What question did this study set out to answer?

This study aims to compare the efficacy of microwave ablation and lauromacrogol injection for treating cystic thyroid nodules composed of 50-75% fluid.

March 13, 2026Open Access

Comparison of microwave ablation versus lauromacrogol injection ablation for 50–75% cystic thyroid nodules: a two-center retrospective study

Key Points

This study aims to compare the efficacy of microwave ablation and lauromacrogol injection for treating cystic thyroid nodules composed of 50-75% fluid.
Retrospective analysis of 106 patients with cystic thyroid nodules
Patients underwent ultrasound-guided MWA (51 patients) or LIA (55 patients)
Primary endpoint assessed was 12-month volume reduction rate (VRR)
ANCOVA was used for intergroup comparisons
Kaplan-Meier analysis estimated regrowth-free survival
Mean VRR at 12 months: MWA 91.5% vs LIA 81.1% (P=0.005)
Effective treatment rate: MWA 96.1% vs LIA 81.8% (P=0.018)
Regrowth rates: MWA 3.9% vs LIA 20.0% (P=0.006)
MWA showed significantly longer regrowth-free survival (Log-rank P=0.010)

Abstract

Purpose To compare the efficacy between microwave ablation (MWA) and lauromacrogol injection ablation (LIA) for treating 50-75% cystic thyroid nodules and systematically identify the factors influencing outcomes. Materials and methods This retrospective study included 106 patients with predominantly cystic thyroid nodules (PCTNs) with 50-75% proportion of cystic components (simple as 50–75% cystic thyroid nodules) who underwent ultrasound-guided MWA (n=51) or LIA (n=55) in two hospitals between April 2017 and November 2023. The primary endpoint was 12-month volume reduction rate (VRR). ANCOVA was used to compare adjusted 12-month VRR between groups after adjusting for confounders. Secondary endpoints included effective treatment rate (VRR 50% at 6 or 12 months), recurrence, and stratified analysis analyses by initial nodule volume (10 ml and ≤10 ml) and vascularity (Grades 0–1 and 2-3). Regrowth-free survival was estimated by Kaplan-Meier (KM) analysis and compared with the Log-rank test. Results At 12 months postoperatively, the mean VRR for MWA was 91.5 ± 9.8% and 81.1 ± 2.4% for LIA (F = 4.40, P = 0.005). MWA yielded higher VRR than LIA at 6 and 12 months across both low- and high-vascularity subgroups (P0.05). For nodules 10 ml, MWA produced significantly greater VRR at 3, 6 and 12 months (P0.05); no significant difference was observed for nodules ≤10 ml (P0.05). The 12-month effective treatment rate was 96.1% (49/51) after MWA versus 81.8% (46/55) after LIA (P = 0.018). Regrowth rates were 3.9% (2/51) for MWA and 20.0% (11/55) for LIA (P = 0.006). The KM analysis showed significantly longer regrowth-free survival following MWA (Log-rank P = 0.010). Conclusion Both MWA and LIA exhibit favorable efficacy in the treatment of 50–75% cystic thyroid nodules. Importantly, based on the approximately 12-month follow-up, MWA demonstrates superior efficacy and improved control of regrowth compared to LIA. This advantage of MWA is further amplified in the management of larger nodules.

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