Since 2022, some European Centers published their positive results about safety and efficacy of TATO MW system for the ablation of benign thyroid nodules.
PUBLICATIONS AND MAIN RESULTS
Uncooled microwave ablation as a treatment option to preserve thyroid function in patients with benign thyroid nodules" by Gulsah Yildirim et al.
In this publication Dr. Gulsah Yildirim and Hakki Muammer Karakas, at Istanbul Fatih Sultan Mehmet Training and Research Hospital in Turkey, highlighted the safety, feasibility, performance of this system, following up the first 40 patients, without major complications.
Antibody levels and thyroid function tests have remained within normal limits with no significant change during follow-ups. Symptoms and cosmetic scores were significantly improved at all follow-up, obtaining notable volume reductions of the nodules.
Artery-first microwave ablation in the treatment of benign thyroid nodules" by Gulsah Yildirim et al.
In this publication Dr. Yildirim et al. confirmed the previous results and investigated successfully the option to improve the ablation in highly vascularized nodules by treating the arterial feeder ("Artery first" approach), to obtain a good hemostasis. Notably this approach showed an increased volume reduction at 3 and 6 months compared to the control group.
Dr. Dionisio et al. initial-experience-of-microwave-ablation-for-benign-and-malignant-thyroid-nodules-our-short-term-results, CIRSE 2022 poster
In her initial experience, Dr. Dionisio reports similar results to previous publications in terms of safety and effectiveness of the procedure, with follow ups at 1, 6 and 12 months:
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1 month FU - #5 pts – Volume reduction from 11,3 cc to about 7,00 cc
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6 months FU - #12 pts – Volume reduction from13,0 cc to around 2,0 cc
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12 months FU - #2 pts – Volume reduction from 11,2 cc to 0,41 cc
Conclusions: >60% VRR after 6 months, > 80% VRR after 12 months. Disappearance of compressive and cosmetic symptoms of 80% after 1 month and 90% after 6 months. Moreover, she also reported the treatment of two malignant nodules: CT scan at 4 months showed tumor disappearance and absence of locoregional or distant disease progression in both patients.
Multiple overlapping microwave ablation in benign thyroid nodule: a single-center 24-month study" by Eduardo Crespo Vallejo et al.
A novel publication on December 2022, from a single center study conducted by Eduardo Crespo et al. at Hospital Universitario Fundacion Jiménez Diaz, in Madrid, Spain, further consolidated the evidence on safety, performance and clinical outcomes, with a solid follow up of 24 months on 30 patients.
Microwave ablation for large benign thyroid nodules: a proposal for a new approach: the fluid-motion technique" by Camillo Aliberti et al.
On October 2023, Dr. Aliberti and Dr. Casaril from Pederzoli Hospital in Peschiera del Garda, an Italian center of excellence for thyroid disease, published their experience on BTN Uncooled Microwave Ablation. A novel, dedicated procedure – the fluid-motion technique – was developed and implemented to obtain faster and potentially more effective ablations in all kinds of nodules, with a further confirmation of the results obtained at different European site.
US-Guided Percutaneous Microwave Ablation for Benign Thyroid Nodules by Dr. Leonor Fernandes et al.
On September 2024, Dr. Fernandes (Hospital Santa Maria, Lisbon) presented their initial experience on 48 patients, confirming that MWA of thyroid benign nodules is well tolerated, cost & risk effective vs. surgery and radioiodine therapy. Retreatment, if needed, can be done safely and effectively (5 patients were retreated within 12 months). To avoid regrowth, ablation of at least 70-80% of the nodule should be obtained.
Results Of Thyroid Nodule Ablation With Uncooled Microwave Systems, Facts And Truths by Prof. G. Yildirim et al
In April 2025 Dr. G. Yildirim updated her personal results with 3 years follow-up on 45 BTN patients. 5 pts undergone a second treatment at 6 month and N. 3 pts, at 12 months. In these patients the mean neutrophil-to-lymphocyte ratio (NLR) was higher (prognostic factor). Mean initial volume for pts requiring a second ablation was 46.45cc, vs. 19.51cc for patients undergoing a single-session procedure (p<0.01).
No major complications recorded.
17-18G MW antennas were utilized at 15W to reach 80-100C, obtaining cytotoxic effect, coagulative necrosis followed by phagocytosis. Inflammation response is key to necrotic tissue removal and prevention of regrowth.
More publications are in the making in Europe, that will be made available to the thyroid community soon.
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Publications
