Microwave ablation effective for benign thyroid nodules - EMJ

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Microwave Ablation Effective for Benign Thyroid Nodules

Microwave ablation, thyroid

MICROWAVE ablation (MWA) offers a safe and effective non-surgical treatment for benign thyroid nodules, with high volume reduction rates and promising outcomes for autonomously functioning thyroid nodules (AFTNs), according to new retrospective data. 

MWA Delivers Strong Outcomes for Benign Thyroid Nodules

In a retrospective single-centre study of 112 patients, researchers evaluated the safety and efficacy of MWA in reducing benign thyroid nodule volume, including solitary nodules and multinodular goitres (MNG). Most patients were women (68.5%), with a mean age of 58 years. The procedure achieved a median volume reduction rate (VRR) of 62.9% at 3 months, improving to 88.2% at 12 months. Technical efficacy, defined as a ≥50% reduction in volume, was observed in 94.6% of nodules after one year. Notably, there was no significant difference in 12-month VRR between solitary nodules and MNG (89.0% vs 87.5%), suggesting MWA performs consistently across different nodule types. 

Predictors of Success and Safety of the Procedure

MWA was well-tolerated, with no major complications reported. Transient hoarseness occurred in 2.7% of patients, but all cases resolved without intervention. Regression analysis revealed that calcification, nodule composition, and energy delivered per millilitre were independent predictors of VRR (p<0.001 for all), offering important clinical insight for optimising treatment planning. Cosmetic outcomes also improved significantly (p<0.001), supporting MWA’s role in addressing both functional and aesthetic concerns in thyroid nodule management. 

MWA Shows Promise for Autonomously Functioning Thyroid Nodules

Among the 18 patients with AFTNs, 11 were on antithyroid medication before treatment. Following MWA, seven patients (63.6%) were able to discontinue medication and maintain euthyroidism, a statistically significant outcome (p<0.001). These findings suggest MWA may offer a viable therapeutic alternative to radioiodine or surgery for selected AFTN patients, particularly those seeking minimally invasive approaches. 

This study supports MWA as an effective and safe option for treating benign thyroid nodules, including AFTNs. Future prospective trials could further validate its role in standard thyroid care. 

Reference 

Eryuruk U et al. Clinical Outcomes and Volume Reduction Predictors Following Microwave Ablation of Benign Thyroid Nodules: A Comparative Study of Solitary Nodules and Multinodular Goiters. Acad Radiol. 2025;DOI: 0.1016/j.acra.2025.09.007. 

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