cystic thyroid nodules(CNs/pCNs, respectively), conducting a systematic review and meta-analysis of published data on VRR outcomes across these intervals.  Design and methods: A systematic search of articles published up to October 30,2025 identified studies reporting PEI treatment for CNs/pCNs.Characteristics of the study design, CNs/pCNs cohorts, and outcomes of interest(VRR at 1,3 and 6 months of follow up)were extracted.Statistical analysis included a random-effects meta-analysis, assessment of heterogeneity with use of the I2 statistic, and meta-regression and subgroup analyses to explore potential sources of heterogeneity.  Results: Six studies comprising 431 CNs/pCNs were included.The pooled VRRs at 1,3 and 6 months post-PEI were 85.18%(95% CI: 80.72–89.64),91.50%(95% CI: 88.88–94.12) and 93.11%(95% CI: 90.91–95.31),respectively. Stratifying by nodule cystic composition, the VRR at consecutive follow-up time points was significantly different between the 1- and 3-month intervals in both subgroups [CN: VRRs at 1, 3 and 6 months were 91.16% (88.38–93.93), 95.69% (94.16–97.22) and 96.02% (94.16–97.87), respectively; pCN: VRRs at 1,3 and 6 months were respectively 80.19% (77.04–83.33), 87.08% (84.95–89.2) and 90.01%(88.83–91.19)].A secondary meta-regression analysis with baseline mean volume as covariate demonstrated a significant inverse association with VRR at 1 and 3 months in pCN(p = 0.02).  Conclusion: By providing pooled VRRs for the short- and mid-term follow-up, this meta-analysis should be regarded as an initial step, paving the way for larger, high-quality studies aimed at standardizing the PEI procedure and supporting its incorporation into future dedicated guidelines.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s40618-026-02927-y.
SN  - 0391-4097
SN  - 1720-8386
ER  -