How I Do It: Thyroid and Parathyroid Thermal Ablation.

Li, Jianming; Zheng, Lin; Dou, Jianping; Han, Zhiyu; Liu, Fangyi; Liu, Yang; Liang, Ping · Radiology · 2025

expert_opinion · Level V

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Abstract

Thyroid and parathyroid ablation have gained substantial attention as promising minimally invasive alternatives to surgery. Despite growing evidence supporting their use, standardized ablation protocols remain scarce. This practical guide focuses on the essential aspects of thyroid and parathyroid ablation, including practitioner qualifications, standardized procedures, critical techniques, complication prevention, and evaluation. These areas are emphasized due to the anatomic proximity of the thyroid and parathyroid glands, which results in procedural similarities. Practitioners need proper qualifications before performing thyroid and parathyroid nodule ablation. Doctors interested in conducting these procedures should possess foundational knowledge and undergo prior training. Patient selection should involve multidisciplinary consultations to carefully weigh the advantages and disadvantages of different treatment options. Preprocedural preparations, including anesthetic and technical considerations, are discussed to enhance treatment efficacy and optimize patient safety. The hydrodissection technique is recommended to minimize complications and prevent tissue adhesion. Detailed descriptions of ablation techniques are provided to facilitate understanding and application. Contrast-enhanced US assessment is performed immediately after ablation to evaluate its effectiveness. Management of complications and follow-up practices are also addressed. By outlining the clinical implementation of this technology, this practical guide aims to standardize thyroid and parathyroid ablation, ensuring efficacy and reducing risks.

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