Microwave ablation: a technical and clinical comparison to other thermal ablation modalities to treat benign and malignant thyroid nodules

Microwave ablation (MWA) is a novel modality for thermal ablation (TA) to treat benign and malignant thyroid nodules, mostly papillary thyroid cancer (PTC). Compared to surgery, TA is less invasive and less painful, has faster recovery, better cosmetic outcomes, and fewer complications. TA techniques have been evolving over the past decade to be more energy efficient, precise, and produce long-lasting results. The general approach is similar between various TA techniques. However, each technique has uniqueness in its energy delivery and, thus, risk profile and outcomes. MWA has a few critical technical differences that make it safer for patients with surgical implants and cardiac comorbidities. It has proven effective in treating benign thyroid nodules (BTNs) in adults and pediatric populations with benign and malignant lesions. The clinical and theoretical outcomes of MWA compared to other thermal ablative techniques, such as radiofrequency ablation (RFA) and laser ablation (LA), have been investigated in some studies and meta-analyses. Minimally invasive procedures such as MWA are an important tool for the management of thyroid lesions. Thus, it is crucial for clinicians to be equipped with the knowledge to use these tools. In this review, we provide a clinical review detailing the technical differences and clinical outcomes for the three major TA techniques-MWA, RFA, and LA.