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

Area of Science:

• Endocrinology
• Minimally Invasive Surgery
• Medical Imaging

Background:

• Benign thyroid nodules (BTNs) are common, often requiring treatment for symptomatic or cosmetic reasons.
• Percutaneous ablation techniques offer minimally invasive alternatives to surgery for BTNs.
• Microwave ablation (MWA) and laser ablation (LA) are established thermal ablation methods.

Purpose of the Study:

• To compare the efficacy and safety of ultrasound-guided percutaneous MWA and LA for treating benign thyroid nodules.
• To evaluate nodule volume reduction, symptom improvement, cosmetic outcomes, and complication rates between MWA and LA.

Main Methods:

• Retrospective comparison of 318 patients with 328 BTNs treated with MWA or LA.
• Propensity-score matching was used to create comparable groups of 160 nodules each.
• Follow-up included nodule volume, symptom scores, cosmetic scores, and adverse events at regular intervals up to 12 months and beyond.

Main Results:

• Both MWA and LA significantly reduced nodule volume and improved neck symptoms and cosmetic scores.
• Overall volume reduction rates were comparable between MWA and LA.
• For nodules ≥13 mL, LA demonstrated significantly greater volume reduction at ≥6 months follow-up.
• MWA had a shorter average ablation time compared to LA.
• Incidence of major complications, minor complications, and side effects were similar between groups.

Conclusions:

• Percutaneous ultrasound-guided MWA and LA are safe and effective treatments for benign thyroid nodules.
• Both methods significantly improve nodule volume, patient symptoms, and cosmetic appearance with low adverse event rates.
• MWA is more efficient, but LA may be preferred for larger nodules (≥13 mL) due to superior long-term volume reduction.