Ultrasound-Guided Radiofrequency Ablation of Benign Thyroid Nodules: 2-Year Follow-Up Results From a Single Center

Abstract

Objectives

Ultrasound-guided radiofrequency ablation (RFA) is an effective alternative to surgery for benign thyroid nodules (BTNs). This study aimed to evaluate the 2-year clinical outcomes of RFA, focusing on volume reduction rate across different baseline volume strata.

Methods

This single-center prospective study included 200 patients with 213 BTNs treated with RFA. Nodules were stratified into 3 groups based on baseline volume: Group A (<5 mL, n = 91), Group B (5–15 mL, n = 95), and Group C (>15 mL, n = 27). Clinical outcomes were assessed at 6, 12, 18, and 24 months. The primary metrics were the volume reduction rate (VRR), therapeutic success (VRR >50%), and complication rates.

Results

RFA resulted in continuous and significant volume reduction. Median VRR increased from 66.06% at 6 months to 97.08% at 24 months. Distinct reduction patterns were observed: at 6 months, larger nodules (Group C) exhibited a higher VRR (85.40%) than Group A (59.51%) and Group B (64.33%) (p = .001). However, disparities narrowed over time. By 24 months, all groups achieved comparable outcomes (VRR: 97.67, 95.22, and 98.53%, respectively). Therapeutic success ranged from 92.3 to 100%. Regrowth occurred in 2.8% of cases. The complication rate was 2.5% with no major events.

Conclusion

RFA demonstrates favorable long-term efficacy. Larger nodules shrink faster initially, while smaller nodules reduce gradually but eventually achieve comparable success. Patients with smaller nodules should be counseled to expect a more gradual volume reduction process.