What is Thyroid Radiofrequency Ablation (RFA)?

Radiofrequency ablation (RFA) is a non-surgical treatment option that can reduce size of benign thyroid nodules & restore function. Learn more about this minimally invasive technique & its benefits.

What is Thyroid Radiofrequency Ablation (RFA)?

Thyroid nodules, even when benign (not cancerous), can grow visibly large and cause difficulty swallowing or breathing, persistent cough, and hoarseness. Radiofrequency ablation (RFA) is a non-surgical treatment option that can reduce the size of thyroid nodules and restore thyroid function. ARF is a minimally invasive technique performed by an endocrine surgeon guided by ultrasound images. The doctor emits targeted radio waves that disrupt the cells in the node, causing them to shrink as the removed tissue is absorbed by the body. ARF for thyroid nodules is done by inserting a needle-like probe into the thyroid nodule.

The tip of the needle heats up, destroying the nodule from the inside and causing it to shrink. Therapy has been shown to be a safe and effective treatment for benign thyroid nodules through extensive studies and point-of-care use in Asia, Europe and South America. Radiofrequency ablation, also known as ARF, is a minimally invasive option for treating thyroid nodules. RFA uses radiofrequency waves to heat thyroid nodules. Guided by ultrasound images, doctors can accurately deliver radiofrequency waves to the target tissue.

The procedures are performed in an outpatient setting with local anesthetics or conscious sedation anesthesia. Treatment is a rapid, non-surgical outpatient option, which allows patients to resume normal daily activity almost immediately after. Radiofrequency ablation, or RFA, is a minimally invasive technique that reduces the size of tumors, nodules, or other growths in the body. RFA is used to treat a variety of conditions, including benign and malignant tumors, chronic venous insufficiency in the legs, as well as chronic back and neck pain. What is thyroid ARF? This is a cutting-edge technology used for the treatment of benign thyroid nodules.

We use alternating electric current to stir the ions in the tissues, resulting in ionic friction, which in turn causes heat production. Heat is transferred from the tip of the needle (electrode) to the surrounding thyroid tissue, in a pre-specified area depending on the type of electrode used (7 mm or 10 mm diameter of the treated area), allowing the operator accuracy and precision. Basically, we use electricity to generate heat in a small area within the thyroid nodule. The doctor inserts the needle under the ultrasound guidance using the trans-isthmic approach (from the middle of the neck), and when it is in the target area of the node, the RF generator is activated and the procedure is started. Subsequently, the doctor uses the technique of “mobile firing”, to move the needle around the node, so that 100% of the nodule is removed. At the end of the procedure, all or most of the nodule cells are dead, without compromising healthy thyroid cells, and the nodule is dramatically reduced in size over time.

The trans-isthmic approach and moving shooting technique were developed to ensure safety, accuracy and effectiveness of thyroid rfa. They are now considered standard care for RFA procedures worldwide and are used at Utah Thyroid Institute. Before proceeding to treat with RFA, it's important for doctors to know about vessels that surround thyroid gland (e.g. This procedure induces a substantial reduction in volume of thyroid nodules, relieves compressive symptoms and improves aesthetic appearance while preserving normal thyroid function. Clinical trials involving ARF for benign thyroid nodules have shown reduction in size by 51-85% within first six months. If you and your doctor decide that ARF is appropriate for treating your thyroid nodule(s), you will have one or more fine-needle aspiration biopsy procedures to make sure that they are benign.

The lidocaine needle should be inserted into midline of front of neck just above thyroid isthmus and advanced into thyroid capsule. However thermal damage to perityroid structure can be induced when marginal venous ablation technique is applied especially for hypervascular thyroid nodules located on lateral side of gland. During follow-up all patients expressed general satisfaction with decision to undergo thyroid rfa. Of 14 patients 13 had normal thyroid function before RFA (two were taking levothyroxine replacement) and one had thyrotoxicosis. Because treatment of thyroid nodule with rfa is relatively new risk of these procedures still being evaluated. Similar results were observed for thyroid function such as normalization of blood hormone levels for patients who had a thyroid nodule producing toxic hormones. However since thyroid nodules are often exophytic ellipsoidal of gland they are difficult to remove with fixed technique.

ARF may be an option if you live with symptoms of thyroid nodules that have been biopsied and found to be benign. It has been presented at national and international meetings on thyroid rfa and published in several renowned journals. At Utah Thyroid Institute RFA procedure performed in office only with local anesthesia and no increased risk of procedure.

Chester Lonabaugh
Chester Lonabaugh

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