Treatment of cystic thyroid nodules

Kepal N. Patel, Catherine Sinclair

Research output: Contribution to journalArticlepeer-review


The optimal treatment option for cystic thyroid lesions depends on the composition of the lesion, prior interventions, and patient preference. Simple aspiration is a good initial diagnostic and treatment modality for thyroid lesions that are predominantly cystic. However, recurrence rates are high and, should fluid re-accumulate, further aspirations are unlikely to be effective. Ethanol ablation is an excellent first line treatment as it is relatively safe, well-tolerated, and simple to perform. It is at least as effective, if not more effective, than radiofrequency ablation (RFA) for simple cysts, and complex thyroid cysts with a solid component <20%. The efficacy of EA is inversely related to the percentage of solid component within any given lesion. There is some evidence that complex cysts with >20% solid component may have better long-term outcomes with RFA over EA, although EA is still a reasonable first line consideration. RFA salvage after EA is possible and effective, especially for complex nodules with larger solid components.

Original languageEnglish
Article number100822
JournalTechniques in Vascular and Interventional Radiology
Issue number2
StatePublished - Jun 2022
Externally publishedYes


  • Ablation
  • Cyst
  • Ethanol
  • Nodule
  • Thyroid


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