Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Ultrasound, Ruijin Hospital/Lu Wan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Int J Hyperthermia. 2024;41(1):2379983. doi: 10.1080/02656736.2024.2379983. Epub 2024 Jul 16.
As the utilization of high-resolution imaging modalities, such as ultrasound, becomes increasingly prevalent, there has been a swift rise in the detection rates of malignant thyroid nodules (MTC). Surgery remains the cornerstone of standard treatment for these nodules. However, the advent and evolution of thermal ablation (TA) techniques, encompassing radiofrequency ablation, laser ablation, and microwave ablation, have emerged as a novel therapeutic avenue for patients with MTC, particularly for those deemed unsuitable for surgery due to high risks or for those who refuse surgery. Presently, TA has been validated as an efficacious and safe intervention for both benign thyroid nodules and a subset of MTC. An expanding body of research has been dedicated to broadening the applicability of TA, initially from recurrent thyroid cancer and lymph nodes to now encompass isolated papillary thyroid microcarcinomas (PTMC) alongside a comprehensive exploration into the expanded parameters such as size, number, and location of PTMC, and its applicability in other types of thyroid cancer. This review provides a detailed synthesis of the clinical evidence about the use of TA in the management of MTC, as endorsed by current guidelines. It further delves into the ongoing research efforts aimed at extending its indications and discusses the prospective implications and challenges of integrating TA into the clinical management paradigms for MTC.
随着高分辨率成像模式（如超声）的应用日益普及，恶性甲状腺结节（MTC）的检出率迅速上升。手术仍然是这些结节标准治疗的基石。然而，热消融（TA）技术的出现和发展，包括射频消融、激光消融和微波消融，为 MTC 患者提供了一种新的治疗途径，特别是对于那些由于高风险而不适合手术或拒绝手术的患者。目前，TA 已被验证为治疗良性甲状腺结节和一部分 MTC 的有效和安全的干预措施。越来越多的研究致力于拓宽 TA 的适用性，最初从复发性甲状腺癌和淋巴结扩展到现在包括孤立性甲状腺乳头状微小癌（PTMC），并全面探讨了 PTMC 的大小、数量和位置等扩展参数及其在其他类型甲状腺癌中的适用性。本综述详细综合了目前指南中关于 TA 在 MTC 管理中应用的临床证据，并深入探讨了旨在扩大其适应证的正在进行的研究工作，讨论了将 TA 纳入 MTC 临床管理模式的预期影响和挑战。
