Who have tried it
Prof. Stefano Spiezia
Director of Endocrine and Eco-guided Surgery Unit – Ospedale del Mare ASL Napoli 1 Centro
Professor Stefano Spiezia is one of the pioneers of the thermal ablation of thyroid nodules, together with Professor Claudio Pacella he published the first clinical papers on the advantages and results of the induced laser thermal ablation procedure in the late 1990s.
Percutaneous laser treatment is indicated for neck lesions, it is performed through a micro-invasive approach, using laser energy with the right indications according to the guidelines, to heat and destroy the pathological tissue, thus avoiding the patient’s surgical approach, related inconveniences and possible complications. The aim of the treatment is to determine a significant volumetric reduction of the nodule that can already be assessed after one to three months, due to the cytoreduction process induced by laser ablation, with consequent improvement or disappearance of the symptoms. Professor Spiezia is an expert in the treatment of benign nodules and relapses and lymph node metastases from thyroid carcinoma.
Dott. Giovanni Mauri
Radiology Department of European Oncological Institute – Milan
Dr. Giovanni Mauri works at IEO in Milan dealing with Thermal Ablation in oncology field. He began his activity with laser thermoablation for treating benign thyroid nodules at the Busto Arsizio Hospital, where he was one of the first used ModìLite on malignant neck diseases, such as metastatic lymph nodes from thyroid carcinoma, in which the aim of the treatment is not merely the reduction of the lesion, but rather, complete destruction with a sufficient safety margin.
Dott.ssa Teresa Rago
Assistant Professor of Endocrinology Department – AOUP – Pisa
The ENDOCRINOLOGY department of the Cisanello Hospital has used ModìLite to treat more than 250 patients with benign thyroid nodules, achieving a volumetric reduction of over 60% of the initial volume at three years. This was one of the first centres in Italy to implement laser thermotherapy (ModìLite) on benign modules and it has now become a reference centre where training is also carried out for physicians interested in this method at both a national and international level.
Prof. CM Pacella
Ex Director of Diagnostic Image and Interventional Radiology Department – Regina Apostolorum Hospital
In the early ’90s I introduced in Italy the use of laser to destroy tumour lesion (laser ablation). On the basis of experimental ex-vivo and in vivo studies I studied the most suitable physical parameters (exposure time, delivery mode and power) to get in a safe and predictable manner an area of necrosis in order to destroy (ablate) liver cancer up to 5-6 cm in diameter in a safe and predictable manner without causing harm to the patient or the healthy tissue surrounding the tumour.
By extrapolating the data obtained in patients with primitive and secondary cancerous pathologies of the liver, and at the suggestion of Dr. Papini, the endocrinologist of the hospital where I worked, I decided to apply laser ablation to benign thyroid nodules. The fine needles and fibres allow for reaching the benign (and also malignant) nodules of the thyroid – a small gland located in the neck and surrounded by delicate structures such as the carotid artery and the trachea – in a far safer and easier manner than with other hyperthermal methods.
The encouraging results led us to propose the use of this technique to the scientific community in order to obtain a reduction in the volume of benign nodules in patients with disorders of a cosmetic or compression nature, and those who do not require or refuse to undergo excision surgery.
Nowadays, ModìLite is a routine therapeutic choice.
Prof. Enrico Papini
Scientific Director – Regina Apostolorum Hospital
In this short paper I report the results of the 3-year multicenter study on laser ablation of benign thyroid nodules ModìLite. In four Italian centers of reference for thyroid disease 201 patients with benign nodule cytology (volume 5-18 mL) were enrolled to be undergone randomly to control or to a single session of laser ablation. All patients were carefully selected to have similar characteristics: normal thyroid function and immunity, no previous treatment, solid content of the thyroid lesion. After 36 months of observation the average volume of the thyroid nodule was increased by 25% in the control group. For the group subjected to laser ablation, there was an average reduction of nodule volume of 49% at 6 months, 59% at 12 months, 60% at 24 months and 58% at 36 months. Laser ablation also led to a significant reduction in compressive symptoms (from 31% to 5% of patients at 36 months) and cosmetic discomfort. Laser ablation was well tolerated in 92% of patients. There was only one case of vocal cord paresis, which resolved spontaneously within 2 weeks. This study demonstrates that a single session laser is able to modify, in the majority of patients, the natural history of benign nodules in progressive growth.
Prof. Pierpaolo De Feo
Endocrinologist at CdC Liotti – Perugia
Since the beginning of 2017, Prof. Pierpaolo De Feo, in collaboration with Dr. Giovanni Gambelunghe have implemented ModìLite in a private clinic: Delta Implants in Perugia. The latter also treats foreign patients interested in this micro-invasive solution. Prof. Pierpaolo De Feo and Dr. Giovanni Gambelunghe previously worked at the Hospital of Perugia where they treated more than 700 patients with ModìLite and where they also took part in the multicentre study on laser ablation of thyroid nodules with a 3-year follow-up.
Dott. Giovanni Gambelunghe
Endocrinologist at CdC Liotti – Peurgia
Specialist in Endocrinology and Metabolic Deseases. PhD in Endocrinology at Karolinska Hospital of Stockholm, started to perform laser thermal ablation procedures on thyroid in 2004, and he performed more than 1000 treatments so far.
His scientific publications allowed to improve the technique of treatment. The statistical median of volume reduction of the treated nodules is of 69%.