Inside access By Lorant Szabo, MD, EBIR
Radiofrequency Ablation in the Management of Extensive Multinodular Goiter: A Midterm Single-Center Experience
Szabo, Lorant et al. JVIR;36(10):1597 - 1604
Read the full article on
jvir.org.
Tell us about you, your team, and your institution. Lorant Szabo, MD, EBIR: I am an interventional radiologist with eight years of experience in both vascular and nonvascular procedures. Our center is part of a tertiary care private hospital with a strong focus on a wide range of interventional treatments, including endovascular and percutaneous image-guided procedures. We work in close collaboration with endocrinology and endocrine surgery, particularly in the management of thyroid disorders.
Since 2016, our team has performed minimally invasive thyroid interventions, with extensive experience in image- guided ablation—especially for benign thyroid nodules and multinodular goiter. The team includes interventional radiologists supported by endocrine specialists who assist with patient selection and provide longitudinal care, including structured follow-up over 12 to 24 months.
Why did you pursue this topic? Dr. Szabo: Multinodular goiter is a common condition, particularly in iodine-deficient areas, and traditional
Patient feedback has been overwhelmingly positive. Many were relieved to avoid surgery and the risks associated with general anesthesia, including potential complications such as hypoparathyroidism or vocal cord paralysis. They also appreciated the short recovery time and the preservation of thyroid function.
treatments—such as surgery or radioiodine therapy—are not always feasible or preferred by patients. We were driven by the need for minimally invasive alternatives, especially for patients who are not surgical candidates or who decline surgery. While radiofrequency ablation (RFA) has shown excellent outcomes for isolated nodules, its role in treating large, complex multinodular goiters had not been well established. Our aim was to assess whether RFA could serve as a safe and effective alternative to total thyroidectomy in appropriately selected patients.
What are the key takeaways from your research? Dr. Szabo: RFA can achieve substantial and sustained volume reduction in large, symptomatic multinodular goiters—even in patients who would otherwise be surgical candidates.
Most patients experienced durable symptom relief and improved cosmetic
outcomes, with a low complication rate. A staged treatment approach and selective retreatment of incompletely ablated or growing nodules can optimize long-term results. Thyroid function was preserved in all treated patients, including those with toxic nodules, who returned to a euthyroid state without surgery.
How might this research influence treatment, practice, or clinical processes in interventional radiology? Dr. Szabo: Our findings support RFA as a viable, minimally invasive alternative to surgery for selected patients with benign multinodular goiter. This could broaden the scope of interventional radiology in thyroid disease management, particularly for patients who are poor surgical candidates or prefer to avoid lifelong thyroid hormone replacement. We anticipate that dedicated thyroid ablation programs may become more common, with
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