[Ultrasound-guided ablation techniques for thyroid lesions]

Area of Science:

• Endocrinology
• Oncology
• Medical Imaging

Context:

• Ultrasound-guided ablation is emerging as a key treatment modality for thyroid lesions.
• It complements established therapies like surgery and radioiodine treatment.
• Both instillation therapy for cystic lesions and thermal ablation for solid lesions are utilized.

Purpose:

• To review the current status and future directions of ultrasound-guided ablation techniques for thyroid lesions.
• To highlight the efficacy and safety of various thermal ablation methods (RFA, MWA, LA, HIFU).
• To emphasize the need for comparative trials and standardized clinical practice.

Summary:

• Thermal ablation techniques (radiofrequency ablation, microwave ablation, laser ablation, high-intensity focused ultrasound) achieve irreversible cellular effects by heating thyroid tissue to ≥ 60 °C.
• These methods allow selective treatment of symptomatic or hyperfunctional lesions under continuous sonographic monitoring.
• Instillation therapy with ethanol or polidocanol is effective for cystic or predominantly cystic thyroid lesions.

Impact:

• Establishes local ablative techniques as viable alternatives or adjuncts to conventional thyroid treatments.
• Promotes the integration of these minimally invasive options into patient decision-making processes.
• Highlights the necessity for prospective comparative trials and standardized quality assessment to advance the field.