International expert consensus on thermal ablation for benign thyroid nodules (2025 Edition)

In recent decades, thermal ablation (TA) has gained acceptance as an effective and safe treatment for benign thyroid nodules (BTNs). However, despite its increasing popularity, the indications and techniques of TA for BTNs lack a unified standard, resulting in differences in treatment outcomes. In particular, the current guidelines and consensus statements adopt indications based on surgical criteria, which focus on larger BTNs with symptoms or cosmetic concerns. However, these indications may not adequately demonstrate the advantages of TA, as it is a fundamentally distinct therapeutic approach. To establish novel and specific indications for TA in BTNs and to standardize the use of this technique, a panel of experts issued the current expert consensus.

Based on a systematic review of the literature and clinical experience, the drafting group developed preliminary recommendations on TA for BTNs. A multidisciplinary panel of 30 experts with specific competence and expertise in TA for thyroid nodules reviewed, rated, and revised these recommendations through multiple rounds of the modified Delphi method.

Twenty-six recommendations on TA for BTNs were proposed in the present consensus, covering indications and contraindications, physician training suggestions, preablation preparation, technical procedures, complications, efficacy assessment, follow-up strategies, and postablation management.

The present consensus emphasizes the indication of TA for BTNs and outlined the technique details and periablation management. The implementation of this consensus is expected to standardize treatment practices, enhance patient outcomes, and shape future research and policy developments in the management of BTNs.