AIUM: Both thermal ablation methods work for thyroid

ORLANDO, FL - Both radiofrequency (RF) and microwave ablation are effective for treating benign thyroid nodules, offering patients an alternative to surgery, according to research presented at the American Institute of Ultrasound in Medicine (AIUM) meeting.

The findings are good news for patients, especially since thyroid nodules are a common clinical problem, said presenter Dr. Yue Wenwen of Shanghai Tenth People's Hospital in China.

"Surgery is the well-established treatment method for benign thyroid nodules," he said. "But RF ablation and microwave ablation have gained increasing attention as satisfactory alternatives."

Although interest in these two thermal ablation techniques has grown, it hasn't been established whether one is superior over the other. So Wenwen's team compared the two techniques to discover which might be the better treatment choice.

The study included 260 patients, 102 of which were treated with RF ablation and 158 of which underwent microwave ablation. Average nodule volume for patients who underwent RF ablation was 5.7 ml and 6.2 ml for those who were treated with microwave ablation.

Inclusion criteria consisted of the following:

• A maximum nodule diameter of ≥ 2 cm
• Patient underwent a single treatment session of RF or microwave ablation
• Pathological confirmation of the nodule being benign without any changes on ultrasound for at least 12 months
• Serum levels of thyrotropin, thyroid hormone, and calcitonin within normal limits

The researchers tracked each technique's volume reduction rate, therapeutic success rate, symptom scores (neck pain, difficulty swallowing, dysphasia, cough), cosmetic score (the presence or absence of a palpable mass) and complications at six- and 12-month follow-up intervals.

At six- and 12-month follow-up, the investigators found no statistically significant differences between the two techniques. No complications occurred in either group.

Performance in treating benign thyroid nodules
Performance measure	RF ablation	Microwave ablation
Volume reduction rate
6 months	76.4%	77.5%
12 months	79.9%	78.3%
Symptom score
6 months	2.1	1.9
12 months	1.5	1.5
Cosmetic score
6 months	2.1	2.3
12 months	1.5	1.4
Therapeutic success rate
6 months	99%	98%
12 months	100%	100%

The results demonstrate that both microwave and RF ablation are safe and effective ways to treat benign thyroid nodules, Wenwen concluded.

"With well-matched treatment groups and consistent ablation procedure design, our results demonstrated the volume reduction ratio, therapeutic success ratio, symptoms, and complications related to treatment for the two techniques are equivalent," he said. "RF ablation and microwave ablation are both effective and safe methods for treating benign thyroid nodules."