Microwave ablation (MWA) with ultrasound has moderate efficacy in treating patients with benign nodules and papillary thyroid carcinoma, suggest results published August 22 in Ultrasound in Biology & Medicine.
In a three-year study, researchers led by Xiaoling Yu, MD, from First Medical Center of Chinese PLA General Hospital in Beijing reported high complete remission rates and no serious complications or disease progression in patients who underwent MWA.
“MWA is a safe and effective treatment option for hyperthyroidism with benign nodules or papillary thyroid carcinoma,” Yu and colleagues wrote.
Current standard treatment methods for hyperthyroidism with nodules include antithyroid drugs, radioactive iodine therapy, and surgical resection. However, each has its drawbacks, including invasiveness, limited effectiveness, and post-treatment complications.
MWA under ultrasound guidance has emerged in recent years as a potential alternative treatment that supporters say is minimally invasive, safe, and effective at treating lesions.
The Yu team compared the three-year efficacy and safety outcomes of MWA in treating hyperthyroidism with benign nodules and patients with thyroid cancer.
The retrospective study included 66 patients with hyperthyroidism accompanied by nodules. The patients underwent MWA treatment between 2009 and 2024, and the researchers conducted a three-year follow-up after treatment to monitor indicators such as the complete remission rate of hyperthyroidism and the tumor disappearance rate.
They also used propensity score matching to analyze differences in therapeutic effects between benign nodule and cancer patient groups.
After propensity score matching, the team reported the following findings:
After three years, the complete remission rate of hyperthyroidism in the benign nodule group was 93.8% and 62.5% in the cancer group (p = 0.083).
The tumor disappearance rate in the benign nodule group was 50% and 18.8% in the cancer group (p = 0.0627).
The researchers observed no disease progression and no serious complications in either group of patients.
While the differences between the groups were not statistically significant, the researchers highlighted that the results point toward MWA’s “good effect” on improving hyperthyroidism in patients.
“MWA may indirectly regulate hyperthyroidism by reducing the functional thyroid volume, and its mechanism is similar to that of simple ablation of hyperthyroidism,” the investigators suggested.
They called for multicenter, prospective, randomized controlled studies with large sample sizes to extend the follow-up period and verify MWA’s long-term efficacy and safety profile.
The full study can be found here.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
