Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt Praxis und Beruf Seltene Erkrankungen GOÄ & EBM
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Fachpsychotherapie Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende Patientenratgeber
Erweiterte Suche
Anmelden
nach oben
European Radiology
Erschienen in:

24.07.2024 | Head and Neck

Comparative efficacy and safety of radiofrequency ablation and microwave ablation in benign thyroid nodule treatment: a systematic review and meta-analysis

verfasst von: Hunjong Lim, Se Jin Cho, Jung Hwan Baek

Erschienen in: European Radiology | Ausgabe 2/2025

Einloggen, um Zugang zu erhalten

Abstract

Objective

Ultrasound-guided thermal ablation, including radiofrequency ablation (RFA) and microwave ablation (MWA), has become one of the main options for treating benign thyroid nodules (BTNs). To assess the efficacy of thermal ablation of BTNs, we performed a systematic review and meta-analysis of relevant studies.

Materials and methods

A comprehensive search of MEDLINE, EMBASE, and COCHRANE databases was performed up to September 25, 2023, to identify studies directly comparing RFA and MWA for pathologically proven BTNs and reporting clinical outcomes and complications. Data extraction and quality assessment were independently performed by two radiologists according to PRISMA guidelines. The analysis yielded the serial volume reduction ratios (VRRs) of ablated nodules for up to 12 months, symptom and cosmetic scores, and complications.

Results

This analysis included nine studies with 1305 BTNs treated by RFA and 1276 by MWA. VRRs at 1 month, 3 months, and 6 months were similar between RFA and MWA, but RFA showed a significantly higher VRR (83.3%) than MWA (76.9%) at 12 months (p = 0.02). Complication rates showed no significant difference between the two methods. Symptom and cosmetic scores significantly decreased after ablation, without a significant difference between the methods. Subgroup analysis indicated a significantly higher VRR at 12 months for RFA than for MWA for less experienced investigators (≤ 10 years), but no significant difference for more experienced investigators (> 10 years).

Conclusion

RFA and MWA are both effective and safe methods for treating BTNs. RFA showed a higher VRR at 12 months and seems more suitable for less experienced investigators.

Clinical relevance statement

RFA and MWA are both effective and safe treatments for BTNs, with RFA showing a higher VRR at 12 months. Both methods offer minimally invasive and reliable treatment for thyroid nodules.

Key Points

  • The most effective thermal ablation technique for BTNs remains undetermined.
  • RFA showed a higher VRR at 12 months than MWA.
  • Both techniques are effective for treating thyroid nodules; RFA offers greater benefits, particularly for less experienced investigators.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Tan GH, Gharib H (1997) Thyroid Incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med 126:226–231PubMed
2.
Guo DM, Chen Z, Zhai YX, Su HH (2021) Comparison of radiofrequency ablation and microwave ablation for benign thyroid nodules: a systematic review and meta-analysis. Clin Endocrinol 95:187–196
3.
Durante C, Grani G, Lamartina L, Filetti S, Mandel SJ, Cooper DS (2018) The diagnosis and management of thyroid nodules: a review. JAMA 319:914–924PubMed
4.
5.
Sung JY, Baek JH, Kim KS et al (2013) Single-session treatment of benign cystic thyroid nodules with ethanol versus radiofrequency ablation: a prospective randomized study. Radiology 269:293–300PubMed
6.
Pacella CM, Bizzarri G, Guglielmi R et al (2000) Thyroid tissue: US-guided percutaneous interstitial laser ablation-a feasibility study. Radiology 217:673–677PubMed
7.
Jeong WK, Baek JH, Rhim H et al (2008) Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol 18:1244–1250PubMed
8.
Dossing H, Bennedbaek FN, Hegedus L (2011) Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules. Eur J Endocrinol 165:123–128PubMed
9.
Gambelunghe G, Fede R, Bini V et al (2013) Ultrasound-guided interstitial laser ablation for thyroid nodules is effective only at high total amounts of energy: results from a three-year pilot study. Surg Innov 20:345–350PubMed
10.
Gambelunghe G, Stefanetti E, Colella R, Monacelli M, Avenia N, De Feo P (2018) A single session of laser ablation for toxic thyroid nodules: three-year follow-up results. Int J Hyperth 34:631–635
11.
12.
13.
Papini E, Rago T, Gambelunghe G et al (2014) Long-term efficacy of ultrasound-guided laser ablation for benign solid thyroid nodules. Results of a three-year multicenter prospective randomized trial. J Clin Endocrinol Metab 99:3653–3659PubMed
14.
Valcavi R, Riganti F, Bertani A, Formisano D, Pacella CM (2010) Percutaneous laser ablation of cold benign thyroid nodules: a 3-year follow-up study in 122 patients. Thyroid 20:1253–1261PubMed
15.
16.
Deandrea M, Trimboli P, Garino F et al (2019) Long-term efficacy of a single session of rfa for benign thyroid nodules: a longitudinal 5-year observational study. J Clin Endocrinol Metab 104:3751–3756PubMed
17.
Jung SL, Baek JH, Lee JH et al (2018) Efficacy and safety of radiofrequency ablation for benign thyroid nodules: a prospective multicenter study. Korean J Radiol 19:167–174PubMedPubMedCentral
18.
Lim HK, Lee JH, Ha EJ, Sung JY, Kim JK, Baek JH (2013) Radiofrequency ablation of benign non-functioning thyroid nodules: 4-year follow-up results for 111 patients. Eur Radiol 23:1044–1049PubMed
19.
Sim JS, Baek JH, Lee J, Cho W, Jung SI (2017) Radiofrequency ablation of benign thyroid nodules: depicting early sign of regrowth by calculating vital volume. Int J Hyperth 33:905–910
20.
Cho SJ, Baek JH, Chung SR, Choi YJ, Lee JH (2020) Long-term results of thermal ablation of benign thyroid nodules: a systematic review and meta-analysis. Endocrinol Metab) 35:339–350
21.
Kim J-h, Baek JH, Lim HK et al (2018) 2017 Thyroid radiofrequency ablation guideline: Korean society of thyroid radiology. Korean J Radiol 19:632–655PubMedPubMedCentral
22.
Cui T, Jin C, Jiao D, Teng D, Sui G (2019) Safety and efficacy of microwave ablation for benign thyroid nodules and papillary thyroid microcarcinomas: a systematic review and meta-analysis. Eur J Radiol 118:58–64PubMed
23.
Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71PubMedPubMedCentral
24.
Baek JH, Kim YS, Lee D, Huh JY, Lee JH (2010) Benign predominantly solid thyroid nodules: prospective study of efficacy of sonographically guided radiofrequency ablation versus control condition. AJR Am J Roentgenol 194:1137–1142PubMed
25.
Ahmed M, Solbiati L, Brace CL et al (2014) Image-guided tumor ablation: standardization of terminology and reporting criteria–a 10-year update. Radiology 273:241–260PubMed
26.
Baek JH, Lee JH, Sung JY et al (2012) Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study. Radiology 262:335–342PubMed
27.
Kim C, Lee JH, Choi YJ, Kim WB, Sung TY, Baek JH (2017) Complications encountered in ultrasonography-guided radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers. Eur Radiol 27:3128–3137PubMed
28.
Kim SY, Park JE, Lee YJ et al (2013) Testing a tool for assessing the risk of bias for nonrandomized studies showed moderate reliability and promising validity. J Clin Epidemiol 66:408–414PubMed
29.
Kim SY, Seo HJ, Lee YJ, Park JE (2013) Study design algorithm for medical literature of intervention (DAMI) and risk of bias for nonrandomized studies (robans) ver 2.0 by HIRA. Health Insurance Review & Assessment Service, Seoul
30.
Kim KW, Lee J, Choi SH, Huh J, Park SH (2015) Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers-part I. General guidance and tips. Korean J Radiol 16:1175–1187PubMedPubMedCentral
31.
Lee J, Kim KW, Choi SH, Huh J, Park SH (2015) Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers-part II. Statistical methods of meta-analysis. Korean J Radiol 16:1188–1196PubMedPubMedCentral
32.
Suh CH, Park SH (2016) Successful publication of systematic review and meta-analysis of studies evaluating diagnostic test accuracy. Korean J Radiol 17:5–6PubMedPubMedCentral
33.
34.
Liang P. (2015) Thermal ablation of benign thyroid disease: A prospective multi-center study. J Vasc Interv Radiol 26:e41–e42.
35.
Cheng Z (2017) US-guided percutaneous radiofrequency versus microwave ablation for benign thyroid nodules: a prospective multicenter study. J Clin Oncol 35:e17593–e17593
36.
Jin H, Lin W, Lu L, Cui M (2021) Conventional thyroidectomy vs thyroid thermal ablation on postoperative quality of life and satisfaction for patients with benign thyroid nodules. Eur J Endocrinol 184:131–141PubMed
37.
38.
Bo X-W, Lu F, Yu S-Y et al (2022) Comparison of efficacy, safety, and patient satisfaction between thermal ablation, conventional/open thyroidectomy, and endoscopic thyroidectomy for symptomatic benign thyroid nodules. Int J Hyperth 39:379–389
39.
Cheng Z, Che Y, Yu S et al (2017) US-guided percutaneous radiofrequency versus microwave ablation for benign thyroid nodules: a prospective multicenter study. Sci Rep 7:9554PubMedPubMedCentral
40.
Korkusuz Y, Gröner D, Raczynski N et al (2018) Thermal ablation of thyroid nodules: Are radiofrequency ablation, microwave ablation and high intensity focused ultrasound equally safe and effective methods? Eur Radiol 28:929–935PubMed
41.
Yue WW, Wang SR, Lu F et al (2017) Radiofrequency ablation vs microwave ablation for patients with benign thyroid nodules: a propensity score matching study. Endocrine 55:485–495PubMed
42.
Jin H, Fan J, Lu L, Cui M (2021) A propensity score matching study between microwave ablation and radiofrequency ablation in terms of safety and efficacy for benign thyroid nodules treatment. Front Endocrinol 12:584972
43.
44.
45.
Hu K, Wu J, Dong Y, Yan Z, Lu Z, Liu L (2019) Comparison between ultrasound-guided percutaneous radiofrequency and microwave ablation in benign thyroid nodules. J Cancer Res Ther 15:1535–1540PubMed
46.
Vorländer C, David Kohlhase K, Korkusuz Y et al (2018) Comparison between microwave ablation and bipolar radiofrequency ablation in benign thyroid nodules: differences in energy transmission, duration of application and applied shots. Int J Hyperth 35:216–225
47.
Javadov M, Karatay E, Ugurlu MU (2021) Clinical and functional results of radiofrequency ablation and microwave ablation in patients with benign thyroid nodules. Saudi Med J 42:838–846PubMedPubMedCentral
48.
Poulou LS, Botsa E, Thanou I, Ziakas PD, Thanos L (2015) Percutaneous microwave ablation vs radiofrequency ablation in the treatment of hepatocellular carcinoma. World J Hepatol 7:1054–1063PubMedPubMedCentral
49.
Wang B, Han ZY, Yu J et al (2017) Factors related to recurrence of the benign non-functioning thyroid nodules after percutaneous microwave ablation. Int J Hyperth 33:459–464
50.
Zhao CK, Xu HX, Lu F et al (2017) Factors associated with initial incomplete ablation for benign thyroid nodules after radiofrequency ablation: first results of CEUS evaluation. Clin Hemorheol Microcirc 65:393–405PubMed
51.
52.
Sim JS, Baek JH, Cho W (2018) Initial ablation ratio: quantitative value predicting the therapeutic success of thyroid radiofrequency ablation. Thyroid 28:1443–1449PubMed
53.
Ahmed M, Brace CL, Lee Jr FT, Goldberg SN (2011) Principles of and advances in percutaneous ablation. Radiology 258:351–369PubMed
54.
Yue W, Wang S, Wang B et al (2013) Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: safety and imaging follow-up in 222 patients. Eur J Radiol 82:e11–e16PubMed
55.
Shin JH, Baek JH, Ha EJ, Lee JH (2012) Radiofrequency ablation of thyroid nodules: basic principles and clinical application. Int J Endocrinol 2012:919650PubMedPubMedCentral
56.
Jin H, Fan J, Lu L, Cui M (2021) A propensity score matching study between microwave ablation and radiofrequency ablation in terms of safety and efficacy for benign thyroid nodules treatment. Front Endocrinol 12:584972
Metadaten
Titel
Comparative efficacy and safety of radiofrequency ablation and microwave ablation in benign thyroid nodule treatment: a systematic review and meta-analysis
verfasst von
Hunjong Lim
Se Jin Cho
Jung Hwan Baek
Publikationsdatum
24.07.2024
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 2/2025
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-024-10881-7

Weitere Artikel der Ausgabe 2/2025

CT features in sigmoid volvulus: validating predictors of outcomes and recurrence

  • Letter to the Editor

Robustness of radiomics among photon-counting detector CT and dual-energy CT systems: a texture phantom study

  • Open Access
  • Computed Tomography

An imaging-based model to predict the malignant potential of intraductal papillary mucinous neoplasm of the pancreas

  • Hepatobiliary-Pancreas

Fat-signal suppression in breast diffusion-weighted imaging: the Good, the Bad, and the Ugly

  • Open Access
  • Special Report

T2* cartilage mapping in early axial spondyloarthritis: diagnostic accuracy and correlation with clinical characteristics, sacroiliitis MRI scorings, and diffusion metrics

  • Musculoskeletal

Breaking new ground in COPD imaging: 3D-PREFUL MRI versus traditional techniques

  • Commentary

Neu im Fachgebiet Radiologie

Röntgen-Thorax oder LDCT fürs Lungenscreening nach HNSCC?

Personen, die an einem Plattenepithelkarzinom im Kopf-Hals-Bereich erkrankt sind, haben ein erhöhtes Risiko für Metastasen oder zweite Primärmalignome der Lunge. Eine Studie hat untersucht, wie die radiologische Überwachung aussehen sollte.

Statine: Was der G-BA-Beschluss für Praxen bedeutet

Nach dem G-BA-Beschluss zur erweiterten Verordnungsfähigkeit von Lipidsenkern rechnet die DEGAM mit 200 bis 300 neuen Dauerpatienten pro Praxis. Im Interview erläutert Präsidiumsmitglied Erika Baum, wie Hausärztinnen und Hausärzte am besten vorgehen.

Brustdichte nicht mit Multivitaminpräparat-Einnahme assoziiert

Der regelmäßige Gebrauch von Nahrungsergänzungsmitteln scheint nicht die mammografische Brustdichte zu erhöhen. In einer US-amerikanischen Studie jedenfalls ließ sich ein derartiger Zusammenhang nicht bestätigen.

Erhöhte Suizidrate unter US-Ärztinnen

Während der Arztberuf Männer eher vor Suizid schützt, erhöht er das Risiko bei Frauen – zumindest in den USA: Die Suizidinzidenz unter Ärztinnen ist um die Hälfte höher als unter Frauen mit anderen Berufen. Männliche Ärzte töten sich dennoch wesentlich häufiger selbst als weibliche.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise