{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T05:01:19Z","timestamp":1780290079890,"version":"3.54.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Approximately 10\u201312% of thyroid nodule radiofrequency ablations (RFA) result in failure or regrowth, particularly for nodules larger than 20\u201330 mL. Adjustable-tip needles (ATN) have recently been introduced to allow tailored heat distribution, although current literature does not demonstrate clear advantages over fixed-tip needles (FTN). This study aimed to assess the efficacy of ATNs in nodules with baseline volume &amp;gt;20 mL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, monocentric observational study included 75 patients (38 FTN, 37 ATN) who underwent RFA for benign thyroid nodules &amp;gt;20 mL, with at least 12 months of follow-up. All patients had confirmed cytological benignity, negative serum calcitonin, normal thyroid function, and ENT evaluation. Technical parameters (energy, duration), volume reduction ratio (VRR), and Compressive\/Cosmetic scores were collected at 1, 6, and 12 months. Therapeutic success was defined as VRR \u226550%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ATNs yielded greater and sustained volume reduction (VRR at 12 months: 60.5% vs 52.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004; final volume: 14.1 vs 18.4 mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.012; AUC\n                      <jats:sub>VRR<\/jats:sub>\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.019; AUC\n                      <jats:sub>Vol<\/jats:sub>\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.040), with a progressive time-related effect (\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>GROUP: TIME<\/jats:sub>\n                      = 0.001; \u03b2 = 1.12). ATNs were associated with higher 12-month success rates (84% vs 55%, OR 4.18 (1.42\u201312.35),\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.015). Energy deposition was significantly higher. The volumetric cutoff for achieving 75% success shifted from 35 mL (FTN) to 80 mL (ATN).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In benign thyroid nodules &amp;gt;20 mL, RFA with ATNs proved more effective than FTNs, thanks to a higher energy deposition. This could suggest a shift in the eligibility threshold for RFA up to 80 mL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1832999","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T04:19:27Z","timestamp":1780287567000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving radiofrequency ablation outcomes in large thyroid nodules: superiority of adjustable tip needles"],"prefix":"10.3389","volume":"17","author":[{"given":"Mattia","family":"Rossi","sequence":"first","affiliation":[{"name":"Endocrinology, Diabetology and Metabolism, AO Ordine Mauriziano di Torino","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Voena","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Medical Sciences, University of Turin","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Lucatello","sequence":"additional","affiliation":[{"name":"Endocrinology, Diabetology and Metabolism, AO Ordine Mauriziano di Torino","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Ragazzoni","sequence":"additional","affiliation":[{"name":"Endocrinology, Diabetology and Metabolism, AO Ordine Mauriziano di Torino","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Retta","sequence":"additional","affiliation":[{"name":"Endocrinology, Diabetology and Metabolism, AO Ordine Mauriziano di Torino","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefina","family":"Ramunni","sequence":"additional","affiliation":[{"name":"Endocrinology, Diabetology and Metabolism, AO Ordine Mauriziano di Torino","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Mormile","sequence":"additional","affiliation":[{"name":"Endocrinology, Diabetology and Metabolism, AO Ordine Mauriziano di Torino","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurilio","family":"Deandrea","sequence":"additional","affiliation":[{"name":"Endocrinology, Diabetology and Metabolism, AO Ordine Mauriziano di Torino","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1530\/ETJ-23-0067","article-title":"2023 European Thyroid Association Clinical Practice Guidelines for thyroid nodule management","volume":"12","author":"Durante","year":"2023","journal-title":"Eur Thyroid J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4158\/ep161208.gl","article-title":"American 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