About half the population in the U.S. develops a thyroid nodule by the time they turn 60. Thyroid nodules are usually benign, and most small nodules don’t cause any pain or symptoms. However, if your thyroid nodules begin to grow or cause unwanted symptoms like changes in your hormone levels or physical discomfort, you must seek treatment.
Treating thyroid nodules used to require surgery, but newer techniques like radiofrequency ablation are now available. If you’re suffering from a thyroid condition, including thyroid nodules, it’s essential to seek treatment with an endocrinologist.
At Associated Endocrinologists, our experienced physicians received training from top medical schools throughout Michigan and have been providing care for endocrine disorders since 1984. We’ll work with you to find the best treatment option for your thyroid nodules.
What is Radiofrequency Ablation?
Radiofrequency ablation (RFA) is a type of interventional radiological treatment that can be used to treat large thyroid nodules. The procedure sends an electric current through a needle-like probe to a targeted area of tissue. The current heats the tissue, causing the cells to die.
RFA is an effective treatment for thyroid nodules because it only targets the nodule. It kills the cells inside the nodule and causes it to shrink without damaging healthy tissue or critical structures of your thyroid or neck, such as the lymph nodes.
It is a minimally invasive procedure performed in an outpatient clinic or doctor’s office. Patients remain conscious throughout the RFA treatment session. They receive a local anesthetic to numb their neck and keep them comfortable during the procedure. The FDA approves thyroid RFA for treating benign solid thyroid nodules with a success rate of 50% to 80%.
Typically RFA takes less than one hour from start to finish. The length of your procedure depends on the number and size of your thyroid nodules. You’ll be able to resume normal activities immediately following your thyroid RFA.
What is Thyroid RFA Used For?
Thyroid RFA is only used to treat benign thyroid nodules. Nodules are abnormal growths that develop in or around your thyroid. They can be solid or fluid-filled and vary in size.
Small nodules cause few symptoms and are monitored over time instead of being removed. Large nodules can be painful and cause difficulty breathing or talking. They are often the result of an underlying thyroid hormone imbalance.
Indications for Thyroid RFA
- Nodules that are compressing your throat and causing voice changes, difficulty swallowing or breathing
- Nodules that are adversely affecting your appearance
- Nodules that form multinodular goiters
- Nodules that are causing hyperthyroidism and hypothyroidism
- Recommendation from a doctor that a non-invasive procedure is the best treatment option
How Thyroid RFA is Performed
The thyroid RFA procedure uses what’s known as the moving shot technique, which is best for the treatment of benign thyroid nodules. The moving shot technique uses a needle electrode guided into your thyroid nodule then heated with an electrical charge. The needle moves continuously throughout the treatment to prevent damage to surrounding tissue and destroys all the abnormal thyroid tissue.
At Associated Endocrinologists, thyroid RFA is performed in a series of non-invasive steps during a single RFA session lasting between 15 to 60 minutes.
Preparation for the RFA procedure
When you come in for your RFA appointment, you lie flat on your back, with your head and shoulders on a pillow. Your doctor may also put a pillow under your lower back to make you more comfortable.
Placement of grounding pads
Two grounding pads are attached to your thighs. These grounding pads are known as dispersive electrodes, and they act as a return path for the electrical current used during the thyroid RFA. This step protects you from electrical injury during the procedure.
Application of local anesthetic
Your physician then injects the skin near your thyroid gland with a local anesthetic to ensure your procedure is pain-free. A small number of patients may experience temporary discomfort; however, 97% experience a painless procedure. Local anesthetic also ensures you can talk to your physician throughout the procedure.
Using ultrasound guidance to place the needle
Your doctor uses an ultrasound transducer to help guide the electrode needle. The doctor places a small amount of lubricating gel on your throat to make it easier for the transducer to pick up accurate images.
Inserting the needle
Your doctor uses the ultrasound images to insert a thin needle into your thyroid nodule. An electrical current, created by alternating radiofrequency waves, is passed into the probe, causing it to heat to a high temperature, between 111°F and 141°F. This allows your doctor to cauterize the abnormal thyroid tissue. This tissue is discarded by your body over the following months, shrinking the size of your nodule.
Going for a follow-up consultation
After your thyroid RFA session, expect to come in for follow-up visits over the next year. Typically follow-up appointments occur at six to eight weeks, six months, and twelve months. Your physician checks the progress of your nodule reduction and ensures
it hasn’t triggered hypothyroidism.
Heat damage to the surrounding tissue may trigger a reduction in your thyroid hormone, which could lead to hypothyroidism. Your doctor may order blood work at your follow-up appointment to assess your hormone levels.
How Effective is Thyroid RFA?
Thyroid RFA is a highly effective procedure for treating non-cancerous thyroid nodules. The procedure has a 50% to 80% overall success rate in reducing thyroid nodule size over twelve months. In the case of benign cold thyroid nodules, there is a 32.7% to 58.2% reduction rate one month after thyroid RFA and a 50.7% to 84.8% reduction rate after six months.
For most patients, one single RFA session is enough to produce a 90% reduction rate of their thyroid nodule. If you have an extra-large nodule or there is a high chance of regrowth, you may need multiple RFA sessions to see a long-lasting reduction in size and symptoms caused by the nodule.
Complications from RFA
Thyroid RFA is widely accepted as a safe procedure for individuals with thyroid nodules that are ≥ 3 cm. In a representative study, the major complication rate out of 1,500 patients is a very low 1.4%, while the overall complication rate is just 3.3%.
The most commonly reported complications are:
- Temporary or permanent voice change
- Skin burn
- Nodule rupture
- Nerve damage
Of these complications, all are present in only a small number of patients and are usually temporary. No life-threatening complications have been reported due to thyroid RFA in recent literature.
Is Thyroid RFA Treatment for Everyone?
Thyroid radiofrequency ablation for benign thyroid nodules is an effective option for treatment. However, thyroid RFA is not recommended for all patients with thyroid nodules.
To qualify for thyroid RFA, you must meet the following criteria:
- Be thyroid cancer-free
- Not have a suspected carcinogenic thyroid nodule
- Cold benign nodules – have 2 FNA biopsies that show benign results
- Hot thyroid nodules – have 1 FNA biopsy with benign results
- Not taking anticoagulation medications
Several factors can disqualify you from thyroid RFA, including if you have:
- A history of thyroid surgery, sclerosing, or radiation
- A history of recurrent thyroid cancers
- Thyroid nodules that are too small
- Wear an implantable defibrillator or pacemaker
- Previous vocal cord damage
- Severe heart disease
- Suspicious features that indicate a cancerous nodule
In addition to these factors, if you are pregnant or cannot discontinue your anticoagulant medication for the procedure, you are not a good candidate for thyroid RFA. At your initial consultation with Associated Endocrinologists, your physician can discuss whether thyroid RFA is a good option for your condition.
Thyroid RFA Treatment vs. Thyroid Surgery
In many cases, thyroid RFA is preferred over surgery. Thyroid surgery is an invasive procedure that carries some risks.
Patients who undergo thyroid surgery face complications such as adverse reactions to general anesthesia, infection, and bleeding.
May cause permanent damage
There is potential for damage to vocal cords, parathyroid glands, or developing hypocalcemia.
Patients may need to take thyroid replacement medication long-term
The surgical route requires some patients to take thyroid replacement medication following the procedure for the rest of their life.
It’s likely to leave behind visible scars on your neck from incisions and sutures.
Long recovery period
Surgery is an in-patient procedure which also means taking time off from work to recover and potentially costly medical expenses.
Thyroid RFA treatment
Unlike thyroid surgery, thyroid RFA offers several benefits to candidates who qualify for the procedure.
Due to the small size of the needle probe, the procedure leaves little to no scarring on your neck.
Thyroid RFA is typically a single session procedure completed in under one hour and requires no long-term recovery time.
No need for medications
A significant benefit of choosing thyroid RFA is preserving your healthy thyroid tissue during and after treatment. Your thyroid can continue functioning normally so you don’t have to take thyroid replacement medication.
The local anesthetic used in a thyroid RFA session has a lower complication rate than general anesthesia used for an in-patient invasive surgery.
Higher success rate
RFA thyroid treatment also has a high success rate, making it an excellent option for achieving volume reductions in thyroid nodules.
Schedule a Thyroid RFA Consultation
Associated Endocrinologists is one of the first locations in Michigan to offer thyroid RFA treatments. Our board certified physicians have extensive training in endocrinology and metabolism and can work with you on the right approach for your thyroid issues.
Receive treatment for your thyroid condition onsite with thyroid RFA, thyroid ultrasound, and thyroid biopsies. Our physicians can also address health issues like adrenal insufficiency, osteoporosis, type 1 diabetes, and PCOS to improve your overall wellbeing.
If you would like to discuss thyroid RFA to treat your thyroid nodules, schedule a consultation with Associated Endocrinologists today. We offer in-person consultations and telehealth visits for your convenience. Contact us at (248) 487-8335 or fill out the online form.