• Cherry Kim, Jeong Hyun Lee, Young Jun Choi, Won Bae Kim, Tae Yon Sung, and Jung Hwan Baek.
• Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43 gil, Songpa-Gu, Seoul, South Korea.
• Eur Radiol. 2017 Aug 1; 27 (8): 3128-3137.

ObjectivesTo evaluate the complication rates and describe the possible complications of ultrasonography-guided radiofrequency ablation (RFA) of benign thyroid nodules (BTN) and recurrent thyroid cancers (RTC), and to compare the complication rates between BTN and RTC.MethodsThis retrospective study reviewed 875 patients who underwent RFA for BTN (746 patients; 83.5%) or RTC (129 patients; 14.7%). Medical records were reviewed for all types of complications occurring during and after the RFA procedure. The baseline characteristics and the complication rates of BTN and RTC were compared.ResultsThe overall complication rate was 3.5% (31/875), and the major complication rate was 1.6% (14/875). The major complication rate of RTC was significantly higher than that of BTN (5.4% vs. 0.9%, P = 0.002), while there were no significant differences in the minor complications rate. New complications, such as Horner syndrome, spinal accessory nerve injury, and complications due to lidocaine toxicity, were also revealed.ConclusionsVarious complications of RFA may occur in both BTN and RTC, although the complication rate is low. To understand the broad spectrum of complications and minimise the complications and sequela, the suggested technical tips and cervical anatomy are essential.Key Points• The overall complication rate was 3.5% (31/875). • The major complication rate was 1.6% (14/875). • The major complication rate of RTC was significantly higher than BTN. • There were only four patients showing persistent symptoms (0.5%). • Unreported new complications were also demonstrated.

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