Abstract：
OBJECTIVE: Ultrasound-guided thermal ablation, including radiofrequency ablation (RFA) and microwave ablation (MWA), has become one of the main options for treating benign thyroid nodules (BTNs). To assess the efficacy of thermal ablation of BTNs, we performed a systematic review and meta-analysis of relevant studies.
METHODS: A comprehensive search of MEDLINE, EMBASE, and COCHRANE databases was performed up to September 25, 2023, to identify studies directly comparing RFA and MWA for pathologically proven BTNs and reporting clinical outcomes and complications. Data extraction and quality assessment were independently performed by two radiologists according to PRISMA guidelines. The analysis yielded the serial volume reduction ratios (VRRs) of ablated nodules for up to 12 months, symptom and cosmetic scores, and complications.
RESULTS: This analysis included nine studies with 1305 BTNs treated by RFA and 1276 by MWA. VRRs at 1 month, 3 months, and 6 months were similar between RFA and MWA, but RFA showed a significantly higher VRR (83.3%) than MWA (76.9%) at 12 months (p = 0.02). Complication rates showed no significant difference between the two methods. Symptom and cosmetic scores significantly decreased after ablation, without a significant difference between the methods. Subgroup analysis indicated a significantly higher VRR at 12 months for RFA than for MWA for less experienced investigators (≤ 10 years), but no significant difference for more experienced investigators (> 10 years).
CONCLUSIONS: RFA and MWA are both effective and safe methods for treating BTNs. RFA showed a higher VRR at 12 months and seems more suitable for less experienced investigators.
CONCLUSIONS: RFA and MWA are both effective and safe treatments for BTNs, with RFA showing a higher VRR at 12 months. Both methods offer minimally invasive and reliable treatment for thyroid nodules.
CONCLUSIONS: The most effective thermal ablation technique for BTNs remains undetermined. RFA showed a higher VRR at 12 months than MWA. Both techniques are effective for treating thyroid nodules; RFA offers greater benefits, particularly for less experienced investigators.
METHODS: A comprehensive search of MEDLINE, EMBASE, and COCHRANE databases was performed up to September 25, 2023, to identify studies directly comparing RFA and MWA for pathologically proven BTNs and reporting clinical outcomes and complications. Data extraction and quality assessment were independently performed by two radiologists according to PRISMA guidelines. The analysis yielded the serial volume reduction ratios (VRRs) of ablated nodules for up to 12 months, symptom and cosmetic scores, and complications.
RESULTS: This analysis included nine studies with 1305 BTNs treated by RFA and 1276 by MWA. VRRs at 1 month, 3 months, and 6 months were similar between RFA and MWA, but RFA showed a significantly higher VRR (83.3%) than MWA (76.9%) at 12 months (p = 0.02). Complication rates showed no significant difference between the two methods. Symptom and cosmetic scores significantly decreased after ablation, without a significant difference between the methods. Subgroup analysis indicated a significantly higher VRR at 12 months for RFA than for MWA for less experienced investigators (≤ 10 years), but no significant difference for more experienced investigators (> 10 years).
CONCLUSIONS: RFA and MWA are both effective and safe methods for treating BTNs. RFA showed a higher VRR at 12 months and seems more suitable for less experienced investigators.
CONCLUSIONS: RFA and MWA are both effective and safe treatments for BTNs, with RFA showing a higher VRR at 12 months. Both methods offer minimally invasive and reliable treatment for thyroid nodules.
CONCLUSIONS: The most effective thermal ablation technique for BTNs remains undetermined. RFA showed a higher VRR at 12 months than MWA. Both techniques are effective for treating thyroid nodules; RFA offers greater benefits, particularly for less experienced investigators.
摘要：
目的：超声引导热消融，包括射频消融（RFA）和微波消融（MWA），已成为治疗良性甲状腺结节（BTNs）的主要选择之一。为了评估BTN热消融的疗效，我们对相关研究进行了系统评价和荟萃分析.
方法：全面搜索MEDLINE，EMBASE,和COCHRANE数据库在2023年9月25日之前进行,以确定直接比较RFA和MWA经病理证实的BTN并报告临床结局和并发症的研究.根据PRISMA指南，由两名放射科医生独立进行数据提取和质量评估。分析得出了长达12个月的消融结节的连续体积减少率（VRR），症状和美容评分，和并发症。
结果：该分析包括9项研究，其中通过RFA治疗1305个BTN，通过MWA治疗1276个BTN。1个月时的VRR，3个月,RFA和MWA之间的6个月相似，但在12个月时,RFA显示VRR(83.3%)显著高于MWA(76.9%)(p=0.02).两种方法的并发症发生率无明显差异。消融后症状和美容评分明显下降，方法之间没有显着差异。亚组分析显示，12个月时RFA的VRR显著高于MWA的经验较少的研究者（≤10年），但对于更有经验的研究者(>10年)没有显著差异。
结论：RFA和MWA都是治疗BTN的有效和安全的方法。RFA在12个月时显示出较高的VRR，似乎更适合经验不足的研究人员。
结论：RFA和MWA都是有效和安全的BTN治疗方法，RFA在12个月时显示更高的VRR。两种方法都为甲状腺结节提供了微创和可靠的治疗方法。
结论：对BTN最有效的热消融技术仍未确定。RFA在12个月时的VRR高于MWA。两种技术对治疗甲状腺结节都有效；RFA提供了更大的益处，特别是对于经验不足的调查员。
方法：全面搜索MEDLINE，EMBASE,和COCHRANE数据库在2023年9月25日之前进行,以确定直接比较RFA和MWA经病理证实的BTN并报告临床结局和并发症的研究.根据PRISMA指南，由两名放射科医生独立进行数据提取和质量评估。分析得出了长达12个月的消融结节的连续体积减少率（VRR），症状和美容评分，和并发症。
结果：该分析包括9项研究，其中通过RFA治疗1305个BTN，通过MWA治疗1276个BTN。1个月时的VRR，3个月,RFA和MWA之间的6个月相似，但在12个月时,RFA显示VRR(83.3%)显著高于MWA(76.9%)(p=0.02).两种方法的并发症发生率无明显差异。消融后症状和美容评分明显下降，方法之间没有显着差异。亚组分析显示，12个月时RFA的VRR显著高于MWA的经验较少的研究者（≤10年），但对于更有经验的研究者(>10年)没有显著差异。
结论：RFA和MWA都是治疗BTN的有效和安全的方法。RFA在12个月时显示出较高的VRR，似乎更适合经验不足的研究人员。
结论：RFA和MWA都是有效和安全的BTN治疗方法，RFA在12个月时显示更高的VRR。两种方法都为甲状腺结节提供了微创和可靠的治疗方法。
结论：对BTN最有效的热消融技术仍未确定。RFA在12个月时的VRR高于MWA。两种技术对治疗甲状腺结节都有效；RFA提供了更大的益处，特别是对于经验不足的调查员。
