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ObjectiveTo systematically evaluate the efficacy and safety of three-dimensional visualization technology in assisting ablation therapy for hepatocellular carcinoma. MethodsThis study was conducted according to PRISMA guidelines， with a PROSPERO registration number of CRD42023488398. PubMed， Embase， Web of Science， the Cochrane Library， CNKI， Wanfang Data， VIP， and CBM were searched for Chinese and English articles on three-dimensional visualization technology in assisting ablation therapy for hepatocellular carcinoma published up to March 2023. After quality assessment and data extraction of the studies included， RevMan 5.4 software was used to perform the meta-analysis. ResultsA total of 11 studies were included， with 972 patients in total， among whom 447 underwent ablation assisted by three-dimensional visualization technology （3D group） and 525 underwent ablation assisted by traditional two-dimensional imaging technology （2D group）. The meta-analysis showed that compared with the 2D group， the 3D group had significantly higher success rate of first-time ablation treatment （odds ratio ［OR］=5.43， 95% confidence interval ［CI］： 2.64 — 11.18， P<0.001）， technical efficiency （OR=6.15， 95%CI： 3.23 — 11.70， P<0.001）， and complete ablation rate （OR=2.50， 95%CI： 1.08 — 5.78， P=0.03）， as well as significantly lower incidence rate of major complications （OR=0.45， 95%CI： 0.24 — 0.87， P=0.02）， local recurrence rate （OR=0.35， 95%CI： 0.17 — 0.72， P=0.004）， and local tumor progression rate （OR=0.29， 95%CI： 0.16 — 0.50， P<0.001）， while there was no significant difference in the incidence rate of mild complications between the two groups （P>0.05）. ConclusionThree-dimensional visualization technology is safe and feasible in assisting ablation therapy for hepatocellular carcinoma and can improve ablation rate and reduce the incidence rate of serious complications， local recurrence rate， and local tumor progression rate， thereby showing an important application value in clinical practice.
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Objective To compare the value of TACE+microwave ablation(MWA)+programmed death-1(PD-1)and TACE+MWA for treating primary hepatic carcinoma(PHC).Methods Data of 80 PHC patients who underwent TACE+MWA+PD-1(observe group)or TACE+MWA treatment(control group)were retrospectively analyzed(each n=40).The baseline data,therapeutic efficacy of PHC and complications were compared between groups.Results No significant difference of baseline data was found between groups(all P＞0.05).The objective response rate(ORR)of observe group and control group was 90.00％and 72.50％,respectively,while the disease control rate(DCR)was 97.50％and 95.00％,respectively,with no significant difference between groups(both P＞0.05).The median overall survival(OS)of observe group and control group was 30.80 months and 15.70 months,respectively,while the median progression free survival(PFS)was 23.35 months and 6.80 months,respectively.OS and PFS of observe group were both longer than those of control group(both P＜0.05).No significant difference of the incidence of complications was detected between groups(all P＞0.05),and all were improved after symptomatic treatment.Conclusion TACE+MWA+PD-1 was superior to TACE+MWA for treating PHC.
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Objective To observe the value of ultrasound-guided percutaneous ethanol injection(PEI)combined with microwave ablation(MWA)for treating thyroid benign partially cystic masses.Methods A total of 100 patients with single benign partially cystic mass who would undergo ultrasound-guided ablation treatment were prospectively enrolled.The patients were randomly assigned into PEI group(received PEI combined with MWA sequential ablation)or control group(received simple MWA),each n=50.Data before and after treatments were compared within groups,the therapeutic efficacy were compared between groups after treatments,and the value of sequential ablation was analyzed.Results Ultrasound-guided ablation was successfully performed for all 100 masses.During follow-up,5 cases in PEI group and 3 cases in control group were lost.The operation time of MWA,total MWA energy and patients'pain level during treatments in PEI group were all lower than those in control group(all P＜0.05).Significant difference of thyroid mass volumes were found before and 3,6 and 12 months after treatments in both groups(all P＜0.05).The volume reduction rate(VRR)in PEI group before and 1,3,6 and 12 months after treatments were all higher than that in control group(all P＜0.05).The success rate was 95.56％(43/45)in PEI group and 89.36％(42/47)in control group 12 months after treatments,respectively,without significant difference(P=0.451).There were significant differences of neck aesthetics scores and symptom scores before and 3,6 and 12 months after treatments in both groups(all P＜0.05).The incidence of complications in PEI group was 6.67％(3/45),while in control group was 14.89％(7/47),the former was lower than the latter(P＜0.05).Conclusion Ultrasound-guided PEI combined with MWA sequential ablation had better effect for treating thyroid benign partially cystic masses than single MWA.
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Purpose To investigate the safety and effectiveness of ultrasound-guided microwave ablation(MWA)in the treatment of abdominal wall endometriosis(AWE).Materials and Methods A total of 17 patients(19 lesions)with AWE who underwent MWA in Beijing Friendship Hospital from August 2014 to June 2023 were retrospectively analyzed.Grey-scale and color Doppler flow ultrasonography,and contrast-enhanced ultrasonography were used to observe the lesions before and after treatment.The AWE lesion volume,volume reduction rate,pain relief,and complications were recorded 3,6,and 12 months after treatment to evaluate the treatment efficacy.Results Contrast-enhanced ultrasound showed that all lesions underwent successful treatment with single MWA.The average initial nodule volume was(7.46±5.82)ml,which decreased significantly to(4.32±2.76)ml,(2.47±1.68)ml,(1.72±1.16)ml at 3,6 and 12 months follow-up(t=0.423,P=0.005;t=0.198,P=0.001;t=0.556,P=0.002)with a mean volume reduction rate of(46.18±24.36)%,(61.43±18.72)%,(74.25±13.26)%,respectively.Notably,all 17 patients experienced a significant decrease or complete alleviation of periodic abdominal incision pain at 12-month after treatment.One patient experienced local skin burns after the procedure,while the remaining patients did not experience severe complications.Conclusion MWA is safe and effective for treating AWE,and further research is warranted.
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ObjectiveTo investigate the effect of high-frequency irreversible electroporation （H-FIRE） in the ablation of pig pancreatic tissue. MethodsLaparotomy was conducted in this study， and needle electrodes were used to release electric pulses in 12 pigs. Three sets of parameters were established for ablation at the low， medium， and high values of field strength （1 000 V/cm， 1 500 V/cm， and 2 500 V/cm）. The groups were compared in terms of the data including postoperative recovery， ablation area， and histopathological features to validate the safety and efficacy of H-FIRE in the ablation of porcine pancreatic tissue. The paired t-test was used for comparison of continuous data between two groups. ResultsAll pigs in the experiment survived and showed a good effect of ablation. The histopathological analysis of all groups showed thorough and effective ablation， with a clear boundary between the ablated area and the normal tissue area. The mean ablation area in the low， medium， and high field strength groups was 30.96±3.73 mm2， 51.93±25.26 mm2， and 108.90±55.23 mm2， respectively， and the high and medium field strength groups had a significantly larger ablation area than the low field strength group （both P<0.05）， while there was no significant difference in ablation area between the medium and high field strength groups （P>0.05）. ConclusionH-FIRE ablation is safe and effective for porcine pancreatic tissue under specific ablation parameters.
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ABSTRACT There is increasing interest in ultrasound-guided ablation treatments for thyroid diseases, including benign and malignant ones. Surgeons, radiologists, and endocrinologists carry out these treatments, and various organizations within these specialties have recently released multiple international consensus statements and clinical practice standards. The aim of the present consensus statement is to provide guidance, cohesion, and standardization of best practices for thermal ablation procedures of thyroid nodules. The statement includes the indications for these procedures, preprocedural evaluations, technical aspects of the procedures, posttreatment care, follow-up, complications, and training recommendations. This document was written by a panel of specialists from the Brazilian Society of Interventional Radiology and Endovascular Surgery (SOBRICE), the Brazilian Society of Head and Neck Surgery (SBCCP), and the Brazilian Society of Endocrinology and Metabolism (SBEM). The statement does not aim to provide criteria for assessing the capability of specialists to perform the procedure. Instead, it aims to promote the standardization of best practices to reduce potential adverse outcomes. Additionally, it strives to enhance the delivery of high-quality care and the widespread adoption of these technologies on a national level. The recommendations collectively serve as a guidebook for applying best practices in thyroid ablation.
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ABSTRACT Topography-guided ablation was designed to improve corneal regularity throughout the correction of corneal high order aberrations. The present report described three cases with different indications for topography-guided ablation to correct irregular astigmatism. The patients were monitored in the immediate and late postoperative periods to evaluate long-term corneal stabilization. Surgery indications were based on the patient's complaint of poor quality of vision associated with previous radial keratotomy, corneal transplant, or keratoconus. In all three cases, the patients reported an improvement in the quality of their vision and expressed satisfaction with the procedure; however, the patient who had previously been submitted to crosslinking presented with keratoconus progression in the late postoperative period. Finally, topography-guided customized ablation appears to represent a safe and effective technique for reducing corneal irregularities.
RESUMO A ablação guiada por topografia foi projetada para melhorar a regularidade da córnea durante a correção de aberrações de alta ordem da córnea. O presente relato descreveu três casos com diferentes indicações de ablação guiada por topografia para correção de astigmatismo irregular. Os pacientes foram monitorados no pós-operatório imediato e tardio para avaliar a estabilização corneana em longo prazo. As indicações cirúrgicas basearam-se na queixa do paciente de má qualidade de visão associada a ceratotomia radial prévia, transplante de córnea ou ceratocone. Nos três casos, os pacientes relataram melhora na qualidade da visão e manifestaram satisfação com o procedimento; entretanto, o paciente que já havia sido submetido ao crosslinking apresentou progressão do ceratocone no pós-operatório tardio. Finalmente, a ablação personalizada guiada por topografia parece representar uma técnica segura e eficaz para reduzir irregularidades da córnea em córneas não ectásicas.
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Endometrial ablation (EA) is a minimally invasive surgical procedure to reduce abnormal uterine bleeding contemplated for women who have achieved their reproductive goals. EA consists of the destruction of the endometrial layer with preservation of the uterus, although EA has lower complication rates than hysterectomy, it may be associated with metrorrhagia recurrence. One of the major causes of treatment failure is incomplete ablation of the endometrium. Thanks to techniques that have been developed in recent years, endometrial ablation can be performed on an outpatient basis, including by radiofrequency ablation. The main objective of this case series was to report four cases in which Radiofrequency Endometrial Ablation (RFEA) was used to treat abnormal uterine bleeding at a single ambulatory surgical center in Brazil. Hysteroscopic evaluation of the uterine cavity was performed immediately prior to the RFEA to diagnose possible endometrial pathologies and again at the conclusion of the procedure to assess the aspect of the newly treated endometrium. Verification of the completeness of the ablation was assessed by a third hysteroscopy 30 or 60 days after the ablation. In this case series RFEA was efficacious and safe for outpatient use. Although radiofrequency endometrial ablation can be performed without the use of the hysteroscope, we believe it is an important tool for the timely verification of the completeness of the endometrial ablation. (AU)
A ablação endometrial (AE) é um procedimento cirúrgico minimamente invasivo destinado a mulheres com prole estabelecida visando redução do sangramento uterino anormal. A AE consiste na destruição da camada endometrial com a preservação do útero, apesar da AE possuir menores índices de complicação do que a histerectomia, pode estar associada a recorrência do sangramento. Uma das causas da falha de tratamento é a ablação incompleta do endométrio. Atualmente, a ablação endometrial pode ser realizada ambulatorialmente graças às técnicas que vêm sendo desenvolvidas nos últimos anos, as quais incluem o uso de radiofrequência. O objetivo dessa série de casos é descrever 4 casos de Ablação Endometrial por Radiofrequência (AERF) para o tratamento de sangramento uterino anormal realizados em um mesmo ambulatório especializado no Brasil. Uma avaliação histeroscópica da cavidade uterina foi realizada imediatamente antes da AERF para diagnosticar possíveis patologias endometriais e imediatamente ao final do procedimento, para avaliar o aspecto do endométrio recém tratado e a necessidade de nova aplicação de radiofrequência. A integralidade da ablação foi verificada por uma terceira histeroscopia após 30 ou 60 dias depois da ablaçao. A técnica mostrou-se adequada para uso ambulatorial. Embora a ablação endometrial por radiofrequência possa ser realizada sem o uso do histeroscópio, acreditamos que seja uma ferramenta importante para a verificação oportuna da integralidade da ablação endometrial. (AU)
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Odontogenic myxoma is a maxillofacial tumor that is benign in nature. It is characterized by a slow-growing, painless, and site-aggressive behavior. A main feature is that it is not encapsulated so it has high potential of invasiveness and penetration into peripheral tissues. Large lesions may cause extensive compromise of the region. Treatment strategy for Odontogenic Myxoma is still controversial. Radical resection with an appropriate surgical margin is recommended, but emerging evidence has suggested that a more conservative approach will result in less morbidity and adequate results. This report shows a remarkable result on a 16-year-old patient who had a Mandibular Odontogenic Myxoma treated with a conservative approach. Intra-lesional absolute alcohol irrigation was performed during a 5-month period. Considerable volume reduction of the lesion happened which allowed a minimal overall resection. No recurrence was found after a 3 year follow-up.
Subject(s)
Humans , Female , Adolescent , Ablation Techniques/rehabilitation , Myxoma/therapy摘要
Objective To investigate the efficacy and safety of microwave ablation (MWA) combined with chemotherapy versus MWA alone in the treatment of recurrent intrahepatic cholangiocarcinoma (RICC). Methods A retrospective cohort study was conducted among the patients with RICC who received MWA+chemotherapy or MWA in The Second People's Hospital of Neijiang and The Affiliated Hospital of Southwest Medical University from January 2014 to March 2021, and their clinicopathological data were collected. The independent samples t -test was used for comparison of continuous data, and the chi-square test and the Fisher's exact test were used for comparison of categorical data. The Kaplan-Meier method was used to calculate progression-free survival (PFS) and overall survival (OS), and the Log-rank test was used for comparison of survival differences. Univariate and multivariate Cox proportional-hazards regression model analyses were used to investigate the risk factors for survival and prognosis. Results A total of 106 patients with RIC were enrolled, among whom there were 55 patients in the MWA+chemotherapy group and 51 in the MWA group. By the end of follow-up, the MWA+chemotherapy group had a median PFS of 15.0 months (95% confidence interval [ CI ]: 14.5-15.5), and the MWA group had a median PFS of 13.4 months (95% CI : 11.6-15.2), with a significant difference between the two groups ( χ 2 =9.624, P =0.002). The MWA+chemotherapy group had a median OS of 21.0 months (95% CI : 20.0-21.8), and the MWA group had a median OS of 18.0 months (95% CI : 16.3-19.7), with a significant difference between the two groups ( χ 2 =12.784, P 5 cm, time to recurrence < 1 year, and absence of systemic chemotherapy tend to have a poor prognosis.
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Objective To observe the risk factors of recurrence after ultrasound-guided thermal ablation for treating uremia secondary hyperparathyroidism(SHPT).Methods Totally 59 patients with uremia SHPT who underwent ultrasound-guided thermal ablation were enrolled,including 23 cases with(relapse group)and 36 without SHPT recurrence(non relapsed group).Clinical data were compared between groups,univariate and multivariate logistic regression analysis were performed to screen independent risk factors of SHPT recurrence.Results There were significant differences of serum free thyroxine(FT4),urea,intact parathyroid hormone(iPTH)1 day after ablation,1 day decrease rate of iPTH,the maximum diameter of the largest nodule,ablation time,total ablation energy,energy to volume ratio and the proportion of 1 day decrease rate of iPTH≤90%between groups(all P＜0.05).Higher urea,lower energy to volume ratio and 1 day decrease rate of iPTH≤90%were all independent risk factors of SHPT recurrence(all P＜0.05).Conclusion Higher urea,lower energy to volume ratio and 1 day decrease rate of iPTH≤90%were independent risk factors of recurrence after ultrasound-guided thermal ablation for treating uremia SHPT.
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Breast cancer is the most common malignancy of women in China.It seriously affects the quality of life of patients.With the progress of medical technology,minimally invasive treatment has gradually become an important part of breast cancer management.Thermal ablation technology has been proved to have great potential in the treatment of breast cancer.Compared with surgery,it has similar therapeutic effect and more safer.Targeted ablation of breast cancer is expected to become a new treatment mode under the integration of diagnosis and treatment.This article reviews the current status and development trend of thermal ablation therapy for breast cancer.
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Objetivo: El dolor óseo por cáncer óseo o metástasis es un dolor de difícil manejo asociado a dolor incidental. Hay distintas estrategias quirúrgicas para su tratamiento, sin embargo, no todos los pacientes con metástasis óseas pueden beneficiarse de un tratamiento quirúrgico. La presente revisión bibliográfica tiene como objetivo identificar terapias intervencionales mínimamente invasivas para el control del dolor por metástasis óseas. Métodos: Revisión bibliográfica acerca de terapias intervencionales para el control del dolor por metástasis óseas utilizando la base de datos PubMed (www.pubmed.gov) y el motor de búsqueda Google (www.google.cl). Tipos de participantes: Pacientes con metástasis óseas dolorosas de cualquier tumor primario. Tipos de intervenciones: Bloqueos anestésicos, bloqueos neurolíticos, terapias ablativas, cementoplastías. Resultados: Se obtuvieron 384 resultados que incluyeron revisiones sistemáticas, revisiones bibliográficas, ensayos clínicos controlados, series de casos y reporte de casos. Todos los artículos relevantes en inglés y español se incluyeron para su análisis. Conclusión: Las metástasis óseas son un evento común en los pacientes con cáncer, y el dolor óseo es un dolor de difícil manejo asociado a dolor incidental. Se han desarrollado terapias intervencionales no invasivas o mínimamente invasivas para tratar el dolor, mejorar la calidad de vida y la funcionalidad, disminuir el consumo de fármacos, y reducir el tamaño del tumor. La gran mayoría ha demostrado ser terapias seguras y eficaces, con pocos eventos adversos y de rápida resolución, y que si son combinadas mejoran los resultados.
Objective: Bone pain from bone cancer or metastasis is a pain that is difficult to manage associated with incidental pain. There are different surgical strategies for its treatment, however, not all patients with bone metastases can benefit from a surgical treatment. This literature review aims to identify minimally invasive interventional therapies for the control of pain due to bone metastasis. Methods: Literature review of interventional therapies for the control of pain due to bone metastases was done using the PubMed database (www.pubmed.gov) and the Google search engine (www.google.cl). Types of participants: Patients with painful bone metastases from any primary tumor. Types of interventions: Anesthetic blocks, neurolytic blocks, ablative therapies, cementoplasties. Results: We obtained 384 results that included systematic reviews, literature reviews, controlled clinical trials, case series and case reports. All relevant articles in English and Spanish were included for analysis. Conclusion: Bone metastases are a common event in cancer patients, and bone pain is a difficult-to-manage pain associated with incidental pain. Non-invasive or minimally invasive interventional therapies have been developed to treat pain, improve quality of life and functionality, decrease drug use, and reduce tumor size. The vast majority therapies have been shown to be safe and effective ones, with few adverse events and rapid resolution, and that if combined they improve the outcomes.
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Humans , Bone Neoplasms/therapy , Cancer Pain/therapy , Neoplasm Metastasis/therapy , Denervation , Ablation Techniques , Cementoplasty摘要
ABSTRACT Objective: To assess the effect of bladder neck morphology and its incision (BNI) in patients with posterior urethral valve (PUV) on early reintervention rate. Patients and methods: Infants undergoing PUV ablation (PVA) before 24 months of age and had at least 18 months of follow-up, were categorized into three groups according to the bladder neck appearance on baseline radiological and endoscopic examination: group 1; normal bladder neck underwent PVA, group 2; high bladder neck underwent PVA plus BNI, group 3; high bladder neck underwent PVA only. Early reintervention was defined as the need for check cystoscopy because of persistent renal function deterioration, worsening hydronephrosis and/or unsatisfactory VCUG improvement during the 1st six months post primary PVA. Results: Between 2000 and 2017, a total of 114 patients underwent PVA and met the study criteria with a median follow-up of 58 (18-230) months. For group 1, 16 (22.9%) patients needed readmission. Check cystoscopy was free and no further intervention was performed in 5(7.5%) and re-ablation was performed in 11(15.7%) patients. For group 2, 3(14.3%) patients needed reintervention. Re-ablation and re-ablation plus BNI were performed in 1(4.8%) and 2(9.5%), respectively. For group 3, cystoscopy was free in 1(4.3%), re-ablation and re-ablation plus BNI were performed 2(8.7%) and 1(4.3%), respectively. There were no significant differences in the re-admission and re-intervention rates among the three study groups (p=0.65 and p=0.50, respectively). Conclusion: In morphologically high bladder neck associated PUV, concomitant BNI with PVA doesn't reduce early re-intervention rate.
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Objective:To investigate the application value of contrast-enhanced ultrasound (CEUS) before and after microwave ablation of thyroid nodules.Methods:Fifty-six patients (79 thyroid nodules) who received microwave ablation of thyroid nodules in Huaian Medical District, General Hospital of Eastern Theater Command from March 2016 to October 2019 were included in this study. CEUS was performed before microwave ablation to accurately assess the size, number and blood supply of thyroid nodules as well as the position of the feeding vessels. CEUS was performed immediately after microwave ablation to determine whether the lesion area was thoroughly ablated and to measure the volume of thyroid nodules. At 1, 3, 6 and 12 months after surgery, the level of thyroid hormone was measured and the absorption of thyroid nodules was evaluated.Results:Preoperative CEUS showed that among the 79 thyroid nodules, 42 were solid nodules that had different degrees of enhancement, including 33 annular homogeneously highly enhanced nodules and 9 heterogeneously highly enhanced nodules; 24 were cystic mixed solid nodules that had solid components, including 16 homogeneously highly enhanced nodules and 8 nodules with only local high enhancement in the solid component; 13 were cystic nodules, including 9 nodules with septa and 3 nodules with contrast medium on the diaphragm. Contrast medium was still visible around three nodules immediately after microwave ablation. Ablation continued in three nodules until there was no contrast medium. The incidence of complications during and after treatment was 0%. The average volume of the thyroid nodules before treatment was (7.52 ± 6.74) cm3. At 1, 3, 6 and 12 months after surgery, the average volume of the thyroid nodules was (6.06 ± 5.19) cm3, (3.06 ± 2.85) cm3, (1.32 ± 1.23) cm3 and (0.59 ± 0.52) cm 3, respectively. There was significant difference in volume of thyroid nodules between before and after microwave ablation ( F = 96.32, P < 0.001). Conclusion:Preoperative CEUS can determine the distribution of the blood supply of thyroid nodules and the course of the feeding vessels, identify the needle-entering position for microwave ablation and the primary ablation area, improve the accuracy of treatment, and reduce the occurrence of complications such as bleeding. Postoperative CEUS can determine whether lesion area is thoroughly ablated, reduce residual lesions and excessive ablation.
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Objective:To evaluate the safety and efficacy of irreversible electroporation ablation for liver cancer.Methods:A retrospective study was conducted on 21 patients who underwent irreversible electroporation ablation for liver cancer from September 2018 to August 2019. There were 17 males and 4 females, with a median age of 57.9 (48, 69) years old. Complications were graded according to the Clavien Dindo complication grading system. Tumor response was evaluated by the improved evaluation standard of solid tumor efficacy. Clinical data such as tumor size and operation time were recorded. Tumor recurrence and survival outcomes were followed-up until August 27, 2020.Results:All patients had well-compensated cirrhosis (Child-Pugh A 20 cases, Child-Pugh B 1 case). There was no persistent deterioration of liver function after ablation. The diameter of tumor ranged from 10 to 56 mm, with 7 patients having a tumor diameter over 3 cm. Each of the 21 patients received only once irreversible electroporation ablation and the technical success rate was 100%. The operation time was 2.3 (1.5, 3.5) h. All complications were Clavien Dindo grade Ⅰ, which included pain, fever and brachial plexus strain. Imaging examination 4 weeks after treatment showed a complete remission rate of 85.7% (18/21), a partial remission rate of 9.5% (2/21), a stable disease rate of 0(0/21), and a progressive disease rate of 4.8% (1/21). The objective remission rate was 95.2% (20/21). Overall recurrence rates were 9.5% (2/21) at 3 months and 23.8% (5/21) at 12 months. AFP at 3 and 12 months after treatment were (28.0±7.3) and (29.0±8.1) ng/ml, respectively, which were significantly lower than that before treatment (278.0±41.2) ng/ml ( t3m=-3.57, t12m=-4.12, P<0.05). Conclusion:Irreversible electroporation ablation was safe and effective in treating malignant liver tumors.
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With the gradual popularization of high-resolution ultrasound, the wide application of fine-needle aspiration biopsy technology under ultrasound guidance, and the rapid development of molecular marker detection technology, the detection rate of papillary thyroid microcarcinoma (PTMC) has increased year by year.The main clinical treatment method for PTMC is surgery or active surveillance. In recent years, with the good application of thermal ablation technology in the treatment of liver cancer, benign thyroid nodules and other tumors, many scholars at home and abroad advocate applying this technology in the treatment of PTMC.However, there is still a lack of multicenter, prospective long-term studies with large sample size to confirm the safety and effectiveness.Therefore, it is highly controversial whether thermal ablation should be applied to the initial treatment of PTMC.This paper will comment on this hot issue.