Long-term efficacy of ultrasound-guided low power microwave ablation for the treatment of primary papillary thyroid microcarcinoma: a 3-year follow-up study

  • Dengke Teng
  • Guoqing Sui
  • Caimei Liu
  • Yu Wang
  • Yongxu Xia
  • Hui Wang
Original Article – Clinical Oncology



To evaluate the safety and efficacy of ultrasound-guided low-power microwave ablation (MWA) for the treatment of papillary thyroid microcarcinoma (PTMC) with a 3-year follow-up.


A total of 21 nodules diagnosed as PTMC from the 15 patients were performed with MWA at a power of 20 W. The images of the nodules were recorded by ultrasound before MWA and 1, 3, 6, 12 months after MWA, and every 6 months thereafter, respectively. The volumes of the nodules were compared before MWA and at each follow-up point after MWA. The volume reduction rate (VRR) of nodules was also calculated.


The mean volume of the nodules was 134.3 ± 129.8 mm3 initially (the range was 7.4–423.8 mm3), which decreased significantly to 2.3 ± 10.5 mm3 (the range was 0–48.1 mm3) of the ablation area (P = 0.000) at the follow-up point of 36 months with a mean VRR as 98.78 ± 5.61% (the range was 74.28–100%). During the follow-up period (the range was 36–48 months), 20 of the 21 nodules were completely absorbed and no recurrent nodule was found.


After a long-term follow-up of 3 years, the low power MWA showed a good safety and efficacy for the treatment of PTMC. In addition to surgery and active surveillance, MWA might be another alternative for patients with PTMC.


Thermal ablation Microwave Ultrasound Thyroid Papillary carcinoma 



This study was funded by the Finance Department of Jilin Province (no. SCZSY201701) and the Jilin Provincial Health and Family Planning Commission (no. 2016ZC032).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights statement

The studies have been approved by the appropriate institutional research ethics committee and have been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This manuscript does not contain any studies with animals by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. Brito JP, Morris JC, Montori VM (2013) Thyroid cancer: zealous imaging has increased detection and treatment of low risk tumours. BMJ. 347:f4706 CrossRefPubMedGoogle Scholar
  2. Cheng Z et al (2017) US-guided percutaneous radiofrequency versus microwave ablation for benign thyroid nodules: a prospective multicenter. Study Sci Rep 7:9554. PubMedGoogle Scholar
  3. Feng B, Liang P, Cheng Z, Yu X, Yu J, Han Z, Liu F (2012) Ultrasound-guided percutaneous microwave ablation of benign thyroid nodules: experimental and clinical studies. Eur J Endocrinol 166:1031–1037. CrossRefPubMedGoogle Scholar
  4. Gambelunghe G et al (2013) Ultrasound-guided interstitial laser ablation for thyroid nodules is effective only at high total amounts of energy: results from a three-year pilot study. Surg Innov 20:345–350. CrossRefPubMedGoogle Scholar
  5. Gharib H et al (2016) American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules—2016 update. Endocr Pract 22:622–639. CrossRefPubMedGoogle Scholar
  6. Griffin A, Brito JP, Bahl M, Hoang JK (2017) Applying criteria of active surveillance to low-risk papillary thyroid cancer over a decade: how many surgeries and complications can. Be avoided? Thyroid 27:518–523. CrossRefPubMedGoogle Scholar
  7. Haser GC et al. (2016) Active surveillance for papillary thyroid microcarcinoma: new challenges and opportunities for the health care system. Endocr Pract 22:602–611 CrossRefPubMedPubMedCentralGoogle Scholar
  8. Haugen BR et al (2016) 2015 American Thyroid Association Management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association guidelines task force on thyroid nodules and differentiated Thyroid Cancer. Thyroid 26:1–133. CrossRefPubMedPubMedCentralGoogle Scholar
  9. Ito Y, Oda H, Miyauchi A (2016) Insights and clinical questions about the active surveillance of low-risk papillary thyroid microcarcinomas [review]. Endocr J 63:323–328. CrossRefPubMedGoogle Scholar
  10. Ito Y, Miyauchi A, Oda H (2017) Low-risk papillary microcarcinoma of the thyroid: a review of active surveillance trials. Eur J Surg Oncolo J Eur Soc Surg Oncol Br Assoc Surg Oncol. Google Scholar
  11. Jeong WK, Baek JH, Rhim H, Kim YS, Kwak MS, Jeong HJ, Lee D (2008) Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol 18:1244–1250. CrossRefPubMedGoogle Scholar
  12. Jiao D et al (2010) Microwave ablation treatment of liver cancer with 2,450-MHz cooled-shaft antenna: an experimental and clinical study. J Cancer Res Clin Oncol 136:1507–1516. CrossRefPubMedGoogle Scholar
  13. Kim J-h et al (2016) Radiofrequency ablation of low-risk small papillary thyroidcarcinoma: preliminary results for patients ineligible for surgery. Int J Hyperth 33:212–219. CrossRefGoogle Scholar
  14. Korkusuz H, Happel C, Koch DA, Gruenwald F (2016a) Combination of ultrasound-guided percutaneous microwave ablation and radioiodine therapy in benign thyroid disease: a 3-month follow-up. Study Rofo 188:60–68. PubMedGoogle Scholar
  15. Korkusuz Y et al (2016b) Microwave ablation of symptomatic benign thyroid nodules: energy requirement per ml volume reduction. Rofo 188:1054–1060. CrossRefPubMedGoogle Scholar
  16. Korkusuz Y et al (2016c) Cooled microwave ablation of thyroid nodules: Initial experience. Eur J Radiol 85:2127–2132. CrossRefPubMedGoogle Scholar
  17. Li X, Fan WJ, Zhang L, Zhang XP, Jiang H, Zhang JL, Zhang H (2013) CT-guided percutaneous microwave ablation of liver metastases from nasopharyngeal carcinoma. J Vasc Interv Radiol JVIR 24:680–684. CrossRefPubMedGoogle Scholar
  18. Li M, Yu X, Liang P, Dong B, Liu F (2015) Ultrasound-guided percutaneous microwave ablation for hepatic malignancy adjacent to the gallbladder. Int J Hyperth 31:579–587. CrossRefGoogle Scholar
  19. Lim HK, Lee JH, Ha EJ, Sung JY, Kim JK, Baek JH (2013) Radiofrequency ablation of benign non-functioning thyroid nodules: 4-year follow-up results for 111 patients. Eur Radiol 23:1044–1049. CrossRefPubMedGoogle Scholar
  20. Lim H, Devesa SS, Sosa JA, Check D, Kitahara CM (2017) Trends in thyroid cancer incidence and mortality in the United States, 1974–2013. JAMA 317:1338–1348. CrossRefPubMedGoogle Scholar
  21. Liu W et al (2017a) Risk factors of central lymph node metastasis of papillary thyroid carcinoma: a single-center retrospective analysis of 3273 cases. Medicine 96:e8365. CrossRefPubMedPubMedCentralGoogle Scholar
  22. Liu YJ, Qian LX, Liu D, Zhao JF (2017b) Ultrasound-guided microwave ablation in the treatment of benign thyroid nodules in 435 patients. Exp Biol Med (Maywood) 242:1515–1523. CrossRefGoogle Scholar
  23. Papini E et al (2013) Percutaneous ultrasound-guided laser ablation is effective for treating selected nodal metastases in papillary thyroid cancer. J Clin Endocrinol Metab 98:E92-97. CrossRefGoogle Scholar
  24. Papini E et al (2014) Long-term efficacy of ultrasound-guided laser ablation for benign solid thyroid nodules. Results of a three-year multicenter prospective randomized trial. J Clin Endocrinol Metab 99:3653–3659. CrossRefPubMedGoogle Scholar
  25. Qu P, Yu X, Liang P, Cheng Z, Han Z, Liu F, Yu J (2013) Contrast-enhanced ultrasound in the characterization of hepatocellular carcinomas treated by ablation: comparison with contrast-enhanced magnetic resonance imaging. Ultrasound Med Biol 39:1571–1579. CrossRefGoogle Scholar
  26. Shaha AR, Tuttle RM (2017) Risk of disease progression during active surveillance of papillary thyroid cancer. Surgery. PubMedGoogle Scholar
  27. Shin JE, Baek JH, Lee JH (2013) Radiofrequency and ethanol ablation for the treatment of recurrent thyroid cancers: current status and challenges. Curr Opin Oncol 25:14–19. CrossRefPubMedGoogle Scholar
  28. Tuttle RM et al (2017) Natural history and tumor volume kinetics of papillary thyroid cancers during active surveillance. JAMA Otolaryngol Head Neck Surg 143:1015–1020. CrossRefPubMedGoogle Scholar
  29. Valcavi R, Riganti F, Bertani A, Formisano D, Pacella CM (2010) Percutaneous laser ablation of cold benign thyroid nodules: a 3-year follow-up study in 122 patients. Thyroid 20:1253–1261. CrossRefPubMedGoogle Scholar
  30. Wang B et al. (2017) Factors related to recurrence of the benign non-functioning thyroid nodules after percutaneous microwave ablation. Int J Hyperth. Google Scholar
  31. Wu W, Gong X, Zhou Q, Chen X, Chen X, Shi B (2017) US-guided percutaneous microwave ablation for the treatment of benign thyroid nodules. Endocr J 64:1079–1085. CrossRefPubMedGoogle Scholar
  32. Yu J et al (2014) US-guided percutaneous microwave ablation versus open radical nephrectomy for small renal cell carcinoma: intermediate-term results. Radiology 270:880–887. CrossRefPubMedGoogle Scholar
  33. Yue W, Wang S, Wang B, Xu Q, Yu S, Yonglin Z, Wang X (2013) Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: safety and imaging follow-up in 222 patients. Eur J Radiol 82:e11–e16. CrossRefGoogle Scholar
  34. Yue W, Wang S, Yu S, Wang B (2014) Ultrasound-guided percutaneous microwave ablation of solitary T1N0M0 papillary thyroid microcarcinoma: initial experience. Int J Hyperth 30:150–157. CrossRefGoogle Scholar
  35. Yue W, Chen L, Wang S, Yu S (2015) Locoregional control of recurrent papillary thyroid carcinoma by ultrasound-guided percutaneous microwave ablation: a prospective study. Int J Hyperth 31:403–408. CrossRefGoogle Scholar
  36. Zhang M, Luo Y, Zhang Y, Tang J (2016) Efficacy and safety of ultrasound-guided radiofrequency ablation for treating low-risk papillary thyroid microcarcinoma. A prospective study. Thyroid 26:1581–1587. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UltrasoundChina-Japan Union Hospital of Jilin UniversityChangchunChina
  2. 2.Department of Interventional Ultrasoundthe 208th Hospital of PLAChangchunChina

Personalised recommendations