Cryoablation in Thyroid Nodules: Current Evidence, Technical Considerations, and Clinical Applications

Cryoablation is an emerging image-guided minimally invasive treatment for selected thyroid nodules.Unlike radiofrequency, laser, and microwave ablation, cryoablation produces tissue destruction through controlled freezing and thawing.The formation of a visible ice ball provides a distinctive means of monitoring the developing treatment zone during the procedure.This narrative review summarizes the contemporary evidence regarding cryoablation of thyroid nodules, with emphasis on patient selection, confirmation of benignity, procedural technique, cryoprobe positioning, ice-ball monitoring, protection of adjacent cervical structures, complications, treatment response, and follow-up.Publications (total 20 articles) from 2020 through September 2026 were considered, with earlier publications included when necessary to describe fundamental cryobiological mechanisms.Because the thyroid-specific cryoablation literature remains limited, evidence from radiofrequency, laser, and microwave ablation was incorporated primarily for contextual comparison.At present, direct clinical evidence for thyroid cryoablation consists of one 10patient pilot study of benign thyroid nodules and one retrospective study of 71 papillary thyroid cancers in 65 patients.In the benign-nodule pilot study, technical success was achieved in all patients without moderate or severe adverse events.Mean volume reduction ratios were 42.3%, 65.4%, 68.4%, and 63.7% at one, three, six, and 12 months, respectively.In the papillary thyroid cancer study, technical success was achieved in all treated tumors, moderate adverse events occurred in 3% of patients, and no local recurrence or lymph-node metastasis was observed during a mean follow-up of 34.8 months.These preliminary findings support technical feasibility and provide encouraging short-to intermediate-term outcomes, but they are insufficient to establish comparative efficacy, long-term safety, or superiority over established ablation techniques.Radiofrequency, laser, and microwave ablation have substantially larger clinical evidence bases and longer follow-up.Cryoablation should therefore currently be considered an emerging treatment option for carefully selected patients rather than an established first-line modality.Larger prospective studies, standardized technical protocols, and direct comparative trials are required to define its clinical role.