North American Society for Interventional Thyroidology Statement on Directed Ablative Therapy for the Management of Benign Non-functional Thyroid Nodules.

Directed ablative therapy (DAT) for benign non-functional thyroid nodules (BNFTNs) is a first line management strategy for providing effective relief of compressive and cosmetic symptoms as an alternative to surgical excision or observation. The success of ablation procedures relies on careful patient selection and the technical expertise of the treating physician. These procedures have demonstrated significant nodule volume reduction and improvements in quality of life, with safety profiles and costs comparable to thyroid surgery while reducing the risk of postprocedural thyroid hormone deficiency. This statement supports the application of DAT for benign symptomatic thyroid nodules, as well as for appropriately selected nodules that are growing with impending symptoms, or indeterminate cytology with negative molecular markers. Robust data support DAT as an effective, cost-neutral, and safe alternative to surgery, expanding options for individualized care of symptomatic BNFTN.