Thyroid Radiofrequency ablation (Thyroid RFA)

What is Thyroid Radiofrequency Ablation?

This is an effective minimally invasive method for treatment of benign thyroid nodules. A thyroid-specific electrode is used to ablate the thyroid nodule in the office, without damaging the surrounding thyroid tissue, and without leaving a scar. After the procedure, the thyroid nodule usually gradually shrinks significantly over time, leading to dramatic improvement of compressive symptoms caused by the nodule. Therefore, it is an excellent alternative to surgery! We are excited to offer this groundbreaking procedure for our patients at the Utah Thyroid Center! 

Frequently Asked Questions

How is thyroid radiofrequency ablation done?

A special thyroid-specific needle/electrode is inserted to the targeted thyroid nodule under ultrasound guidance. When activated by the doctor, electricity is converted to radiofrequency waves, which are emitted by the tip of the electrode (active tip), and immediately raise the temperature of a small area (typically 7-10 mm in diameter) around that active tip. Subsequently, the electrode is gradually moved inside the nodule, with a goal to ablate it completely, and cause cell death in the thyroid nodule cells, while leaving the normal thyroid tissue and the surrounding structures intact.​ Once the procedure is completed, the patient is observed briefly and then goes home. The nodule is expected to decrease in volume over the next few months after treatment, faster in the first few weeks and more slowly afterwards. There is no scar, no damage to parathyroid function, and thyroid function is almost always preserved!

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Who is a candidate for Thyroid RFA of benign thyroid nodules?

Patients are candidates for thyroid RFA if they have large biopsy-proven cytologically benign thyroid nodules that are causing compressive symptoms (such as difficulty swallowing, difficulty breathing, etc), cosmetic concerns, or hyperthyroidism (if they are autonomously functioning), are visible on ultrasound in their entirety, and do not have certain contraindications. Depending on certain features of the nodules, there are certain criteria that need to be met for a patient to be a candidate for thyroid radiofrequency ablation. Please call us to schedule a consultation, in order to determine if you are a candidate for this procedure.

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What results are usually expected after Thyroid Radiofrequency Ablation?

For benign thyroid nodules, volume reduction of 60-80% is usually seen with thyroid RFA, with marked improvement or even complete resolution of compressive symptoms. About 85-90% of the nodules are expected to decrease in volume by more than 50% within 6-12 months. About 10-15% of the ablated nodules may regrow within 5 years after the ablation. Some patients with larger thyroid nodules may need more than 1 treatment for optimal results.

In toxic adenomas (thyroid nodules that overproduce thyroid hormone causing hyperthyroidism), in addition to the above results, normalization of thyroid function is expected in 50-80% of patients who undergo thyroid RFA.

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What are the possible complications of radiofrequency ablation of benign thyroid nodules?

The complication rate of thyroid RFA is very low, and lower compared to thyroid surgery, especially at the hands of an experienced doctor who uses advanced techniques for safe and effective ablation. 

The most serious complications include recurrent laryngeal nerve paresis/paralysis with resultant voice change/hoarseness, which is usually temporary (1% chance), but can rarely by permanent (~0.2% chance). Another serious complication is nodule rupture, which is also rare (~0.2% chance). More serious or life threatening complications are exceedingly rare.

Pain is usually mild and local anesthesia is usually sufficient to control it. Other complications, such as nausea, vomiting, skin burn, parasympathetic reaction (sudden changes in heart rate or blood pressure, feeling of faint, etc), fever, infection, abscess formation, bleeding, hematomas, other nerve damage, are very uncommon. Post-procedural hypothyroidism is rare.