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Ethanol Ablation or Percutaneous Ethanol Injection (PEI) of Thyroid Nodules

Thyroid nodules are very common. The more imaging we do, not always intent on looking at the thyroid, the more nodules we find. If we performed a neck ultrasound on everyone, about 1 in 3 persons will show some sort of abnormality.

Ultrasound-guided fine needle aspirations (FNA) are performed on persons who have nodules with certain characteristics, including size, to rule out thyroid cancer. From there, if thyroid cancer is ruled out, the general recommendation is serial follow- up ultrasounds to monitor for change.

What about nodules that are not cancer, but cause discomfort or continue to grow? Surgery has been the mainstay of therapy in this circumstance; however, there is a procedure that may be an option. This procedure is called percutaneous ethanol injection (PEI).

PEI is a technique that is validated by American Association of Clinical Endocrinologists (AACE), Endocrine Society, and American Thyroid Association (ATA). It was originally performed on nodules that were determined to be pure cysts, or fluid-filled. The indications have expanded to include a wider spectrum of nodules. PEI involves injecting dehydrated alcohol into the nodule oftentimes after aspirating as much fluid as possible out of the nodule. The goal is a decrease in the size of the nodule and prevention of growth over time. This procedure itself is virtually painless and requires no recuperation.

If you think that this procedure may be right for you, Dr. Mazza performs PEI in the office on a regular basis. Ask us about it!​

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