TABLE 2.
Clinical guidelines and recommendations for benign thyroid nodules
| European Thyroid Association (ETA) 77 | Korean Society of Thyroid Radiology (KSThR) 62 | Italian Working Group on Minimally Invasive Treatments of the Thyroid (MITT) 78 | Austrian thyroid associations 79 | Italian scientific societies 80 | |
|---|---|---|---|---|---|
| Thermal ablation for compressive or cosmetic reasons. | Yes | Yes | Yes | Yes | Yes |
| Benign cytopathology confirmation | Yes | Yes | Yes | Yes | Yes |
| First line treatment for AFTN | Radioiodine (RI) or surgery | RI or surgery | RI or surgery | RI or surgery | RFA plus RI if volume > 20 mL (weak recommendation) |
| First line treatment for cystic or predominantly cystic nodules. | Ethanol ablation (TA only if relapse or residual large solid component) | EA | EA | EA | EA |
| First line TA for solid nodules. | RFA or LA | RFA | NA | RFA superior to LA | RFA |
| RFA and nodule's size | NA | Growing nodule >2 cm | NA | Limited or no indication for solid or mixed >30 mL (single intervention) and AFTN > 15 mL | Solid nodules with volume > 20 mL |
| Trans‐isthmic approach and the moving‐shot technique for RFA | Yes | Yes | Yes | Yes | Yes |
| Laryngoscopy | Only in patients with hoarseness, previous neck surgery, or with nodules close to critical structures. | NA | NA | All patients before and after RFA | NA |