Microwave ablation works in the same principle as the microwave ovens do in our kitchen. Thy send electromagnetic waves into the target tissue, which moves water molecules (oscillation). This movement causes friction and heat that destroys and kills the cells of the tumor or diseased tissue. Like radiofrequency (RF), microwave is the preferred ablation method in the liver, lung and bone tumors. Compared with RF, microwave provides a faster and more aggressive ablation, and is not affected by the electrical conductivity of the tissue.
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In the thyroid, microwave is a relatively newer ablation technique compared with RF and laser. Its use in a thyroid nodule was first reported by Dr Feng in 2012. Since then, it has been actively used for benign solid nodules in some centers.
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Like alcohol, laser and RF, microwave ablation can also be used in the treatment of low risk papillary microcarcinomas and the recurrent lymph node metastases of papillary cancer.
How to do microwave ablation of a thyroid nodule?
After an ultrasound examination is done, the thyroid nodule to be ablated is visualized. Then, local anesthetic is injected into the skin and the microwave needle is placed into the nodule under ultrasound guidance. The microwave machine is turned on and ablation is started. During the ablation, the microwave needle is directed into the different parts of the nodule (moving shot technique) to ensure that the nodule is ablated completely. After the procedure, the microwave needle is removed and the patient is discharged after one hour observation.
Which nodules are suitable for microwave ablation?
Like laser and RF, microwave ablation uses heat to destroy the tissue and is suitable for benign solid thyroid nodules. However, the worldwide experience is more limited with microwave ablation.
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What are the advantages of microwave ablation?
Microwave ablation is similar to RF in many aspects. Its needle is also slightly thicker than those of laser and alcohol. Similar to other ablation, it is done under local anesthesia plus ultrasound guidance, and the patient can go home one hour after the procedure.
A 70-year-old woman with a giant nodule of 72x53x47 mm in the thyroid istmus region underwent ultrasound-guided microwave ablation. One year later, the swelling of the patient disappeared, and the ultrasound showed a volume reduction of more than 90% in the nodule.
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