RFA Is Safe, Effective for Molecular Negative Bethesda III Thyroid Nodules

Jackson K, McCabe J, Stern S, et al. Early Results of Radiofrequency Ablation for Treating Molecular Negative Bethesda III Thyroid Nodules. J Am Coll Surg. 2025; in press.

Radiofrequency ablation (RFA) is associated with reduced risk for nerve injury and improved cosmesis compared to surgical thyroidectomy; RFA is an accepted approach for benign (up to Bethesda II) thyroid nodules.

Nodules classified as Bethesda III have a risk of malignancy of 22% and are less frequently treated with RFA. Molecular testing can reduce the risk of malignancy to 3%–10%. This article reported a retrospective analysis of data from a prospectively maintained database (n = 32) of patients with Bethesda III nodules with low-risk molecular profiles treated with RFA.

After RFA, patients with Bethesda III nodules had nodule volume reduction similar to Bethesda II nodules (77% at 24 months follow up), and all patients had significant symptom improvement.

The authors concluded that RFA was safe for patients with Bethesda III thyroid nodules with low-risk molecular profiles, but longer follow up data are needed.