Comparative Efficacy of Two‐Session Radiofrequency Ablation Versus Transarterial Embolization Followed by Radiofrequency Ablation for the Treatment of Large Benign Thyroid Nodules

Purposes To treat large benign thyroid nodules (BTNs), radiofrequency ablation (RFA) and transarterial embolization (TAE) combined with RFA are both used. This study aimed to compare the effectiveness of both treatments. Methods Nineteen subjects with 20 BTNs received two sessions of RFA, while eight patients with 10 BTNs underwent TAE followed by RFA in a single medical center. Propensity score matching (PSM) was utilized to control for inherent potential biases by matching similar characteristics between the two groups. Results Prior to treatment, a larger median nodule volume was observed in the TAE with the RFA group (150.75 ± 202.61 mL) compared to that of the double‐session RFA group (81.44 ± 58.00 mL). The volume reduction ratio (VRR) was found to be 74.60 ± 14.49% in the TAE/RFA group and 83.93 ± 12.70% in the double‐session RFA group. To account for follow‐up duration, we calculated the variation of VRR (ΔVRR, %) divided by the follow‐up time in days. The TAE with the RFA group showed a median reduction of 0.17 ± 0.05%/day, while the double‐session RFA group showed 0.13 ± 0.05%/day, with a p value of 0.040. The TAE with the RFA group exhibited a relatively higher daily VRR after treatment. Additionally, a higher nodular volume reduction was observed in the TAE with the RFA group due to the larger pretreatment nodular volume. Conclusions Our findings suggest that TAE combined with RFA may be a more effective treatment option for large BTNs compared to two sessions of RFA alone, thus providing an alternative treatment approach.