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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">J.H. Baek</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">September 2015,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">E61; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4479 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14155--61783762090" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">J.H. Baek </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Radiology and Research Institute of Radiology
University of Ulsan College of Medicine
Asan Medical Center
Seoul, Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.H.%2BBaek%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Baek%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.H.%2BBaek%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article fulltext-view "><span class="highwire-journal-article-marker-start"></span><p id="p-1">We have read the letter regarding our recently published article in the <em>American Journal of Neuroradiology</em><sup><a id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1</a></sup> and hereby provide a reply. Tez and Tez suggested the issue of incidental small papillary thyroid cancer. A 10% incidence of incidental small papillary thyroid cancer was found in multinodular goiter with benign cytology. To minimize missing cancer, the Korean Society of Thyroid Radiology (KSThR) recommended at least 2 different benign biopsy results before radiofrequency ablation.<sup><a id="xref-ref-2-1" class="xref-bibr" href="#ref-2">2</a></sup> In addition, the KSThR recommended careful examination of sonography findings and lymph node metastasis before treatment.<sup><a id="xref-ref-3-1" class="xref-bibr" href="#ref-3">3</a></sup> KSThR also does not recommend thyroid radiofrequency ablation for follicular neoplasms or primary thyroid cancers.<sup><a id="xref-ref-2-2" class="xref-bibr" href="#ref-2">2</a></sup> On the basis of these KSThR recommendations, missing cancer was a rare complication after radiofrequency ablation in a large-population multicenter study<sup><a id="xref-ref-4-1" class="xref-bibr" href="#ref-4">4</a></sup> and long-term follow-up studies by thermal ablation techniques.<sup><a id="xref-ref-5-1" class="xref-bibr" href="#ref-5">5</a><a id="xref-ref-6-1" class="xref-down-link" href="#ref-6"><span>⇓</span></a><a id="xref-ref-7-1" class="xref-down-link" href="#ref-7"><span>⇓</span></a>–<a id="xref-ref-8-1" class="xref-bibr" href="#ref-8">8</a></sup></p><p id="p-2">Regarding complications after surgery and radiofrequency ablation, surgery showed a higher incidence of hypothyroidism than radiofrequency ablation (71% versus 0%) in our study. Because our study included a considerable number of patients with total thyroidectomy (due to bilateral thyroid nodules), hypothyroidism was an inevitable complication in these patients. Hypothyroidism depends on the surgical methods (ie, total thyroidectomy or lobectomy). Regarding the statistical issue, the Wilcoxon signed rank test was used for comparison of the volume reductions between enrollment and the follow-up visit of the radiofrequency group.</p><p id="p-3">The main conclusion of our study was that radiofrequency ablation effectively treats benign thyroid nodules with a low amount of complications.<sup><a id="xref-ref-1-2" class="xref-bibr" href="#ref-1">1</a></sup> Hence, radiofrequency ablation may be considered as possibly the first-line treatment for benign thyroid nodules. However radiofrequency ablation has a potential limitation of missing incidental small papillary thyroid cancers. This limitation should be carefully validated in the future.</p><div class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-36.9.E61.1" data-doi="10.3174/ajnr.A4276"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Che</span>  <span class="cit-name-given-names">Y</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Jin</span>  <span class="cit-name-given-names">S</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Shi</span>  <span class="cit-name-given-names">C</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Treatment of benign thyroid nodules: comparison of surgery with radiofrequency ablation</span>. <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2015</span> 
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</li><li><span class="cit-auth"><span class="cit-name-surname">Lee</span>  <span class="cit-name-given-names">YH</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Baek</span>  <span class="cit-name-given-names">JH</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Jung</span>  <span class="cit-name-given-names">SL</span></span>, <span class="cit-etal">et al</span></li></ol><cite>; <span class="cit-auth cit-collab">Korean Society of Thyroid Radiology (KSThR), Korean Society of Radiology</span>. <span class="cit-article-title">Ultrasound-guided fine needle aspiration of thyroid nodules: a consensus statement by the Korean Society of Thyroid Radiology</span>. <abbr class="cit-jnl-abbrev">Korean J Radiol</abbr> <span class="cit-pub-date">2015</span>;<span class="cit-vol">16</span>:<span class="cit-fpage">391</span>–<span class="cit-lpage">401</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.3348/kjr.2015.16.2.391</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>25741201</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.3348/kjr.2015.16.2.391&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=25741201&amp;link_type=MED&amp;atom=%2Fajnr%2F36%2F9%2FE61.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">4.</span><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4. in text" id="ref-4">↵</a><div class="cit ref-cit ref-journal" id="cit-36.9.E61.4" data-doi="10.1148/radiol.11110416"><div class="cit-metadata"><ol class="cit-auth-list"><li>
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</li><li><span class="cit-auth"><span class="cit-name-surname">Lim</span>  <span class="cit-name-given-names">HK</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Lee</span>  <span class="cit-name-given-names">JH</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Ha</span>  <span class="cit-name-given-names">EJ</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Radiofrequency ablation of benign non-functioning thyroid nodules: 4-year follow-up results for 111 patients</span>. <abbr class="cit-jnl-abbrev">Eur Radiol</abbr> <span class="cit-pub-date">2013</span>;<span class="cit-vol">23</span>:<span class="cit-fpage">1044</span>–<span class="cit-lpage">49</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1007/s00330-012-2671-3</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>23096937</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1007/s00330-012-2671-3&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=23096937&amp;link_type=MED&amp;atom=%2Fajnr%2F36%2F9%2FE61.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">6.</span><a class="rev-xref-ref" href="#xref-ref-6-1" title="View reference 6. in text" id="ref-6">↵</a><div class="cit ref-cit ref-journal" id="cit-36.9.E61.6" data-doi="10.1089/thy.2008.0202"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Spiezia</span>  <span class="cit-name-given-names">S</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Garberoglio</span>  <span class="cit-name-given-names">R</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Milone</span>  <span class="cit-name-given-names">F</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation</span>. <abbr class="cit-jnl-abbrev">Thyroid</abbr> <span class="cit-pub-date">2009</span>;<span class="cit-vol">19</span>:<span class="cit-fpage">219</span>–<span class="cit-lpage">25</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1089/thy.2008.0202</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>19265492</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1089/thy.2008.0202&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=19265492&amp;link_type=MED&amp;atom=%2Fajnr%2F36%2F9%2FE61.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">7.</span><a class="rev-xref-ref" href="#xref-ref-7-1" title="View reference 7. in text" id="ref-7">↵</a><div class="cit ref-cit ref-journal" id="cit-36.9.E61.7" data-doi="10.1530/EJE-11-0220"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Døssing</span>  <span class="cit-name-given-names">H</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Bennedbæk</span>  <span class="cit-name-given-names">FN</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Hegedüs</span>  <span class="cit-name-given-names">L</span></span></li></ol><cite>. <span class="cit-article-title">Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules</span>. <abbr class="cit-jnl-abbrev">Eur J Endocrinol</abbr> <span class="cit-pub-date">2011</span>;<span class="cit-vol">165</span>:<span class="cit-fpage">123</span>–<span class="cit-lpage">28</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1530/EJE-11-0220</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>21551168</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6MzoiZWplIjtzOjU6InJlc2lkIjtzOjk6IjE2NS8xLzEyMyI7czo0OiJhdG9tIjtzOjE5OiIvYWpuci8zNi85L0U2MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><span class="ref-label">8.</span><a class="rev-xref-ref" href="#xref-ref-8-1" title="View reference 8. in text" id="ref-8">↵</a><div class="cit ref-cit ref-journal" id="cit-36.9.E61.8" data-doi="10.1089/thy.2010.0189"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Valcavi</span>  <span class="cit-name-given-names">R</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Riganti</span>  <span class="cit-name-given-names">F</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Bertani</span>  <span class="cit-name-given-names">A</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Percutaneous laser ablation of cold benign thyroid nodules: a 3-year follow-up study in 122 patients</span>. <abbr class="cit-jnl-abbrev">Thyroid</abbr> <span class="cit-pub-date">2010</span>;<span class="cit-vol">20</span>:<span class="cit-fpage">1253</span>–<span class="cit-lpage">61</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1089/thy.2010.0189</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>20929405</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1089/thy.2010.0189&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=20929405&amp;link_type=MED&amp;atom=%2Fajnr%2F36%2F9%2FE61.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li></ol></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2015 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 36</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 9 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Sep 2015 </div></div>
      
      
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">J.H.</span> <span class="nlm-surname">Baek</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Sep 2015, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">E61; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4479 </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">J.H.</span> <span class="nlm-surname">Baek</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Sep 2015, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">E61; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4479 </span></div>
  
  
  
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