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A preliminary comparative study of three different microwave ablation methods for cystic-solid thyroid nodules.

Xiang-Rong Xie1,2, Yu-Fan Wu3, Geng-Biao Zhang4

  • 1Shantou University Medical College, Shantou, Guangdong Province, China.

International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group
|September 15, 2025
PubMed
Summary

Microwave ablation (MWA) techniques involving epinephrine solution immersion (ESIG) and high-power ablation (HPAG) reduced bleeding and ablation time for cystic-solid thyroid nodules compared to simple aspiration (SAG). Long-term outcomes were similar across all MWA methods.

Keywords:
Thyroidcontrast-enhanced ultrasonographycystic-solid nodulesmicrowave ablationvolume reduction rate

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Area of Science:

  • Endocrinology
  • Minimally Invasive Surgery
  • Oncology

Background:

  • Cystic-solid thyroid nodules are common, and microwave ablation (MWA) is a minimally invasive treatment option.
  • Optimizing MWA techniques for improved procedural efficiency and patient outcomes is crucial.

Purpose of the Study:

  • To compare the effectiveness of three MWA techniques in managing cystic-solid thyroid nodules.
  • To evaluate intraoperative bleeding, ablation time, and 12-month outcomes including nodule volume reduction, symptom scores, and cosmetic scores.

Main Methods:

  • A retrospective study analyzed 60 patients undergoing MWA for cystic-solid thyroid nodules, divided into Simple Aspiration Group (SAG), Epinephrine Solution Immersion Group (ESIG), and High-Power Ablation Group (HPAG).
  • Key metrics included intraoperative intracapsular bleeding, ablation time, 12-month nodule volume reduction rate (VRR), and patient-reported symptom and cosmetic scores.

Main Results:

  • ESIG and HPAG significantly reduced intraoperative intracapsular rebleeding compared to SAG (p<0.05).
  • Ablation time was shorter in ESIG and HPAG versus SAG (p<0.01).
  • No significant differences were observed in 12-month VRR, symptom scores, or cosmetic scores among the three groups (p>0.05).

Conclusions:

  • Epinephrine solution immersion and high-power ablation enhance procedural efficiency by reducing bleeding and ablation time in MWA for cystic-solid thyroid nodules.
  • Despite improved intraoperative metrics, long-term therapeutic outcomes (volume reduction, symptom relief, cosmesis) are comparable across the evaluated MWA techniques.