Microwave Ablation Compared With Laser Ablation for Treating Benign Thyroid Nodules in a Propensity-Score Matching Study

Abstract

Objective: The efficacy and safety of percutaneous ultrasound-guided microwave and laser ablation (MWA and LA, respectively), for treating benign thyroid nodules (BTNs), were retrospectively compared.Methods: Patients (n = 318) underwent ablation of 328 BTNs. Confounding bias was reduced by propensity-score matching, and finally the MWA and LA groups each comprised 160 nodules. At baseline (before ablation), 3, 6, and 12 months, and every 6 months thereafter, the following were recorded: nodule volume reduction rate (VRR), neck symptom scores, cosmetic scores, complications, and side effects.Results: The baseline characteristics of the MWA and LA groups were comparable. The volumes of all nodules were less at all follow-ups relative to the baseline, as were the symptom and cosmetic scores at postoperative 6 months and thereafter (P < 0.01). At each follow-up, the overall VRRs of the MWA and LA groups were comparable. However, for nodules ≥13 mL, the VRR associated with LA at ≥6 months was significantly greater than that of MWA. The average ablation time for MWA was less than that of LA (P < 0.01). The overall incidences of major complications, minor complications, and side effects were 1.6, 2.2, and 18.4%, respectively, and there were no significant differences between the MWA and LA groups.Conclusion: Percutaneous ultrasound-guided MWA and LA are both safe and effective for the treatment of BTNs. Each can significantly reduce the nodule volume and improve the neck symptoms and appearance of patients, with a low incidence of adverse side effects. The efficiency of MWA is higher than that of LA. For nodules ≥13 mL, MWA may be preferred, but at 6 months and subsequent follow-ups the reduction in volume was greater in patients receiving LA.

Comparison of radiofrequency ablation and microwave ablation for benign thyroid nodules: A systematic review and meta‐analysis

“…MWA is a recently developed percutaneous thermal ablation technique, and has shown the advantages of consistently higher intratumoural temperatures, faster ablation times, and an improved convection profile compared to RFA 10 . The mean volume reduction rate (VRR) of BTNs at the 12‐month follow‐up was reportedly 75%–92.4% after MWA 11–13 . However, although MWA performs better than RFA for treating BTNs in some respects, few studies concern about the comparisons in effectiveness and security between them.…”

“…10 The mean volume reduction rate (VRR) of BTNs at the 12-month follow-up was reportedly 75%-92.4% after MWA. [11][12][13] However, although MWA performs better than RFA for treating BTNs in some respects, few studies concern about the comparisons in effectiveness and security between them. Therefore, it is necessary to collect published data for a comprehensive analysis on this issue.…”

Clinical and functional results of radiofrequency ablation and microwave ablation in patients with benign thyroid nodules

“…The efficiency of minimally invasive approaches have been increasingly reported in clinical studies. [13][14][15] Minimally invasive procedures include ethanol ablation (EA), percutaneous laser ablation (PLA), microwave ablation (MWA), and radiofrequency ablation (RFA). [13][14][15][16][17] High-intensity focused ultrasound (HIFU) looks to be a noninvasive therapeutic option for BTN.…”

Ultrasonography-guided radiofrequency ablation for the treatment of T2N0M0 papillary thyroid carcinoma: a preliminary study

“…With characteristics of minimal invasiveness, fast recovery and better appearance, image-guided thermal ablation, such as radiofrequency ablation (RFA), laser ablation (LA) and microwave ablation (MWA), has been used to treat benign thyroid nodules, low-risk papillary thyroid microcarcinomas and metastatic cervical lymph nodes in the past few years [12][13][14][15][16][17]. RFA has been recommended for the treatment of benign thyroid nodules and recurrent thyroid cancers by several guidelines and consensus statements [18][19][20][21].…”