Preview of the ATA Poster
THYROID NO SURGERY TUMOR ABLATION BREAKTHROUGH METHODS AND TECHNOLOGY
RICHARD B. GUTTLER MD, FACE, ECNU Clinical Professor of Medicine Keck/USC Medical School INTERVENTIONAL THYROIDOLOGIST SANTA MONICA THYROID CENTER Santa Monica California USA
What took so long before RFA arrival in the USA? 4000 cases of goiter, nodules, cancer lymph nodes and even primary micro-papillary cancer have been ablated in Europe, Asia, and even in Latvia! 2002 Professor JH Baek in Korea published the first series on RFA ablation of benign symptomatic large thyroid nodules.
Thyroid RFA Breakthrough Technology
1.Bipolar electrode 2. Thin thyroid friendly #18 and 19 gauge probes. 3. Very small burn area on the tips ( 3, 5,7, and 10 mm) 4. RFA needle tracking system. 5. Electrode with only a one half heat surface.
Breakthrough Thyroid RFA Techniques
- Dextrose Injection Avoidance Method for Dangerous Structures. 2. Pre-Thyroid RFA ablation of Heat Sinking local arteries and veins. 3. Use of 3, 5, 7 mm hot tips for smaller targets such as primary micro-papillary thyroid cancer, and thyroid cancer lymph nodes. 4. Use of 1/2 hot tipped RF for completion of ablation near dangerous structures. 5.Use of bipolar RF electrode for pregnant females and patients with pacemakers. 6. Local Thyroid Capsule Injection with Lidocaine instead of Conscience Sedation.
- Thyroid Interventional Tumor Ablation 1. 2014-2017 Patients traveling to Korea or Europe have returned with positive results and no complications in my practice. 2. More patients are demanding to have ethanol ablation alternatives to Surgery after reading about the success on the Internet. 3. 517 AACE ECNU endocrinologists are targeted to train in PEI and RFA as they are already doing their own nodule biopsies. 4. Thyroid Ablation Society of America was formed in Boston at the World Thyroid Cancer Congress in 2017. www.thyroidablation.net 5. Armed with two ablation methods interventional thyroidologists are in a position to decrease the number of thyroid surgeries even further.
- Conclusion Ethanol Ablation is an underutilized less expensive alternative. 2. Endocrinologists need to adopt these procedures as their own. 3. PEI and RFA are now potential treatment options for primary micro- papillary cancers as alternative to surgery or active surveillance. 4. PEI or RFA almost always preserves thyroid function. 5. PEI and RFA always costs less and has less complications than surgery. 6. PEI and RFA training for endorinologists is already available in the US. 7. Solid Benign symptomic Thyroid nodules can have RFA in Europe and Korea now by referral.