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NICE publishes a guidance supporting the use of percutaneous ultrasound-guided microwave ablation for symptomatic benign thyroid nodules

​Terumo Europe welcomes the positive guidance released by the National Institute for Health and Care Excellence (NICE) mentioning that microwave ablation can be used provided standard arrangements are in place for clinical governance, consent, and audit. This is positive news as it broadens access to minimally invasive alternatives to surgery available to patients with symptomatic benign thyroid nodules.  

16/11/2022 - LEUVEN, BELGIUM

The guidance describes ultrasound-guided percutaneous microwave ablation for symptomatic benign thyroid nodules as a minimally invasive procedure that can be performed in an outpatient setting using local anaesthesia. The aim is to reduce symptoms and improve cosmetic appearance by making the nodule smaller while preserving thyroid function, and with fewer complications than surgery.

This guidance is part of NICE's interventional procedure programme which considers whether interventional procedures are safe and work well enough for wider use in the NHS. A comprehensive review of the literature and consultations with clinical experts and patient representatives informed the decision of the Committee.

This is a positive endorsement of the treatment and a complement to the 2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules.1

The NICE document also reports that using uncooled microwave ablation devices means thinner needles can be used.

"Nowadays microwave technology is widely used in liver, lung, and kidney ablation" says Dr. Eduardo Crespo, Chief of Radiology Department at Hospital Universitario Fundación Jimenez Diaz in Madrid, Spain. "So far, the main gap to approach thyroid ablation has been the lack of thinner and shorter probes, to avoid potential damage to the adjacent nerves, which could lead to complications. Within the TATOpro antennae range, Terumo Interventional Systems introduced a dedicated thyroid antenna as thin as 18G with a length of 8 cm, to be used at limited power. Moreover, a 17G antenna is also available to treat larger nodules in one session, avoiding the need for patients to come back for multiple treatments."


Two recent publications by Yildirim and Karakas (2022)2, concluded that uncooled microwave ablation with the TATO system is an effective and safe method for the treatment of benign thyroid nodules that preserves the thyroid function.

Dr. Camillo Aliberti, Head of Diagnostic and Interventional Radiology Department Hospital Pederzoli, Peschiera del Garda, Italy, further explains: "In comparison to radiofrequency technology, microwaves are not influenced by tissue impedance and are less influenced by blood flow (heath sink effect). Microwaves are quicker in coagulating the treated area, requiring less antenna repositioning and producing a very small amount of vapor which allows a good visibility under ultrasound guidance and precise ablation execution, enabling any type of nodule (solid, cystic, or mixed) to be treated."

Terumo Interventional Systems offers dedicated workshops to support professional education for physicians willing to start the service.  

About Terumo

Terumo (TSE: 4543) is a global leader in medical technology and has been committed to "Contributing to Society through Healthcare" for 100 years. Based in Tokyo and operating globally, Terumo employs more than 28,000 associates worldwide to provide innovative medical solutions in more than 160 countries and regions. The company started as a Japanese thermometer manufacturer and has been supporting healthcare ever since. Now, its extensive business portfolio ranges from vascular intervention and cardio-surgical solutions, blood transfusion and cell therapy technology, to medical products essential for daily clinical practice such as transfusion systems, diabetes care, and peritoneal dialysis treatments. Terumo will further strive to be of value to patients, medical professionals, and society at large. 

About Terumo Europe

Terumo Europe N.V. is a core player in the EMEA healthcare market by providing best in class quality medical products and services. We are a strong actor of the Terumo Group by contributing to innovation and sustainable growth. Terumo Europe produces, distributes, markets, and sells a vast range of medical devices in five main business units: Interventional Systems, Pharmaceutical Solutions, Medical Products, Cardiovascular Products and Diabetes Management. Terumo Europe EMEA headquarters and production facilities are located in Leuven (Belgium), production facility in Knowsley (UK), European Distribution Center in Genk (Belgium) and sales offices across EMEA.

About TATO Microwave System

TATO and TATOpro are trademarks of Biomedical srl. TATO and TATOpro are manufactured by and exclusively distributed by Terumo Europe NV in EMEA region.

Papini E, Monpeyssen H, Frasoldati A, Hegedüs L. 2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules. Eur Thyroid J. 2020 Jul;9(4):172-185. doi: 10.1159/000508484. Epub 2020 Jun 8. PMID: 32903999; PMCID: PMC7445670.

2 Yildirim G, Karakas HM. Artery-first microwave ablation in the treatment of benign thyroid nodules. Adv Clin Exp Med. 2022 Jun 29. doi: 10.17219/acem/150829. Epub ahead of print. PMID: 35766894.

Yildirim G, Karakas HM. Uncooled Microwave Ablation as a Treatment Option to Preserve Thyroid Function in Patients with Benign Thyroid Nodules. J Belg Soc Radiol. 2022 May 26;106(1):50. doi: 10.5334/jbsr.2746. PMID: 35651913; PMCID: PMC9138712.