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Int J Hyperthermia. 2017 Dec;33(8):931-937. doi: 10.1080/02656736.2017.1331268. Epub 2017 May 25.

Radiofrequency ablation of small follicular neoplasms: initial clinical outcomes.

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a Department of Radiology and Thyroid Center , Chung-Ang University Hospital, Chung-Ang University College of Medicine , Seoul , Korea.
b Department of Radiology and Thyroid Center , Daerim St. Mary's Hospital , Seoul , Korea.
c Department of Radiology and the Research Institute of Radiology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Korea.
d Department of Radiology , GangNeung Asan Hospital , Seoul , Korea.
e Department of Radiology , Seoul National University College of Medicine , Seoul , Korea.
f Department of Pathology and Thyroid Center , Daerim St. Mary's Hospital , Seoul , Korea.
g Department of Internal Medicine and Thyroid Center , Daerim St. Mary's Hospital , Seoul , Korea.
h Department of Surgery and Thyroid Center , Daerim St. Mary's Hospital , Seoul , Korea.



In thyroid gland, radiofrequency ablation (RFA) has been applied to both recurrent cancers and benign nodules, although, according to the American Thyroid Association (ATA) and the Korean Society of Thyroid Radiology (KSThR) guidelines, surgery is the first-line treatment for follicular neoplasm. However, it has been argued that follicular neoplasm with lower risk of malignancy can be managed by close follow-up. In this study, we evaluated the effectiveness of RFA of small follicular neoplasms, examining reductions in volume and related clinical problems, and making observations over long-term follow-up.


We evaluated 10 follicular neoplasms in 10 patients who were treated with RF ablation between 2009 and 2011. A RF generator and an 18-gauge internally cooled electrode were used to perform complete ablation of the whole nodules. Changes in nodules or ablated zones on follow-up ultrasound, and complications during and after RF ablation were evaluated.


The mean follow-up period was 66.4 ± 5.1 months (range: 60-76 months). In eight patients, single session of RF ablation was sufficient, while two patients required two sessions. There was a significant reduction in the mean volume (99.5 ± 1.0%) of lesions, with eight ablated lesions (8/10, 80%) disappearing completely on follow-up. No recurrences were found in any ablated zones at last follow-up. Transient mild neck pain (n = 6) occurred during the procedure without requiring any medication.


In addition to active surveillance, RF ablation may be an effective and safe alternative for the management of patients with small (<2 cm) follicular neoplasm suspected on thyroid biopsy and who strongly refuse surgery.


Thermal ablation; radiofrequency/microwave; thyroid neoplasm; ultrasound

[Indexed for MEDLINE]

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