on treatment staging, follow-up intervals, and procedural algorithms.
• Structured training programs and closer integration of interventional radiology with endocrine care will be essential to facilitate wider adoption.
Given the favorable long-term outcomes, how do you see the role of RFA evolving in thyroid disease management? What further research would be most valuable? Dr. Szabo: We anticipate that RFA will increasingly be recognized as a first-line option for managing benign thyroid nodules and multinodular goiter, especially in patients who prioritize gland preservation. As long- term data accumulate, its role may expand even further.
Future research priorities include:
• Comparative trials between RFA and surgery or thyroid artery embolization
• Cost-effectiveness analyses
• Optimization of treatment protocols for large-volume goiters
We anticipate that RFA will increasingly be recognized as a first-line option for managing benign thyroid nodules and multinodular goiter, especially in patients who prioritize gland preservation. As long-term data accumulate, its role may expand even further.
improved patient selection protocols and the development of formal treatment guidelines.
What has been the patient response or feedback to RFA for multinodular goiter? Dr. Szabo: 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.
32 IRQ | FALL 2025
What challenges or considerations do you see in adopting RFA into routine practice? Dr. Szabo: Key challenges include:
• Training and experience: Thyroid RFA requires specific technical skills and a thorough understanding of neck anatomy.
• Equipment availability: Not all centers are equipped with RFA generators and thyroid-specific electrodes.
• Patient selection: Careful evaluation with high-resolution ultrasound and endocrine consultation is critical.
• Protocol standardization: There remains a need for broader consensus
Investigation of expanded indications, including selected low-risk thyroid malignancies—such as papillary microcarcinomas, which are already being treated with RFA in some centers.
Any next steps or plans for followup research? Dr. Szabo: Yes. We plan to expand our patient cohort and investigate predictors of successful long-term outcomes, including nodule characteristics and technical parameters. Additionally, we are working on refining staging algorithms to guide treatment planning more effectively.
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