Endocrinology and Metabolism

Review Articles

Thyroid
Novel and Advanced Ultrasound Techniques for Thyroid Thermal Ablation: Wai-Kin Chan, Jui-Hung Sun, Miaw-Jene Liou, Chia-Jung Hsu, Yu-Ling Lu, Wei-Yu Chou, Yan-Rong Li, Feng-Hsuan Liu; Endocrinol Metab. 2024;39(1):40-46. Published online February 13, 2024; DOI: https://doi.org/10.3803/EnM.2024.1917

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Thyroid radiofrequency ablation and microwave ablation are widely adopted minimally invasive treatments for diverse thyroid conditions worldwide. Fundamental skills such as the trans-isthmic approach and the moving shot technique are crucial for performing thyroid ablation, and advanced techniques, including hydrodissection and vascular ablation, improve safety and efficacy and reduce complications. Given the learning curve associated with ultrasound-guided therapeutic procedures, operators need training and experience. While training models exist, limited attention has been given to ultrasound maneuvers in ablation needle manipulation. This article introduces two essential maneuvers, the zigzag moving technique and the alienate maneuver, while also reviewing the latest ultrasound techniques in thyroid ablation, contributing valuable insights into this evolving field.

Citations

Citations to this article as recorded by

A cost-effective porcine training model for thermal ablation of thyroid nodules and subsequent transoral endoscopic thyroidectomy
Lei Min, Yujing Weng, Weichun Chen, Debiao Chen, Qing Ai, Jiang Jiang, Zhiheng Huang
Minimally Invasive Therapy & Allied Technologies.2026; 35(1): 79. CrossRef
Factors associated with early complete resolution after radiofrequency ablation for low-risk papillary thyroid microcarcinoma: a dual-center retrospective study
Yuxuan Qiu, Yina Zhang, Jingqi Zhu, Yun Gong, Lu Yin, Pin Fan, Lian Zhang, Lingyun Bao, Jianhua Fang, Jun Lou, Chenke Xu
European Radiology.2026; 36(7): 5277. CrossRef
Controlled minimally invasive surgical interventions for the treatment of patients with thyroid carcinoma
David D. Dolidze, Zurab A. Bagatelia, Suren G. Laboyan, Arshak V. Vardanyan, Konstantin S. Titov, Ivan N. Lebedinsky, Georgi Genadi Melkonyan, Dmitriy V. Matveev, Nodar N. Gogitidze, Andrei Y. Lukin, Armen R. Oganyan, David G. Gogolashvili, Anastasia V. B
Journal of Experimental and Clinical Surgery.2026; 19(1): 45. CrossRef
Expression of serum inflammatory factors and vascular endothelial growth factor and volume reduction rate in thyroid nodules treated with ultrasound-guided radiofrequency ablation
Hui Yang, Mei Liu, Yadong Zhou, Yali He, Huijuan Jin
Journal of Medical Biochemistry.2026; (00): 87. CrossRef
North American Society for Interventional Thyroidology Statement on Directed Ablative Therapy for the Management of Low Risk Papillary Thyroid Carcinoma
Chelsey K. Baldwin, Kaitlyn M. Frazier, Jennifer H. Kuo, Julia E. Noel, Jonathon O. Russell, Victoria E. Banuchi
Endocrine Practice.2026;[Epub] CrossRef
Volumetric outcomes of ultrasound-guided microwave ablation for benign thyroid nodules: A single-centre retrospective cohort study
İsmail Engin, Ali H. Emirkadı, Zafer Ü. Coşkun
Ultrasound.2026;[Epub] CrossRef
Advances in Ultrasound-Targeted Microbubble Destruction (UTMD) for Breast Cancer Therapy
Yunfeng Wu, Yuxi Liu, Han Wu, Mengying Tong, Linyao Du, Shuangsong Ren, Ying Che
International Journal of Nanomedicine.2025; Volume 20: 1425. CrossRef
Diagnostic accuracy of ultrasound in hyperthyroidism: A comprehensive review of recent studies
Dawei Wang, Chao Xie, Xuena Zheng, Min Li
Journal of Radiation Research and Applied Sciences.2025; 18(2): 101370. CrossRef
Current evidence and strategies for preventing tumor recurrence following thermal ablation of papillary thyroid carcinoma
Ru Li, Luyang Yang, Ming Xu, Baofeng Wu, Qinhao Liu, Qin An, Yuchen Sun, Yi Zhang, Yunfeng Liu
Cancer Imaging.2025;[Epub] CrossRef
Ablación de nódulos tiroideos: revisión de la literatura
Alex Wash Franulic
Revista Médica Clínica Las Condes.2025; 36(4): 267. CrossRef
Thermal ablation for papillary thyroid microcarcinoma in the isthmus: a systematic review and meta-analysis
Yuqi Hao, Kun Liao, Ling Zeng, Lili Feng
Endocrine Connections.2025;[Epub] CrossRef
Current role of interventional radiology in thyroid nodules
Onur Taydas, Erbil Arik, Omer Faruk Sevinc, Ahmet Burak Kara, Mustafa Ozdemir, Hasret Cengiz, Zulfu Bayhan, Mehmet Halil Ozturk
Frontiers in Endocrinology.2024;[Epub] CrossRef
Recurrent laryngeal nerve monitoring by flexible laryngoscopy during thyroid radiofrequency ablation in the awake patient
Marsida Teliti, Antonio Occhini, Rodolfo Fonte, Laura Croce, Benedetto Calì, Federica Antonella Ripepi, Andrea Carbone, Mario Rotondi, Spyridon Chytiris
Frontiers in Endocrinology.2024;[Epub] CrossRef

Thyroid
Percutaneous Adrenal Radiofrequency Ablation: A Short Review for Endocrinologists: Byung Kwan Park; Endocrinol Metab. 2020;35(4):750-755. Published online December 2, 2020; DOI: https://doi.org/10.3803/EnM.2020.880

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Image-guided radiofrequency ablation (RFA) has been accepted as a minimally invasive treatment for adrenal tumors in patients who are unable to undergo adrenalectomy. Accordingly, this treatment has become more readily available for treating functioning or non-functioning adrenal masses. Thus, endocrinologists need a better understanding of percutaneous RFA of adrenal tumors. The purpose of this review is to briefly describe the basic mechanism of RFA, indications and contraindications, patient preparation prior to RFA, type of complications, how to avoid complications, RFA procedures, and treatment outcomes.

Citations

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Byung Kwan Park, Jae Hyeon Kim, Young Lyun Oh, Jung-Han Kim
Journal of Vascular and Interventional Radiology.2026; 37(9): 108894. CrossRef
Endoscopic, ultrasound-guided, radiofrequency ablation of aldosterone-producing adenomas (FABULAS): a UK, multicentre, prospective, proof-of-concept trial
Giulia Argentesi, Xilin Wu, Alexander Ney, Emily Goodchild, Kate Laycock, Yun-Ni Lee, Russell Senanayake, James MacFarlane, Elisabeth Ng, Jessica Kearney, Sam O'Toole, Jackie Salsbury, Nick Carroll, Daniel Gillett, John A Tadross, Alison Marker, Edmund M
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Speculating suitability of partial adrenalectomy for lateralized primary aldosteronism: With emphasis on partial and complete success as optimistic outcomes
Tsae-Ni Lee, Chin-Chen Chang, Jeff S. Chueh, Chi-Shin Tseng, Vin-Cent Wu, Kang-Yung Peng, Po-Lung Yang, Shuo-Meng Wang, Vin-Cent Wu, Tai-Shuan Lai, Shih-Chieh Jeff Chueh, Shao-Yu Yang, Kao-Lang Liu, Chin-Chen Chang, Bo-Chiag Lee, Shuo-Meng Wang, Kuo-How H
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From binary to gradient: EUS-RFA redefines primary aldosteronism therapy
Zhixin Xu, Jing Chang
Hypertension Research.2025; 48(10): 2763. CrossRef
Computed tomography-guided radiofrequency ablation of pheochromocytomas in a small case series with von Hippel–Lindau disease: treatment safety and outcomes
Byung Kwan Park
Abdominal Radiology.2025; 51(5): 2569. CrossRef
Clinical Features and Etiology of Recurrent Hypertension after Adrenalectomy
Xilan Dong, Qianhui Ling, Jin Bian, Yuehua Li, Mengjia Chen, Sufang Hao, Wenjun Ma, Huimin Zhang, Jun Cai, Ying Lou
Cardiovascular Innovations and Applications.2024;[Epub] CrossRef
Short-term outcome of adrenal radiofrequency ablation of adrenal cysts: a single-center experience
Shin Jeong Pak, Yu-mi Lee, Pyo Nyun Kim, Byung-Chang Kim, Jae Won Cho, Won Woong Kim, Tae-Yon Sung, Ki-wook Chung, Suck Joon Hong
Scientific Reports.2023;[Epub] CrossRef
Case report of trans-renal ablation procedures for a recurrent pheochromocytoma in von Hippel-Lindau disease
Byung Kwan Park
Precision and Future Medicine.2023; 7(2): 90. CrossRef
Efficacy and safety of radiofrequency ablation in the treatment of inoperable patients with pulmonary malignant nodules
Peng Qie, Xuejiao Xun, Xiaodong Nie, Qifan Yin, Hongshang Cui, Lijun Liu, Huien Wang
ANZ Journal of Surgery.2023; 93(12): 2969. CrossRef
2023 Korean Endocrine Society Consensus Guidelines for the Diagnosis and Management of Primary Aldosteronism
Jeonghoon Ha, Jung Hwan Park, Kyoung Jin Kim, Jung Hee Kim, Kyong Yeun Jung, Jeongmin Lee, Jong Han Choi, Seung Hun Lee, Namki Hong, Jung Soo Lim, Byung Kwan Park, Jung-Han Kim, Kyeong Cheon Jung, Jooyoung Cho, Mi-kyung Kim, Choon Hee Chung
Endocrinology and Metabolism.2023; 38(6): 597. CrossRef
Minimally invasive techniques in benign and malignant adrenal tumors
Ahmet Bulent Dogrul, Omer Cennet, Anıl Hilmi Dincer
World Journal of Clinical Cases.2022; 10(35): 12812. CrossRef
Asian Conference on Tumor Ablation Guidelines for Adrenal Tumor Ablation
Byung Kwan Park, Masashi Fujimori, Shu-Huei Shen, Uei Pua
Endocrinology and Metabolism.2021; 36(3): 553. CrossRef
The role and place of mini-invasive methods of local tumor destruction in adrenal gland surgery
I.A. Kurganov, D.Yu. Bogdanov, S.I. Emelyanov, M.Sh. Mamistvalov
Endoskopicheskaya khirurgiya.2021; 27(6): 43. CrossRef

Original Articles

Clinical Study
Effectiveness of Injecting Cold 5% Dextrose into Patients with Nerve Damage Symptoms during Thyroid Radiofrequency Ablation: Min Kyoung Lee, Jung Hwan Baek, Sae Rom Chung, Young Jun Choi, Yu-Mi Lee, Tae Yong Kim, Jeong Hyun Lee; Endocrinol Metab. 2020;35(2):407-415. Published online June 24, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.2.407

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Background
Although radiofrequency ablation (RFA) is a safe treatment for thyroid tumors, nerve damage is a frequent complication. A previous retrospective study suggested that an injection of cold 5% dextrose in water (5% DW) can reduce nerve damage during RFA. This study validated the efficacy of injecting cold 5% DW for management of nerve damage during RFA.
Methods
Between November 2017 and December 2018, 242 patients underwent 291 RFA sessions for treatment of benign thyroid nodules or recurrent thyroid cancers. Using a standardized technique, cold (0°C to 4°C) 5% DW was immediately injected around the damaged nerve into patients with any symptoms suggesting nerve damage. The incidence of nerve damage, the volume of 5% DW injected, symptom recovery time and the incidence of permanent nerve damage were evaluated.
Results
Nineteen patients experienced nerve damage symptoms related to 21 RFA sessions, including 17 patients during 19 sessions and two patients on the day after two sessions. Patients with nerve damage symptoms detected during RFA were treated by injection of a mean 41 mL (range, 3 to 260) cold 5% DW, but the two patients who experienced symptoms the next day did not receive cold 5% DW injections. Immediate recovery was observed after 15 RFA sessions in 14 patients. No patient experienced permanent nerve damage.
Conclusion
Injection of cold 5% DW is effective in managing nerve damage during RFA of thyroid lesions.

Citations

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Vocal Fold Immobility After Radiofrequency Ablation of Thyroid Nodules: A Survey of Laryngologists and an Algorithm for Periprocedural Voice Assessment
Vaninder Kaur Dhillon, Catherine Fiona Sinclair
Head & Neck.2026; 48(3): 821. CrossRef
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P.-Y. Marcy, A. Dohan, H. Sharara, G. Russ, P.-Y. Marcy, P. Papadopoulos, N. Villard, F. Ridouani, A. Muller, A. Dohan, A. Varoquaux, M. Sapoval, A. Lesnik, C. Aubé, J. Frandon, M. Tassart, F. Benoudiba, C. Lions, J.-P. Beregi
Journal d'imagerie diagnostique et interventionnelle.2026; 9(4): 182. CrossRef
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Shuangshuang Zhao, Jiayan Bao, Xincai Wu, Zheng Zhang, Yanwei Chen, Yun Cai, Wenjun Li, Jiwen Qian, Xin Zhang, Baoding Chen
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Radiofrequency Ablation for Recurrent Thyroid Cancers: 2025 Korean Society of Thyroid Radiology Guideline
Eun Ju Ha, Min Kyoung Lee, Jung Hwan Baek, Hyun Kyung Lim, Hye Shin Ahn, Seon Mi Baek, Yoon Jung Choi, Sae Rom Chung, Ji-hoon Kim, Jae Ho Shin, Ji Ye Lee, Min Ji Hong, Hyun Jin Kim, Leehi Joo, Soo Yeon Hahn, So Lyung Jung, Chang Yoon Lee, Jeong Hyun Lee,
Korean Journal of Radiology.2025; 26(1): 10. CrossRef
Complications in chemical and thermal ablation of parathyroid lesions: a systematic review and meta-analysis
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European Radiology.2025; 35(12): 7738. CrossRef
Long-Term Outcomes of Radiofrequency Ablation in Patients with Low-Risk Papillary Thyroid Microcarcinoma
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Endocrinology and Metabolism.2025; 40(3): 385. CrossRef
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Clinical Study
Revisiting Rupture of Benign Thyroid Nodules after Radiofrequency Ablation: Various Types and Imaging Features: Sae Rom Chung, Jung Hwan Baek, Jin Yong Sung, Ji Hwa Ryu, So Lyung Jung; Endocrinol Metab. 2019;34(4):415-421. Published online December 23, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.4.415

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Background

To evaluate the imaging features, clinical manifestations, and prognosis of patients with thyroid nodule rupture after radiofrequency ablation (RFA).

Methods

The records of 12 patients who experienced thyroid nodule rupture after RFA at four Korean thyroid centers between March 2010 and July 2017 were retrospectively reviewed. Clinical data evaluated included baseline patient characteristics, treatment methods, initial presenting symptoms, imaging features, treatment, and prognosis.

Results

The most common symptoms of post-RFA nodule rupture were sudden neck bulging and pain. Based on imaging features, the localization of nodule rupture was classified into three types: anterior, posterolateral, and medial types. The anterior type is the most often, followed by posterolateral and medial type. Eight patients recovered completely after conservative treatment. Four patients who did not improve with conservative management required invasive procedures, including incision and drainage or aspiration.

Conclusion

Thyroid nodule rupture after RFA can be classified into three types based on its localization: anterior, posterolateral, and medial types. Because majority of thyroid nodule ruptures after RFA can be managed conservatively, familiarity with these imaging features is essential in avoiding unnecessary imaging workup or invasive procedures.

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Clinical Study
Does Radiofrequency Ablation Induce Neoplastic Changes in Benign Thyroid Nodules: A Preliminary Study: Su Min Ha, Jun Young Shin, Jung Hwan Baek, Dong Eun Song, Sae Rom Chung, Young Jun Choi, Jeong Hyun Lee; Endocrinol Metab. 2019;34(2):169-178. Published online May 15, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.2.169

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Abstract PDF Supplementary Material PubReader ePub

Background

To evaluate the clinical feasibility of radiofrequency ablation (RFA) of benign thyroid nodules along with cytomorphological alteration, and any malignant transformation through biopsy.

Methods

The data were retrospectively collected between April 2008 and June 2013 and core needle biopsy (CNB) was performed on 16 benign thyroid nodules previously treated using RFA. The parameters of the patients were compared, between the time of enrollment and the last follow-up examination, using linear mixed model statistical analysis.

Results

No atypical cells or neoplastic transformation were detected in the undertreated peripheral portion of treated benign nodules on the CNB specimen. RFA altered neither the thyroid capsule nor the thyroid tissue adjacent to the treated area. On histopathological examinations, we observed 81.2% acellular hyalinization, which was the most common finding. After a mean follow-up period of over 5 years, the mean volume of thyroid nodule had decreased to 6.4±4.2 mL, with a reduction rate of 81.3%±5.8% (P<0.0001).

Conclusion

RFA is a technically feasible treatment method for benign thyroid nodules, with no carcinogenic effect or tissue damage of the normal thyroid tissue adjacent to the RFA-treated zone.

Citations

Citations to this article as recorded by

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