ReviewLa Radiologia medica2026
The evolution of image-guided ablations for thyroid disorders: a historical review.
Review in La Radiologia medica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Over the past four decades, the management of thyroid nodules and selected thyroid malignancies has progressively shifted from surgery-centered approaches toward image-guided minimally invasive treatments (MITT). What began in 1985 with ultrasound-guided percutaneous ethanol injection evolved into a range of energy-based techniques, including laser ablation (LA), radiofrequency ablation (RFA), microwave ablation (MWA), and high-intensity focused ultrasound (HIFU).This historical review aimed to reconstruct the major milestones in the development of image-guided thyroid ablation. A systematic PubMed literature search and predefined selection criteria were used to identify seminal studies, first clinical applications, major technological innovations, comparative studies, guideline-defining publications, and landmark long-term follow-up studies. Overall, 43 milestone papers were included for qualitative historical analysis. The evolution of thyroid ablation can be divided into five phases: conceptual origins (1985-1999), birth of the thermal procedures' era (2000-2006), methodological standardization (2007-2012), oncologic consolidation and comparative evidence (2013-2018), and final codification by means of international guideline endorsement and long-term validation (2019-2025). Recent 10-year follow-up studies have confirmed the durable efficacy of MITT for benign nodule management and their sustained oncologic control in low-risk papillary thyroid microcarcinoma. Image-guided thyroid ablation has transitioned from experimental innovation to an evidence-based, guideline-supported therapeutic domain, representing a paradigm shift toward precision medicine, organ preservation, and minimally invasive endocrine oncology.
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