Thermoablation Using Radiofrequency and Microwaves of Autonomous Thyroid Nodules: Our Experience

Introduction: Significant results have been achieved using ultrasound-guided and ultrasound-assisted ablative techniques, such as Laser Thermal Ablation (LTA), Radiofrequency Ablation (RFA), High-Intensity Focused Ultrasound (HIFU), and Microwave Ablation (MWA). These techniques are ideally suited for the treatment of normally functioning benign thyroid nodes with local compressive symptoms or aesthetic problems. These treatments have been applied to hyperfunctioning “hot” nodes. LTA and RFA are the most commonly used. From January 2021 to July 2023 at our Center, a total of 160 patients with benign thyroid nodules were treated, of which 35 had autonomous nodules [1-4]. Our analysis focused on evaluating the locoregional treatment of the latter. Based on the volume and ultrasound-vascular characteristics, patients were selected for thermoablative treatment with either RFA or MWA (Amica Gen HS - Hospital Service) starting in July 2022. Results: No complications were documented. However, one patient was referred for surgery and 1 patient was re-treated with MWA. Conclusion: In the light of personal experience ultrasound-guided thermal ablation treatment with RFA in patients with a single pretoxic or toxic thyroid nodule with or without associated compressive or aesthetic symptoms has proven to be very effective and satisfactory. The treatment must be preceded by adequate information regarding the advantages and disadvantages of the various procedures and the methods of the treatment session. MWA proved to be more effective than RFA with no functional recovery of the treated nodules even if they were relatively larger in size. We obtained the suspension of thyrostatic therapy with normalization of the TSH level in the third month after treatment.