Abstract

Background: Predominantly cystic thyroid nodules (PCTNs) account for a significant proportion of benign thyroid nodules, often requiring intervention due to cosmetic concerns and compressive symptoms. Radiofrequency ablation (RFA) has emerged as a promising minimally invasive alternative to surgery, offering substantial volume reduction and low complication rates.

Objective: To evaluate the efficacy and safety of single-session RFA for PCTNs in a Vietnamese cohort over a 12-month follow-up period.

Methods: This prospective study included 28 patients with PCTNs (50-90% cystic component) treated at the Family Hospital in Da Nang, Vietnam, from June 2023 to April 2025. Primary outcomes included volume reduction rate (VRR) and therapeutic success (VRR > 50%), assessed at 1, 6, and 12 months post-RFA. Thyroid function stability and complication rates were also evaluated.

Results: RFA demonstrated significant volume reduction, with mean VRR improving from 61.5% at 1 month to 81.8% at 12 months (p=0.006). The therapeutic success rate increased from 75% at 1 month to 94.7% at 6 months, maintaining 84.6% at 12 months (p<0.002). No major complications were reported, and thyroid function remained stable throughout the follow-up.

Conclusion: Single-session RFA is a safe and effective minimally invasive treatment for PCTNs, providing substantial volume reduction without major complications. This approach is particularly suitable for patients who decline surgery or have contraindications to surgical intervention. However, longer-term studies are required to assess durability and recurrence rates.