Thyroid RFA, or radiofrequency ablation, is a minimally invasive procedure to treat benign thyroid nodules. It involves using targeted heat to destroy small areas of abnormal tissue in the thyroid gland. The outpatient procedure has been gaining popularity as an alternative to traditional treatments such as surgery and radioactive iodine.
Explore the effectiveness of thyroid RFA, including the benefits and potential risks, and examine the available research on the procedure to learn if thyroid RFA is the right option for you.
What is Thyroid RFA?
Thyroid RFA, or radiofrequency ablation, is a thermal ablative process typically used to treat non-cancerous growths on the thyroid gland. RFA treatment is performed under local anesthesia and usually takes about 30 minutes to an hour to complete.
During the RFA procedure, a thin, needle-like probe is inserted through the skin and into the thyroid nodule using ultrasound guidance. Radiofrequency energy is then delivered through the probe, heating the tissue and causing it to die. The tissue is eliminated from the body, and the nodules shrink over a period of months.
Effectiveness of Thyroid RFA: A Review of the Literature
The use of radiofrequency ablation (RFA) for treating benign thyroid nodules is a relatively new approach, but numerous studies and clinical trials have been conducted to evaluate its effectiveness. The majority of the studies have shown that RFA is a safe and effective treatment option for benign thyroid nodules.
A 2016 study, which involved over 100 patients with benign non-functioning thyroid nodules, found that RFA resulted in a reduction in nodule volume of 93.4% on average, with a recurrence rate of just 5.6%.
In a 2019 long-term study involving 215 patients, researchers found that the most favorable outcome was observed in nodules measuring less than 10 mL. These nodules showed an 81% reduction in volume after 5 years following a single RFA procedure. The study also observed a gradual nodule shrinkage over time and a sustained improvement in cosmetic problems and symptoms related to compression.
Compared to other treatment options, such as surgery and radioactive iodine, RFA has been shown to have similar effectiveness in reducing the size of thyroid nodules.
However, RFA has the advantage of being a minimally invasive procedure with a relatively quick recovery time, and patients do not require general anesthesia. Ultrasound-guided RFA does not affect the rest of the thyroid gland, leaving it functional, nor does it affect the patient’s ability to swallow or speak.
Is Thyroid RFA Safe?
Thyroid RFA is generally considered a safe procedure with a low complication rate. However, as with any medical procedure, there are potential risks and side effects associated with RFA. Some of the most common risks include pain, bleeding, minor skin burns, infection, and damage to surrounding structures like vocal cords. Most side effects are temporary.
A multicenter study on 1,459 patients found that 3.3% experienced complications, of which most of them were minor, including hematomas, vomiting, and skin burns. All patients recovered spontaneously except for one who experienced permanent hyperthyroidism (overactive thyroid hormone production). These rates are generally considered to be low compared to other treatment options, such as surgery.
However, the safety of RFA can depend on several factors, such as the size and location of the thyroid nodule and the patient’s overall health. Thyroid RFA may not be suitable for certain individuals, including:
- Individuals who have had previous surgery, radiation, or sclerosing therapy to the neck as this causes scar tissue which can increase the risk of damage to non-thyroid tissue.
- Individuals with extremely small thyroid nodules.
- Individuals with sonographic features that indicate their nodules may be cancerous unless additional tests have been performed to verify the nodules are benign.
- Individuals with implantable pacemakers or defibrillators.
- Individuals with previous damage to their vocal cord.
- Patients with severe heart disease.
- Pregnant patients.
- Patients taking blood thinners who cannot briefly stop these medications before the RFA procedure.
To ensure the safety of RFA, consult with a specialist experienced in performing the procedure. They can evaluate your medical history and determine whether RFA is a safe and appropriate treatment option.
When is Surgery Preferable for Treating Thyroid Disease?
While radiofrequency ablation (RFA) for benign thyroid nodules is the preferred conservative treatment, there are some cases in which surgery is a better option.
If a blood test and fine needle aspiration biopsy confirm a case of thyroid cancer, surgery is usually the first line of treatment. A complete or partial thyroidectomy may be performed, depending on the extent of the cancer. In some cases, a total thyroidectomy may be recommended to remove the entire thyroid gland, while in others, a lobectomy may be performed to remove only one lobe of the gland.
Surgery may also be considered as a treatment option for large benign thyroid nodules that are causing compression symptoms or cosmesis issues and when RFA is not possible or not recommended. Surgery may also be considered in cases of severe hyperthyroidism due to Graves’ disease when other treatments such as antithyroid medication and radioactive iodine have failed.
Explore Your Options at Associated Endocrinologists
If you experience symptoms of thyroid nodules, hyperthyroidism, or hypothyroidism, it is vital to visit an experienced endocrinologist for an exam. All our physicians have a Board Certification in Endocrinology and Metabolism, with extensive training in endocrinology through fellowships at prestigious institutions such as the University of Michigan, Northwestern, and Henry Ford Hospital.
We specialize in thyroid RFA treatments and use state-of-the-art diagnostic and treatment technology to help you manage thyroid disorders. Contact us today to schedule an appointment.