Heat, not surgery: new trial aims to cure thyroid cancer without a knife

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion criteria: * Histologically confirmed papillary thyroid carcinoma (PTC) by fine-needle aspiration (FNA -Bethesda V/VI ) or core needle biopsy. * Single or multiple lesions, each 2.0 cm in maximum diameter. * Intrathyroidal tumors (i.e., no extrathyroidal extension, no clinical/radiological evidence of nodal metastases, nor distant metastases). * Lesions located at a safe distance (\>2 mm) from critical structures (e.g., trachea, esophagus, carotid artery) or accessible with hydrodissection. * ≤T1b (i.e. \< 2cm maximal diameter), N0 or Nx, M0 (no clinical or radiological evidence of lymph node or distant metastasis). * Patients unfit for surgery due to comorbidities or who refuse surgery. * ≥18 years old * Not pregnant at the time of RFA. * Able to understand and voluntarily sign informed consent. Exclusion Criteria: * Evidence of lymph node involvement (clinically or radiologically suspicious or confirmed metastatic nodes) or distant metastasis (e.g., lung, bone). * Tumors with extrathyroidal extension * Tumors with extensive calcification * Tumors located within 2 mm of critical structures where RFA would pose an unacceptably high risk and where hydrodissection is not feasible. * Previous thyroid surgery or ablation (RFA, ethanol, laser, or microwave) at the index tumor site. * Known diagnosis of anaplastic, poorly differentiated, or other aggressive thyroid cancer variants. * Pregnant or breastfeeding at the time of enrollment. * Bleeding diathesis or use of anticoagulants that cannot be discontinued safely prior to RFA. * Severe comorbid illness that limits life expectancy to less than 5 years. * Inability to adhere to study follow-up schedule or procedures or lacking decision-making capacity. * Implanted electrical devices such as pacemakers or neurostimulators * Infection in the neck including skin infection or thyroiditis at time of planned ablation. * Severe cervical anatomy distortion (prior neck surgery or radiation with distorted anatomy that prevents safe RFA