2024 International Expert Consensus on US-guided Thermal Ablation for T1N0M0 Papillary Thyroid Cancer

Thermal ablation has started to gain acceptance as a therapeutic approach for the management of papillary thyroid cancer (PTC), mainly in the T1 stage (tumor size ≤ 2 cm in greatest dimension and limited to the thyroid). Despite its increasing popularity, a lack of uniformity in the technical details persists, and existing guidelines do not fully align with recent research advancements. To standardize the use of US-guided thermal ablation for T1N0M0 PTC, a panel of experts jointly issued this expert consensus on thermal ablation for PTC. This consensus was developed by experts with specific competence and expertise in this field through rounds of the modified Delphi method. An evidence-based approach incorporating the practical experience of the panelists was adopted. The consensus was developed through extensive discussions, systematic literature review with meta-analysis, and expert evaluations. In this consensus, a total of 27 recommendations are made, addressing the indications and contraindications for thermal ablation for PTC, physician training, preoperative preparation, technical procedures, complications, efficacy assessment, and followup strategies. This expert consensus provides up-to-date, high-quality, standardized guidance to harmonize treatment practices, enhance patient outcomes, and potentially shape future research and policy developments in the management of T1N0M0 PTC using US-guided thermal ablation.