Thyroid nodules, even when benign, can cause a range of symptoms such as difficulty swallowing or breathing, persistent cough, and hoarseness. Radiofrequency ablation (RFA) is a minimally invasive treatment option that can reduce the size of thyroid nodules and restore thyroid function. This procedure is performed by an endocrine surgeon guided by ultrasound images. The doctor emits targeted radio waves that alter the cells in the node, causing them to shrink as the removed tissue is absorbed by the body. RFA for thyroid nodules is done by inserting a needle-like probe into the nodule.
The tip of the needle heats up, destroying the nodule from the inside and causing it to shrink. This therapy has been extensively studied and used in point-of-care settings in Asia, Europe, and South America. It is a rapid, non-surgical outpatient option that allows patients to resume normal daily activity almost immediately after. Until recently, open surgery was the standard treatment for thyroid nodules. However, RFA can now be used in some cases.
Additional studies should be conducted in similar populations with a particular focus on factors that predict greater response to RFA and on comparing its performance with other procedures. Lidocaine injection may be used prior to ablation to anesthetize the thyroid capsule to hydrodissect, which provides a greater distance from the tip of the active RFA needle and vital surrounding structures and also provides a heat sink around the nodule to prevent injury to these structures. Clinical trials involving ARF for benign thyroid nodules have shown a reduction in size from 51 to 85% in the first six months. Studies to date suggest a low rate of serious complications and a small need for thyroid hormone replacement after ARF. If you and your doctor decide that ARF is appropriate for treating the thyroid nodule, you will have one or more fine-needle aspiration biopsy procedures to make sure that the nodule is benign. For non-functioning thyroid nodules, ARF was as effective as surgery in satisfying patients with resolution of nodules-related symptoms.
In addition, if the volume of the thyroid nodule is not fully delineated on ultrasound or there is doubt as to the extent of the nodule, a CT scan of the neck can help determine if there is retrosternal extension and how much is present and whether the patient is an appropriate candidate for ARF. It has been presented at national and international meetings on thyroid rfa and is published in several renowned journals. Of the 14 patients, 13 had normal thyroid function before ARF (two were taking levothyroxine replacement) and one had thyrotoxicosis. In addition, two meta-analyses that included one hundred eighty-nine patients (8) and two hundred seventy patients (8) with a local recurrence of their thyroid cancer found a significant decrease in the volume and largest diameter of the tumor, as well as in the level of thyroglobulin before and after treatment with RFA (87, 8).Radiofrequency ablation (RFA), also known as ARF, may be an option if you live with symptoms of thyroid nodules that have been biopsied and found to be benign. In terms of complications, ARF was superior to surgery and no cases of hypothyroidism were identified, while 37.5% of patients after surgery required thyroid replacement therapy.