Microwave ablation of benign thyroid nodules: the importance of modified hydrodissection

Abstract Purpose: To evaluate the safety and efficacy of microwave ablation (MWA) in treating benign thyroid nodules and any advantage of modified hydrodissection (MHD) techniques while performing these procedures. Materials and Methods: This retrospective study included 76 consecutive patients treated for benign thyroid nodules using MWA. Patients were divided into two groups. Group 1 included patients treated before November 2019 using the HD technique (n=38), and group 2 included patients treated using the MHD technique after November 2019 (n=38). HD-MHD was performed using 5% dextrose. A portable MWA device with a 2450 MHz frequency was used as the generator. MWA antennas with internal water-cooled units and temperature monitoring features with a 16G diameter, 100 cm body length, and 3 mm tip length were used for MWA procedures. Color Doppler ultrasound examinations, thyroid function tests, volume reduction ratios (VRR), visual analog scales, and cosmetic scores were performed on the patients in the first, third, sixth, and every sixth months after ablation procedures. Complications and procedure times were also recorded. Results: No significant differences in VRR, visual analog scale, or cosmetic score were observed between the groups at 3, 6, and 12 months. Lower complication rates ( 26.31% vs. 7.89%, p=0.03) and procedure times (10.30 min vs. 7.30 min; p=0.04) were observed with the MHD technique. There were no residual or recurrent nodules or thyroid hormone deficiencies during the follow-up. Conclusion: MWA of benign thyroid nodules is safe and effective. Using the MHD technique lowers complication rates and procedure time.