Zhao Xinshu, Xue Jianan, Yu Weiying, Dong Rong, Liu Shuqi, Wang Peiwen, Wang Jingyao, Guo Feng, Teng Deng-Ke
Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
School of Physical Education and Sports, Beijing Normal University, Beijing, China.
Eur Radiol. 2025 Apr 11. doi: 10.1007/s00330-025-11543-y.
Ultrasound-guided thermal ablation has become an option for treating benign thyroid nodules. To evaluate the long-term safety and efficacy of thermal ablation for benign thyroid nodules (BTNs), cases involving 3 years of follow-up were studied via a systematic review and meta-analysis.
Studies published up to January 2024 were searched in the MEDLINE, Embase, and Cochrane Library databases; these studies included 3 years of follow-up data on patients with BTNs who underwent thermal ablation therapy. The reduction in the mean nodule volume, volume reduction rate (VRR), rate of regrowth during follow-up, compression symptoms, postoperative cosmetic effects, and ablation complications during follow-up were analyzed over 3 years. In a subgroup analysis, laser ablation (LA), radiofrequency ablation (RFA), and microwave ablation (MWA) were compared.
After 3 years of follow-up, the volumes of BTNs decreased significantly after thermal ablation (p < 0.00001). The VRR was 71.59%. The regrowth rate was 7.41%. The major complication rate was 1.96%. The symptom scores and cosmetic scores significantly decreased (p < 0.00001). According to our subgroup analysis, the combined VRR was 53.27% in the LA group, 79.51% in the RFA group and 89.68% in the MWA group. The regrowth rate in the MWA-treated patients was lower (1.96%) than that in the other groups. Although the rate of the major complication was slightly greater (1.96%), there were no statistically significant differences compared with those in the LA and RFA groups.
Long-term follow-up analysis indicated that thermal ablation is a safe and effective method for treating benign thyroid nodules. In addition, compared with RFA and LA, MWA may be more effective at treating benign thyroid nodules.
Question What is the long-term outcome of thermal ablation in the treatment of benign thyroid nodules? Findings Thermal ablation is safe and effective for benign thyroid nodules. Clinical relevance Laser ablation, radiofrequency ablation, and microwave ablation showed no difference in safety, but microwave ablation may be more effective in treating benign thyroid nodules.
超声引导下热消融已成为治疗良性甲状腺结节的一种选择。为评估热消融治疗良性甲状腺结节（BTN）的长期安全性和有效性，通过系统评价和荟萃分析对随访3年的病例进行了研究。
检索了截至2024年1月在MEDLINE、Embase和Cochrane图书馆数据库中发表的研究；这些研究包括接受热消融治疗的BTN患者的3年随访数据。分析了3年内平均结节体积的减少、体积缩小率（VRR）、随访期间的再生长率、压迫症状、术后美容效果以及随访期间的消融并发症。在亚组分析中，比较了激光消融（LA）、射频消融（RFA）和微波消融（MWA）。
随访3年后，热消融后BTN的体积显著减小（p < 0.00001）。VRR为71.59%。再生长率为7.41%。主要并发症发生率为1.96%。症状评分和美容评分显著降低（p < 0.00001）。根据我们的亚组分析，LA组的联合VRR为53.27%，RFA组为79.51%，MWA组为89.68%。MWA治疗患者的再生长率较低（1.96%），低于其他组。虽然主要并发症发生率略高（1.96%），但与LA组和RFA组相比，差异无统计学意义。
长期随访分析表明，热消融是治疗良性甲状腺结节的一种安全有效的方法。此外，与RFA和LA相比，MWA治疗良性甲状腺结节可能更有效。
问题热消融治疗良性甲状腺结节的长期结果如何？发现热消融对良性甲状腺结节安全有效。临床意义激光消融、射频消融和微波消融在安全性上无差异，但微波消融在治疗良性甲状腺结节方面可能更有效。
