Alternative Treatments Recently, image-guided minimally invasive techniques (percutaneous ethanol ablation, radiofrequency, laser, microwave ablation, and high-intensity focused ultrasound) have been proposed and may be considered for treating clinically relevant benign thyroid nodules. Radioiodine therapy should be considered for patients with hyperfunctioning nodules whose biochemical testing shows hyperthyroidism, but surgery is also a reasonable approach in patients with large (> 4 cm) nodules. Most thyroid nodules are benign. A diagnostic approach that uses ultrasound and, when indicated, fine-needle aspiration biopsy and molecular testing, facilitates a personalized, risk-based protocol that promotes high-quality care and minimizes cost and unnecessary testing.