Thyroid Radiofrequency Ablation (RFA) for Benign Thyroid Nodules
Thyroid nodules, even when benign (non-cancerous), can grow visibly large and cause swallowing or breathing difficulties, persistent cough, and hoarseness. Radiofrequency Ablation (RFA) and Microwave Ablation (WMA) are a non-surgical treatment option that can reduce the size of thyroid nodules and restore thyroid function. RFA and MWA are minimally-invasive technique performed by an endocrine surgeon guided by ultrasound imaging. The physician delivers targeted radio waves that disrupts the nodule’s cells, causing them to shrink as the body absorbs the ablated tissue.
Benefits of Thyroid Radiofrequency Ablation and Microwave Ablation
Clinical trials involving RFA and MWA for benign thyroid nodules have shown a reduction in size by 51-85% within the first six months. In most patients, nodule related symptoms were significantly improved or had disappeared. Similar results were seen for thyroid function, such as normalizing blood-hormone levels for patients that presented with a toxic hormone-producing thyroid nodule.
- A minimally-invasive procedure
- Preserves your healthy thyroid tissue and allows it to function normally without the need for a lifetime of medication
- Performed under local anesthesia as an out-patient procedure (no downtime or hospitalization)
- Shorter recovery time
- No visible scarring
- Reduced the volume of the nodule with a low complication rate
- Improves quality of life
What to expect during RFA and MWA treatment
About an hour prior to the procedure, or upon check-in, patients are typically given a low-dose sedative to help them relax. A local anesthetic is applied externally to the treatment area around the thyroid gland. Patients will sometimes doze off during the procedure or may choose to listen to music.
Once the patient is relaxed, the doctor positions a thin needle into the nodule under continuous ultrasound guidance. Radiofrequency or microwave energy is emitted from the tip of the needle which causes very precise erosion of the targeted tissue. The physician systematically guides the instrument through the entire nodule, treating as much of the inner volume as is safe to do so. Patients can expect to go home fairly quickly after the procedure. Any post-treatment discomfort is easily managed with an orally-taken pain reliever (acetaminophen).
Risks of Thyroid RFA and MWA
All medical treatments and procedures have risks which will be discussed in detail with you or your family member. Serious complications are rare with the RFA and MWA procedure because it is a minimally-invasive, out-patient procedure. Bleeding, hoarse voice (due to nerve bruising), skin burns, and infection are possible, but with safety and best practices protocols for RFA and MWA, side effects can be effectively mitigated, including localized swelling and redness. Though infection can be a very rare problem, it will be continuously monitored by the treating physician and clinical team.
Why is it important to maintain a healthy thyroid?
Our brain, heart, digestive, and metabolic systems function normally with the help of the thyroid gland. It is a butterfly-shaped organ located at the front of the neck near the base of the throat, wrapping around the windpipe. The thyroid gland is part of the endocrine system, where it secretes hormones to regulate the body’s heart rate, blood pressure, temperature, and metabolism.
Additional complications can involve the esophagus, trachea, and nerves that surround the vocal cords. The risk of permanent injury to these areas is extremely rare. Larger nodules may require multiple RFA or MWA treatments for effective nodule shrinkage, which can increase risk. Your doctor will discuss the likelihood of needing additional treatments with you during your initial assessment.
1Primary Prevention of ASCVD and T2DM in Patients at Metabolic Risk: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, Volume 104, Issue 9, September 2019, Pages 3939–3985
https://doi.org/10.1210/jc.2019-01338
If you have questions regarding RFA treatments for benign thyroid nodules, please call today. Request an appointment
Melanie Goldfarb, M.D., M.Sc., FACS, FACE
Director, Center for Endocrine Tumors and Disorders
Medical Director for Cancer Survivorship
Dr. Melanie Goldfarb is a fellowship-trained endocrine surgeon and Director of the Center for Endocrine Tumors and Disorders. Her expertise is minimally invasive surgery for thyroid cancer and disorders, hyperparathyroidism, and adrenal tumors, including pheochromocytoma, Cushings, Conns, and adrenal cancer.
