We evaluated the use of three criteria to determine the need for additional treatment of cystic thyroid nodules after their recurrence following ethanol ablation (EA). In total, 154 patients (male:female=30:124; mean age, 53.4 years; range, 23 to 79 years) with 154 thyroid nodules (49 cystic and 105 predominantly cystic nodules) who presented between January 2014 and August 2017 were enrolled. All patients underwent follow-up ultrasonography (US) 1 month after EA, and were divided into

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... ic success and failure groups. The patients were evaluated according to three previously suggested criteria for recommending additional treatment: nodules with ≥1 mL of remnant fluid, volume reduction <50%, and demonstration of a solid component with vascularity. Thyroid nodules treated by EA showed significant volume reduction (18.4±21.6 mL to 4.2±6.5 mL [1-month follow-up] to 1.9±3.3 mL [final follow-up], P<0.001) and clinical improvement. Additional treatment was unnecessary in 81%, 70%, and 71% of patients deemed to need it according to criteria 1, 2, and 3, respectively. The choice to perform additional treatment after EA should be made according to a combination of clinical problems and US features. Understanding this concept will be useful in planning further treatment following US-guided EA.