Thyroid No Surgery 101: Thyroid Radiofrequency Ablation RFA in 2018

Thyroid No Surgery 101: Thyroid Radiofrequency Ablation RFA in 2018

Thyroid No Surgery 101: Thyroid Radiofrequency Ablation RFA in 2018

Thyroid No Surgery 101: Thyroid Cancer Radiofrequency Ablation RFA in 2018

Dr.Guttler Comments on this article:

RFA to treat recurrent lateral neck lymph nodes without another neck dissection.






RFA when used in combination with external beam to give relief to airway obstruction. 




Future directions for ablation in interventional oncology


Roberto Iezzi

Roberto Iezzi is an interventional radiologist, Catholic University, Rome, Italy.

Dr.Guttler Comments on Dr.Iezzi’s article as it relates to thyroid tumors.

  1. Locally destroying a thyroid cancer percutaneously with minimal morbidity and mortality has been the goal in the modern armamentarium for treating patients with low risk thyroid cancers and metastatic nodal neck disease after a surgery failed to get all the lymph node disease.
  2.  Thyroid RF ablation RFA technology has evolved rapidly during the past decades, with substantial technical and procedural improvements that can help to improve clinical outcomes and safety profiles.
  3. Thyroid Radiofrequency ablation RFA has become widely used in the world.
  4. The United States is one of the few countries without an approved thyroid RFA system.
  5. The beginnings of what we now know as thyroid radiofrequency ablation stretch back to 2002. Dr.JH Baek did the first RFA treatment of thyroid nodules in Seoul Korea.


  1. Radiofrequency ablation is currently the ablation modality supported by the largest number of studies, including randomised controlled trials and meta-analyses.

Treatment of a benign thyroid nodule with RFA is seen below.


  1. RFA Complications are 3% and major ones are 1% and sequelae 0.1%.


  1. Microwave ablation recently presented randomized controlled trial has failed to demonstrate its superiority over radiofrequency ablation.
  2. Thyroid US-guided high-intensity focused ultrasound (HIFU) treatment for patients with thyroid nodules has been less successful than its use for liver.
  3. Contrast-enhanced ultrasound increases RFA performance in terms of localisation and targeting of a thyroid tumour.
  4. The true extent of the systemic ramifications of thyroid thermal ablation is only now beginning to be appreciated.
  5. Primary micro-papillary thyroid cancers are now the target of studies with thyroid RFA and Ethanol Ablation. These are alternatives to surgery or long term active surveillance.

Up to date information on ethanol PEI and RFA ablation procedures call 310-393-8860 or Ethanol is available in the USA at Santa Monica thyroid center and other centers. RFA is not available in the US but referral to Korea or Italy with my evaluation can be arranged. Stay in the country would only be to be treated which can be 2-3 days only.

Richard Guttler MD,FACE,ECNU

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