People with thyroid conditions need routine monitoring to manage their health. Many thyroid patients are referred to endocrinologists, doctors trained in thyroid disorders, and other hormones to treat their condition.
Thyroid patients may need other procedures and services if their health changes, along with blood work and medications. This includes radiofrequency ablation if you develop thyroid nodules.
What is Radiofrequency Ablation?
Radiofrequency ablation (RFA) is a minimally invasive outpatient procedure that uses heat generated by an electrical current. A long, thin needle with an electrode tip is placed under your skin and into the tissue of the thyroid gland needing ablation.
The electrode sends an electric current to the abnormal thyroid gland tissue, causing ions to bounce around your tissue, creating friction and heat. The heat generated is called thermal ablation, and it destroys the abnormal thyroid gland tissue. RF ablation is used in thyroid patients as an alternative to the surgical treatment of thyroid nodules.
How RFA Treats Thyroid Nodules
Thyroid nodules are abnormal growths of cells that form lumps in your thyroid gland. They can be caused by genetics or conditions such as iodine deficiency.
The American Thyroid Association reports that although thyroid nodules can be cancerous, most are benign. The incidence of thyroid cancer in nodules is only around 5%. Treatment of benign thyroid nodules is only needed if the nodule continues to grow in size, causes additional symptoms, or is an autonomously functioning thyroid nodule.
Clinical symptoms of thyroid nodules that suggest treatment is required include:
- Excessive production of thyroid hormones leading to hyperthyroidism
- Problems swallowing or breathing due to the size of the nodule
- Hoarseness or difficulty talking
- Shortness of breath related to the thyroid nodule
- An overactive thyroid, known as hyperthyroidism
- An overactive thyroid, known as hypothyroidism
- Neck pain or discomfort due to a nodular goiter or multinodular goiter
Radiofrequency ablation of benign thyroid nodules treats your nodule using heat to destroy nodule tissue, leading to volume reduction and symptom improvements. This non-surgical procedure can be done for patients with noncancerous thyroid nodules in their doctor’s office following an initial evaluation and physical examination.
You’ll be awake for the treatment, given a local anesthetic to numb your neck and thyroid areas. The thin needle is guided by ultrasound and inserted into your thyroid gland through your neck to deliver the electric current that produces heat.
RFA is a quick outpatient procedure, and you can resume your normal activities immediately after.
A single session of RFA delivers enough thermal ablation for a benign solid nodule to start shrinking. The heat from one ablation treatment is enough to kill all your nodule cells, so you won’t have to return for repeat appointments. After RFA administration, it takes time for your symptoms to resolve completely.
How Does Thyroid RFA Compare to Other Treatments?
RFA of benign thyroids is not your only treatment option. If you are facing the possibility of cancer, you may have to explore treatment options like surgery or percutaneous laser ablation.
Many types of thyroid cancer require surgical treatment. Surgical removal of thyroid nodules is a more invasive procedure that requires patients to undergo anesthesia and face a longer recovery time. This treatment is necessary if you don’t qualify for RFA, have cancerous thyroid nodules, or have other thyroid malignancies that make RFA an unsafe procedure.
Percutaneous laser ablation is a newer procedure used to shrink thyroid nodules. This non-invasive procedure uses lasers to create heat and thermal ablation of your nodule cells. It can be used to treat benign or cancerous thyroid nodules. There is some concern that this treatment can cause nodule regrowth over the long-term.
RFA is preferable to other treatments because it does not destroy normal thyroid tissue. This helps you avoid the need to take thyroid-stimulating hormone due to damaged thyroid tissues, such as the parathyroid glands, during invasive surgical procedures.
Ideal Candidates for RFA
Patients should undergo a thorough evaluation of thyroid nodules to be identified as ideal candidates. Solid benign thyroid nodules are the type of thyroid nodule that responds best to RFA, often shrinking in size up to 80% after the procedure. Other types of thyroid nodules, such as fluid-filled cysts, are not ideal for RFA.
Ideal RFA candidates should not have a risk of cancer or a family history of thyroid cancer. They must also have two fine needle aspiration (FNA) biopsies that show a benign result for a cold nodule or have one needle biopsy for hot thyroid nodules to clear a suspicious nodule.
If you are on blood thinners, you must also be able to stop taking them for the RFA procedure.
Alternatively, those with a risk of thyroid cancer, including a family history of thyroid or other cancers, are not considered ideal candidates for RFA. If you’ve had prior surgery or thyroid cancer treatment procedures such as radioactive iodine therapy, your thyroid tissues may not withstand RFA.
Additional conditions that may make RFA unsafe include:
- You experience irregular heartbeat
- You have an implantable defibrillator or pacemaker
- You have small thyroid nodules
- Your neck ultrasound shows markers for thyroid cancer
- You’ve experienced previous vocal cord damage
- You have cancerous nodules or fluid-filled nodules
- You are taking an anticoagulant that you cannot stop for RFA
Nodule Related Clinical Findings
A retrospective study shows that RFA treatment for patients with thyroid nodules is clinically effective at reducing the size of nodules. One clinical trial quoted in this study saw a volume reduction of 33-58% of their thyroid nodules within one month of their RF ablation. Their nodules continued to shrink over time, with up to 85% reduction from their initial volume six months post-RFA.
Clinical findings also show that RFA effectively treats autonomously functioning thyroid nodules. This multicenter study included patients from 5 different medical institutions and 44 patients with an autonomously functioning nodule, also known as a hot nodule.
After RF ablation, a large percentage of thyroid nodules disappeared. The study reports that 35 patients no longer had hot nodules, and the remaining 9 patients all saw decreased symptoms.
What to Do If you Suspect a Thyroid Issue
If you suspect you have a thyroid issue such as benign nodules or thyroid cancer, schedule a consultation with one of the doctors at Associated Endocrinologists. Your doctor can perform a physical exam and thyroid scan using radioactive iodine and thyroid ultrasonography during your consultation.
This type of scan uses radioactive iodine to show the shape of your entire thyroid gland. It helps your doctor identify where your thyroid gland is functioning normally or showing abnormal growth or function. Radioactive iodine is not harmful to your thyroid gland. You should not experience adverse side effects from the amount of radioactive iodine used for this test.
Your doctor looks for various thyroid issues, such as thyroid nodules, incidental thyroid nodules, thyroid cysts, and thyroid cancers. They can also identify if you have a fluid-filled cyst or other condition. If they find an issue with your thyroid cells, they may perform blood tests, a more thorough physical examination, or a needle biopsy on a suspicious nodule.
Thyroid RFA Services in Michigan
Thyroid patients in Michigan have the opportunity to access this minimally invasive treatment through Associated Endocrinologists.
Our board certified doctors have been treating thyroid patients in Southeast Michigan since 1984. We’re proud to be one of the first places to offer Thyroid RFA services in the area.
Contact our offices today for more information about our services, such as thyroid ultrasound and ultrasound-guided thyroid fine needle aspiration biopsy (FNA), or schedule an appointment with an endocrinologist.