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Transarterial embolization outperforms radiofrequency ablation for thyroid goiters exceeding 100 mL: a study on
Yun-Ju Lee1, An-Ni Lin1,2,3,4, Yueh-Sheng Chen1,2,3,4
1Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
European Radiology
|July 14, 2025
Summary
Transarterial embolization (TAE) is more effective and safer than radiofrequency ablation (RFA) for large benign thyroid nodules over 100mL. TAE offers a better minimally invasive alternative to surgery, improving patient outcomes with fewer risks.
Area of Science:
- Endocrinology
- Interventional Radiology
- Oncology
Background:
- Large benign thyroid nodules (BTNs) present management challenges, especially those exceeding 100mL.
- Established guidelines for minimally invasive treatments for very large BTNs are limited.
- Radiofrequency ablation (RFA) and transarterial embolization (TAE) are emerging minimally invasive options.
Purpose of the Study:
- To compare the efficacy and safety of RFA versus TAE for managing large BTNs (>100mL).
- To evaluate treatment outcomes including volume reduction, symptom improvement, and complication rates.
- To determine the optimal minimally invasive strategy for large BTNs.
Main Methods:
- Retrospective multicenter study (January 2018 - May 2022) of 70 patients with 76 large BTNs.
- Patients were treated with either RFA (n=53) or TAE (n=17).
- Nodule volume, diameter, volume reduction rate (VRR) at 6 months, symptoms, cosmetic scores, and complications were analyzed.
Main Results:
- TAE showed a significantly higher mean VRR than RFA at 6 months (p=0.007), particularly for nodules >100mL (TAE: 63.34% vs. RFA: 49.71%; p=0.035).
- The complication rate was lower in the TAE group (5.26%) compared to the RFA group (14.03%).
- Both treatments significantly improved symptoms and cosmetic scores (p<0.001), with TAE showing greater improvement in larger nodules.
Conclusions:
- TAE is more effective and safer than RFA for treating large BTNs exceeding 100mL.
- TAE presents a viable, less invasive alternative to surgery for patients with large thyroid nodules.
- These findings support TAE as a preferred minimally invasive treatment for large BTNs.
