General principles for the safe performance, training and adoption of ablation techniques for benign thyroid nodules: An American Thyroid Association Statement

Abstract

<div><p><strong>Background: </strong> The primary goal of this interdisciplinary consensus statement is to provide a framework for the safe adoption and implementation of ablation technologies for benign thyroid nodules.</p><p><strong>Summary: </strong> This consensus statement is organized around three key themes: i. safety of ablation techniques and their implementation, ii. optimal skillset criteria for proceduralists performing ablative procedures, and iii. defining expectations of success for this treatment option given its unique risks and benefits. Ablation safety considerations in pre-procedural, peri-procedural and post-procedural settings are discussed including clinical factors related to patient selection and counselling, anesthetic and technical considerations to optimize patient safety, peri-procedural risk mitigation strategies, post-procedural complication management and safe follow-up practices. Prior training, knowledge and steps that should be considered by any physician who desires to incorporate thyroid nodule ablation into their practice are defined and discussed. Examples of successful clinical practice implementation models of this emerging technology are provided.</p><p><strong>Conclusions: </strong> Thyroid ablative procedures provide valid alternative treatment strategies to conventional surgical management for a subset of patients with symptomatic benign thyroid nodules. Careful patient and nodule selection are critical to the success of these procedures as is extensive pre-procedural patient counselling. Although these emerging technologies hold great promise, they are not without risk and require development of a unique skillset and environment for optimal, safe performance and consistent outcomes.</p></div>