Emerging treatments
Percutaneous ethanol injection
This has been studied as a therapy for subclinically or overtly hyperfunctioning thyroid nodules.[50] Patients with smaller nodules (<15 mL) may respond more favorably than those with larger nodules. Decrease in nodule size may occur, but multiple injection sessions (2-16) were needed, and recurrence of thyrotoxicosis is common. Use of this technique has been confined to centers with expertise, and has not become widespread in the US, being most applicable to patients who are not candidates for standard therapies.[51]
Radiofrequency ablation
This has been examined as a therapy for subclinically or overtly hyperfunctioning thyroid nodules.[50][52] It appears to be more effective than treatment with laser thermal ablation at decreasing nodule volumes. Regrowth of hyperfunctioning thyroid nodules has been reported if nodule margins are incompletely ablated. This treatment is currently only performed in selected centers.
Laser thermal ablation
This has been used successfully to normalize thyroid function in some patients with autonomous nodules, although multiple treatments may be required.[50] A meta-analysis has found laser ablation to be less effective than radiofrequency ablation at decreasing benign nodule volume.[53] This treatment is currently only performed in selected centers, and use is not widespread.
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