Efficacy and Safety of Radiofrequency Ablation for Solitary Autonomously Functioning Thyroid Nodules: A Systematic Review and Meta-Analysis
Authors' conclusion
RFA achieves TSH normalization in approximately three-quarters of patients with solitary AFTNs, with an excellent safety profile. Baseline nodule volume may influence treatment success. These findings support RFA as a viable organ-sparing alternative for selected patients.
Study context
- Population
- Patients with solitary autonomously functioning thyroid nodules (AFTNs) treated with ultrasound-guided radiofrequency ablation (RFA), prospective and retrospective studies with minimum 6-month follow-uppatients in fourteen studies, median follow-up 18 months
- Participants
- 514 patients
- Outcome
- TSH normalization rate
Methodological detailsrandom-effects model with the Freeman-Tukey double arcsine transformation, GRADE framework adapted for single-arm proportional meta-analyses
- Random-effects model with the Freeman-Tukey double arcsine transformation
- GRADE framework adapted for single-arm proportional meta-analyses
Pooled result
As reported in the abstract
Pooled TSH normalization rate
76.2%
95% CI 65.7–85.3%
I2
84.7%
Prediction interval
37.1-98.9%
Further pooled results
TSH normalization by nodule volume (subgroup analysis) · higher normalization suggested in nodules <15 mL
P = 0.068
Volume reduction ratio (VRR)
- Pooled VRR
- 80.6% (95% CI: 79.8-81.4%)
Safety
Overall complication rate
- Overall complication rate
- 3.1% (95% CI: 1.5-5.1%)
- I2
- 0%
- No permanent complications reported
- GRADE certainty was moderate for safety
Post-ablation hypothyroidism
- Post-ablation hypothyroidism
- 0.4% (2/514)
Original publication
Efficacy and Safety of Radiofrequency Ablation for Solitary Autonomously Functioning Thyroid Nodules: A Systematic Review and Meta-Analysis. Endocr Pract. Published 10 November 2026. doi:10.
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