{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T22:19:39Z","timestamp":1780352379641,"version":"3.54.1"},"reference-count":37,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T00:00:00Z","timestamp":1664409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002608","name":"Bite Me Cancer and facilitated by the American Thyroid Association","doi-asserted-by":"publisher","award":["THYROIDGRANT2021-0000000232"],"award-info":[{"award-number":["THYROIDGRANT2021-0000000232"]}],"id":[{"id":"10.13039\/100002608","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Tulane University Bridge Fund","award":["THYROIDGRANT2021-0000000232"],"award-info":[{"award-number":["THYROIDGRANT2021-0000000232"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Thyroid nodules can be classified as benign, malignant, or indeterminate, the latter of which make up 10\u201330% of nodules. Radiofrequency ablation (RFA) has become an attractive and promising therapy for the treatment of benign thyroid nodules. However, few studies have investigated the safety and efficacy of RFA for the management of indeterminate thyroid nodules. In this study, 178 patients with thyroid nodules diagnosed as benign (Bethesda II) or indeterminate (Bethesda III\/IV) by preoperative cytopathological analysis were included. Patients in the benign and indeterminate cohorts had similar thyroid nodule volume reduction rates at 65.60% and 64.20%, respectively (p = 0.68). The two groups had similar nodular regrowth rates, at 11.2% for benign nodules and 9.40% for indeterminate nodules (p = 0.72). A total of three cases of transient dysphonia were reported. RFA of indeterminate thyroid nodules was comparable to that of benign thyroid nodules in all parameters of interest, including volume reduction rate. To our best knowledge, our work is the first North American analysis comparing benign and indeterminate thyroid nodules and suggests RFA to be a promising modality for the management of indeterminate thyroid nodules.<\/jats:p>","DOI":"10.3390\/ijms231911493","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T21:03:10Z","timestamp":1664485390000},"page":"11493","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Radiofrequency Ablation of Indeterminate Thyroid Nodules: The First North American Comparative Analysis"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5248-3142","authenticated-orcid":false,"given":"Peter P.","family":"Issa","sequence":"first","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Omar","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad P.","family":"Issa","sequence":"additional","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusef","family":"Buti","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA"},{"name":"Department of Surgery, United Health Services Southern California Medical Education Consortium, Temecula Valley Hospital, Temecula, CA 92592, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Hussein","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Aboueisha","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Abdelhady","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Shama","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7648-4150","authenticated-orcid":false,"given":"Grace S.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, Yale University, New Haven, CT 06520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9267-3787","authenticated-orcid":false,"given":"Eman","family":"Toraih","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA"},{"name":"Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Kandil","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"ref_1","first-page":"282","article-title":"Fine-Needle Aspiration Biopsy of the Thyroid Gland","volume":"118","author":"Dean","year":"2015","journal-title":"Endotext Internet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1159\/000339959","article-title":"The Bethesda System for Reporting Thyroid Cytopathology: A Meta-Analysis","volume":"56","author":"Bongiovanni","year":"2012","journal-title":"Acta Cytol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1089\/thy.2015.0020","article-title":"2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer","volume":"26","author":"Haugen","year":"2016","journal-title":"Thyroid"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1245\/s10434-018-6421-x","article-title":"Reasons Associated with Total Thyroidectomy as Initial Surgical Management of an Indeterminate Thyroid Nodule","volume":"25","author":"Angell","year":"2018","journal-title":"Ann. Surg. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S105","DOI":"10.21037\/gs.2019.01.03","article-title":"Surgical Management of Cytologically Indeterminate Thyroid Nodules","volume":"8","author":"Almquist","year":"2019","journal-title":"Gland Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1016\/j.amjsurg.2015.08.011","article-title":"Outcomes of Thyroidectomy from a Large California State Database","volume":"210","author":"Weiss","year":"2015","journal-title":"Am. J. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"632","DOI":"10.3348\/kjr.2018.19.4.632","article-title":"2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology","volume":"19","author":"Kim","year":"2018","journal-title":"Korean J. Radiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3949","DOI":"10.1210\/jc.2013-1806","article-title":"Nonsurgical, Image-Guided, Minimally Invasive Therapy for Thyroid Nodules","volume":"98","author":"Gharib","year":"2013","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"R133","DOI":"10.1530\/EJE-13-0917","article-title":"Diagnosis of Endocrine Disease: Thyroid Ultrasound (US) and US-Assisted Procedures: From the Shadows into an Array of Applications","volume":"170","author":"Papini","year":"2014","journal-title":"Eur. J. Endocrinol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2564","DOI":"10.1245\/s10434-011-1619-1","article-title":"Inoperable Symptomatic Recurrent Thyroid Cancers: Preliminary Result of Radiofrequency Ablation","volume":"18","author":"Park","year":"2011","journal-title":"Ann. Surg. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"W331","DOI":"10.2214\/AJR.10.5345","article-title":"Locoregional Control of Metastatic Well-Differentiated Thyroid Cancer by Ultrasound-Guided Radiofrequency Ablation","volume":"197","author":"Baek","year":"2011","journal-title":"Am. J. Roentgenol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1001\/jamaoto.2021.4381","article-title":"Assessment of Radiofrequency Ablation for Papillary Microcarcinoma of the Thyroid: A Systematic Review and Meta-Analysis","volume":"148","author":"Coerts","year":"2022","journal-title":"JAMA Otolaryngol. Neck Surg."},{"key":"ref_13","first-page":"931","article-title":"Radiofrequency Ablation of Small Follicular Neoplasms: Initial Clinical Outcomes","volume":"33","author":"Ha","year":"2017","journal-title":"Int. J. Hyperth."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Mansur, A., Garg, T., Shrigiriwar, A., Etezadi, V., Georgiades, C., Habibollahi, P., Huber, T.C., Camacho, J.C., Nour, S.G., and Sag, A.A. (2022). Image-Guided Percutaneous Ablation for Primary and Metastatic Tumors. Diagnostics, 12.","DOI":"10.3390\/diagnostics12061300"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"638880","DOI":"10.3389\/fendo.2021.638880","article-title":"Predictor Analysis in Radiofrequency Ablation of Benign Thyroid Nodules: A Single Center Experience","volume":"12","author":"Bisceglia","year":"2021","journal-title":"Front. Endocrinol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"244","DOI":"10.14366\/usg.15083","article-title":"Radiofrequency Ablation of Benign Thyroid Nodules: Evaluation of the Treatment Efficacy Using Ultrasonography","volume":"35","author":"Ahn","year":"2016","journal-title":"Ultrasonography"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2447","DOI":"10.1007\/s00268-019-05044-5","article-title":"Radiofrequency Ablation for Benign Thyroid Nodules: 1-Year Follow-up in 184 Patients","volume":"43","author":"Vuong","year":"2019","journal-title":"World J. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1089\/thy.2017.0500","article-title":"The 2017 Bethesda System for Reporting Thyroid Cytopathology","volume":"27","author":"Cibas","year":"2017","journal-title":"Thyroid"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1089\/thy.2013.0317","article-title":"Malignancy Rate in Thyroid Nodules Classified as Bethesda Category III (AUS\/FLUS)","volume":"24","author":"Ho","year":"2014","journal-title":"Thyroid"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/BF03346587","article-title":"American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules: Executive Summary of Recommendations","volume":"33","author":"Gharib","year":"2010","journal-title":"J. Endocrinol. Investig."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.3174\/ajnr.A4276","article-title":"Treatment of Benign Thyroid Nodules: Comparison of Surgery with Radiofrequency Ablation","volume":"36","author":"Che","year":"2015","journal-title":"Am. J. Neuroradiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1080\/02656736.2019.1708480","article-title":"Ultrasound-Guided Radiofrequency Ablation for Papillary Thyroid Microcarcinoma: A Retrospective Analysis of 198 Patients","volume":"37","author":"Wu","year":"2020","journal-title":"Int. J. Hyperth."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1097\/SLA.0000000000005594","article-title":"Efficacy and Safety of Radiofrequency Ablation of Thyroid Nodules: A Multi-Institutional Prospective Cohort Study","volume":"276","author":"Kandil","year":"2022","journal-title":"Ann. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1080\/02656736.2021.1912414","article-title":"Radiofrequency Ablation for Treatment of Thyroid Follicular Neoplasm with Low SUV in PET\/CT Study","volume":"38","author":"Lin","year":"2021","journal-title":"Int. J. Hyperth."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1089\/thy.2019.0420","article-title":"Patients\u2019 View on the Management of Papillary Thyroid Microcarcinoma: Active Surveillance or Surgery","volume":"30","author":"Yoshida","year":"2020","journal-title":"Thyroid"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"576576","DOI":"10.1155\/2015\/576576","article-title":"Surgical and Pathological Changes after Radiofrequency Ablation of Thyroid Nodules","volume":"2015","author":"Dobrinja","year":"2015","journal-title":"Int. J. Endocrinol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1080\/02656736.2020.1825835","article-title":"Residual Vital Ratio: Predicting Regrowth after Radiofrequency Ablation for Benign Thyroid Nodules","volume":"37","author":"Yan","year":"2020","journal-title":"Int. J. Hyperth."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1089\/thy.2020.0202","article-title":"Five-Year Results of Radiofrequency and Laser Ablation of Benign Thyroid Nodules: A Multicenter Study from the Italian Minimally Invasive Treatments of the Thyroid Group","volume":"30","author":"Bernardi","year":"2020","journal-title":"Thyroid"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1002\/bjs.4814","article-title":"Conventional Bilateral Cervical Exploration versus Open Minimally Invasive Parathyroidectomy under Local Anaesthesia for Primary Hyperparathyroidism","volume":"92","author":"Bergenfelz","year":"2005","journal-title":"J. Br. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1148\/radiol.11110416","article-title":"Complications Encountered in the Treatment of Benign Thyroid Nodules with US-Guided Radiofrequency Ablation: A Multicenter Study","volume":"262","author":"Baek","year":"2012","journal-title":"Radiology"},{"key":"ref_31","first-page":"752","article-title":"Radiofrequency Ablation of Thyroid Nodules: Prospective Cost-Effectiveness Analysis in Comparison to Conventional Thyroidectomy","volume":"65","author":"Schalch","year":"2021","journal-title":"Arch. Endocrinol. Metab."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3233\/CH-15120","article-title":"Comparison of Ultrasound Guided Percutaneous Radiofrequency Ablation and Open Thyroidectomy in the Treatment of Low-Risk Papillary Thyroid Microcarcinoma: A Propensity Score Matching Study","volume":"80","author":"Zhang","year":"2021","journal-title":"Clin. Hemorheol. Microcirc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1089\/thy.2009.0274","article-title":"The Bethesda System for Reporting Thyroid Cytopathology","volume":"19","author":"Cibas","year":"2009","journal-title":"Thyroid"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1089\/thy.2018.0604","article-title":"Image-Guided Thyroid Ablation: Proposal for Standardization of Terminology and Reporting Criteria","volume":"29","author":"Mauri","year":"2019","journal-title":"Thyroid"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1007\/s12020-020-02598-6","article-title":"Radiofrequency Ablation and Thyroid Nodules: Updated Systematic Review","volume":"72","author":"Muhammad","year":"2021","journal-title":"Endocrine"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1007\/s40136-020-00321-7","article-title":"Technique and Procedural Aspects of Radiofrequency Ablation of Thyroid Nodules","volume":"9","author":"Hadedeya","year":"2021","journal-title":"Curr. Otorhinolaryngol. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1089\/thy.2007.0274","article-title":"Radiofrequency Ablation for an Autonomously Functioning Thyroid Nodule","volume":"18","author":"Baek","year":"2008","journal-title":"Thyroid"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/19\/11493\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:41:57Z","timestamp":1760143317000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/19\/11493"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,29]]},"references-count":37,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["ijms231911493"],"URL":"https:\/\/doi.org\/10.3390\/ijms231911493","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,29]]}}}