Ultrasound-guided ablation procedures have been growing in popularity and offer many advantages compared with traditional surgery for thyroid nodules. Many technologies are available, with thermal ablative techniques being the most popular currently though other nonthermal techniques, such as cryoablation and electroporation, are gaining interest. The objective of the present review is to provide an overview of each of the currently available ablative therapies and their applications in various clinical indications.

RFA is a thermal ablative technique that uses high-frequency alternating electric current to generate heat. As radiofrequency waves agitate tissue ions, their motion under the influence of alternating current produces friction and heat. The temperature can reach up to 100 °C, dehydrating cells and denaturing proteins leading to coagulation necrosis [41]. Heat is generated in the tissue within a few millimeters of the electrode tip and heat conduction from the ablated area leads to additional thermal damage to tissue further from the electrode. As such, RFA efficacy may be limited by tissue carbonization and heat sink effect from adjacent blood flow or cystic components in the target lesion [42]