NICE publishes guidance supporting use of percutaneous ultrasound-guided microwave ablation for benign thyroid nodules


holmium-166Terumo Europe has announced in a press release that it welcomes the guidance released by the National Institute for Health and Care Excellence (NICE) mentioning that microwave ablation can be used provided standard arrangements are in place for clinical governance, consent, and audit. This has the potential to broaden access to minimally invasive alternatives to surgery available to patients with symptomatic benign thyroid nodules. 

The guidance describes ultrasound-guided percutaneous microwave ablation for symptomatic benign thyroid nodules as a minimally invasive procedure that can be performed in an outpatient setting using local anaesthesia. The aim is to reduce symptoms and improve cosmetic appearance by making the nodule smaller while preserving thyroid function, and with fewer complications than surgery.

This guidance is part of NICE’s interventional procedure programme which considers whether interventional procedures are safe and work well enough for wider use in the NHS. A comprehensive review of the literature and consultations with clinical experts and patient representatives informed the decision.

This is a positive endorsement of the treatment and a complement to the 2020 European Thyroid Association clinical practice guideline for the use of image-guided ablation in benign thyroid nodules.

The NICE document also reports that using uncooled microwave ablation devices means thinner needles can be used.

“Nowadays microwave technology is widely used in liver, lung, and kidney ablation” says Eduardo Crespo, chief of the radiology department at Hospital Universitario Fundación Jimenez Diaz (Madrid, Spain). “So far, the main gap to approach thyroid ablation has been the lack of thinner and shorter probes, to avoid potential damage to the adjacent nerves, which could lead to complications. Within the TATOpro antennae range, Terumo Interventional Systems introduced a dedicated thyroid antenna as thin as 18G with a length of 8 cm, to be used at limited power. Moreover, a 17G antenna is also available to treat larger nodules in one session, avoiding the need for patients to come back for multiple treatments.”


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