Factors associated with treatment response to microwave ablation of benign thyroid nodules: a retrospective single-center study of nodule composition and vascularity
- 1Department of Radiology, Faculty of Medicine, Kahramanmaras Sutcu Imam University
- 2Public Health Services Department, Kahramanmaras Provincial Health Directorate
- 3Department of Radiology, Gaziantep City Hospital, Republic of Türkiye Ministry of Health
Abstract
Background: This study aimed to evaluate radiological and procedural factors associated with treatment response in benign thyroid nodules treated with microwave ablation (MWA).
Methods: Of 90 consecutive patients who underwent MWA for cytologically benign (Bethesda II) thyroid nodules, 80 who completed 12 months of follow-up were retrospectively analyzed. Pre-procedural ultrasonography was used to assess nodule volume, composition, and Doppler vascularity. All ablations were performed under ultrasound guidance using the moving-shot technique, and volume reduction ratio (VRR) was calculated during follow-up at 1, 3, 6, and 12 months. The primary outcome, treatment success, was defined as a VRR ≥75% at 12 months. Pearson correlation and multivariable logistic regression (forced-entry method) analyses were performed to determine factors influencing response.
Results: The mean patient age was 46.7 ± 16.6 years, and 66.3% were female. Mean baseline nodule volume was 11.75 ± 3.31 mL. Nodules were predominantly cystic in 38.8%, solid in 35%, and mixed in 26.3%. Mean VRR increased progressively during follow-up, from 26.2 ± 8.1% at 1 month to 72.5 ± 5.9% at 12 months, and treatment success (VRR ≥75%) was achieved in 35.0% of patients (28/80), whereas all nodules (100%) achieved a VRR ≥50%. Regrowth (any volume increase from the smallest recorded volume) occurred in 25.0% of patients, repeat ablation was required in 13.8%, and the complication rate was 5.0%. No significant correlation was found between baseline volume and VRR (r = 0.102, p = 0.367). Logistic regression identified nodule composition (p = 0.009) and vascularity (p = 0.017) as factors independently associated with treatment success. Predominantly cystic nodules and nodules with lower vascularity were more likely to achieve treatment success.
Conclusion: MWA was associated with substantial volume reduction and a low complication rate in benign thyroid nodules. Within the studied volume range, treatment response was associated with nodule composition and vascularity rather than initial size. Pre-procedural evaluation of nodule morphology and perfusion may help optimize patient selection.
Related
- Treatment patterns and prognostic factors of radiation-associated esophageal fistula in patients with esophageal squamous cell carcinoma: a retrospective cohort study
- Pre-Existing Mood Disorder is Associated with Higher Odds of Withdrawal of Life-Sustaining Treatment (WOLST) After Severe Stroke: A Retrospective Cohort Study
- Acyclovir and ganciclovir exposure and short-term outcomes in hospitalized children with EBV-associated mononucleosis-like illness: a retrospective cohort study using inverse probability of treatment weighting
- Treatment Outcomes and Prognostic Factors in Children with Myeloid Leukemia Associated with Down Syndrome: A Nationwide Polish Retrospective Study
- Efficacy and safety of ultrasound-guided microwave “Near-Total Ablation” for refractory hyperthyroidism: a retrospective study
BibTeX
@article{demir2026factors,
title = {{Factors associated with treatment response to microwave ablation of benign thyroid nodules: a retrospective single-center study of nodule composition and vascularity}},
author = {Mehmet Demir and Feza Demir and Cetin Murat Altay and Mehmet Onay and Ali Burak Binboğa},
journal = {Frontiers in Endocrinology},
year = {2026},
month = nov,
doi = {10.3389/fendo.2026.1956986},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1956986/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Factors associated with treatment response to microwave ablation of benign thyroid nodules: a retrospective single-center study of nodule composition and vascularity
AU - Mehmet Demir
AU - Feza Demir
AU - Cetin Murat Altay
AU - Mehmet Onay
AU - Ali Burak Binboğa
PY - 2026
DA - 2026/11/04
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1956986
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1956986/full
AB - Background: This study aimed to evaluate radiological and procedural factors associated with treatment response in benign thyroid nodules treated with microwave ablation (MWA). Methods: Of 90 consecutive patients who underwent MWA for cytologically benign (Bethesda II) thyroid nodules, 80 who completed 12 months of follow-up were retrospectively analyzed. Pre-procedural ultrasonography was used to assess nodule volume, composition, and Doppler vascularity. All ablations were performed under ultrasound guidance using the moving-shot technique, and volume reduction ratio (VRR) was calculated during follow-up at 1, 3, 6, and 12 months. The primary outcome, treatment success, was defined as a VRR ≥75% at 12 months. Pearson correlation and multivariable logistic regression (forced-entry method) analyses were performed to determine factors influencing response. Results: The mean patient age was 46.7 ± 16.6 years, and 66.3% were female. Mean baseline nodule volume was 11.75 ± 3.31 mL. Nodules were predominantly cystic in 38.8%, solid in 35%, and mixed in 26.3%. Mean VRR increased progressively during follow-up, from 26.2 ± 8.1% at 1 month to 72.5 ± 5.9% at 12 months, and treatment success (VRR ≥75%) was achieved in 35.0% of patients (28/80), whereas all nodules (100%) achieved a VRR ≥50%. Regrowth (any volume increase from the smallest recorded volume) occurred in 25.0% of patients, repeat ablation was required in 13.8%, and the complication rate was 5.0%. No significant correlation was found between baseline volume and VRR (r = 0.102, p = 0.367). Logistic regression identified nodule composition (p = 0.009) and vascularity (p = 0.017) as factors independently associated with treatment success. Predominantly cystic nodules and nodules with lower vascularity were more likely to achieve treatment success. Conclusion: MWA was associated with substantial volume reduction and a low complication rate in benign thyroid nodules. Within the studied volume range, treatment response was associated with nodule composition and vascularity rather than initial size. Pre-procedural evaluation of nodule morphology and perfusion may help optimize patient selection.
SN - 1664-2392
ER -