Thyroid Nodules RFA 101: Even the Chinese are Ahead of US in RFA Research !
[Current situation and thoughts on radiofrequency ablation in the treatment of thyroid cancers]
Radiofrequency ablation (RFA) was originally used primarily for the treatment of regional metastatic lymph nodes from recurrent thyroid cancers in the field of thyroid surgery. In recent years it is gradually used to treat a part of benign thyroid nodules. However, the domestic issues resulting from indiscriminately enlarged RFA indication and lack of standardization of therapy become more and more prominent, including initial treatment of operable thyroid cancers by RFA, which is against by the current consensus about RFA for patients with thyroid nodules and management guidelines for patients with thyroid cancers. Therefore, RFA should be avoided for initial treatment of operable thyroid cancers before the introduction of guidelines based on evidence-based medicine.
Korean researcher JH Baek and his team at Asan Medical Center is presently doing resarch on this issue.
China is using RFA for an expanded use for primary thyroid cancers. This is still in research mode in Korea,Europe and the USA. The USA has not been involved in RFA use for thyroid disease but is doing research in Ethanol ablation of primary thyroid micro-papillary cancers
Ian Hay in the USA at Mayo is also working on ethanol ablation of primary micro-papillary cancers instead of active surveillance or surgery.
However that is about to change with the introduction of a thyroid friendly small bore #18-19 Thyroid RF Mini-Electrode and shot probe 7 cm length from Korea. The heated electrode tip can be 3,5,7, and 10 mm with the smaller ones for small primary micro-papillary cancer or lymph nodes.
The mini-electrode is perfect for the confines of the neck with many dangerous structures nearby. Compare the longer length and bore #17 of the Medtronic electrode.
Santa Monica Thyroid Ablation Center is beginning introduction courses in RFA for future use by endocrinologists and interventional radiologists. Call Matt at 310-393-8860 for details or emal at email@example.com.
Richard Guttler MD,FACE,ECNU