What is Radiofrequency Thyroid Ablation RFA?

What is Radiofrequency Thyroid Ablation RFA?

What is Radiofrequency Thyroid Ablation RFA?

What is Radiofrequency Thyroid Ablation RFA?

  1. RFA is a minimally invasive alternative to thyroid surgery.
  2. It can destroy large symptomatic or cosmetic nodules with heat.
  3. Heat at 60-100 C for 4-6 minutes causes irreversible damage to thyroid cells.
  4. Advantages include less cost,reduced pain and suffering, outpatient procedure,and treating poor surgical candidates.
  5. Ultrasound guided probe with cooling system is used. Special short probe with smaller gauge probe is ideal for thyroid work. Star Med Korea #18 cool tip.
  6. img_0983
  7. Roberto Valcavi,Interventional thyroidologist in Italy is seen here at the head of the patient ablating a large thyroid nodule. DR Valcavi is a pioneer in ablation methods including laser and ethanol.
  8. img_0984
  9. img_0985
  10. The probe is moved within the nodule to destroy 10 mm sections at a time. This is called moving shoot method.
  11. img_0986 img_0987
  12. The left shows post RFA residul nodule, and a contrast US on right shows the ablated area in central black.
  13. The patient is off to lunch right after, and returns in 24 hours for the contrast study on the right.
  14. They are free to leave the country 24 hours after the RFA.
  15. My patients from the USA are followed by me at 2,6,12,24 months.
  16. I have had one RFA failure on a patient with a 100+ml nodule that crossed the midline making the ablation very difficult and I referred  that patient for thyroidectomy.
  17. img_0202-300x300
  18. Image shows massive goiter nodule crossing the midline where the probe needs to be inserted.
  19. The best nodules for RFA are spongiform types whereas compact nodule are more likely to have a decreased volume reduction.
  20. images-20
  21. rfa-before-and-after
  22. The effect of RFA lasts for years with usual continued decrease volume up to 4 years.
  23.  resnick-rfa-before05
  24. 4.7 cm compact nodule before the RFA.
  25. resnick-rfa-after-02
  26. This type usually has less volume reduction but still result in symptom relief and less cosmetic effect.
  27. gordon-candace-during-rfa
  28. Probe with 10 mm hot tip seen in white.
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  30. We have come a long way from this 14 th century surgery, but we still have too many low volume surgeons causing more complications that would be avoided by a high volume surgeon. RFA is a great way to avoid any major complications of surgery.
  31. Call Matt seen below for details of our referral system to RFA experts in Europe and Korea.
  32. 310-393-8860
4 Comments
  • Marie Blackman February 26, 2018 3:46 am

    Dear Matt,
    I have 2 hot nodules that have caused a hyperactive thyroid.
    I live in Sydney, Australia and I am currently on anti thyroid medication close to 1 year.
    I refuse to have my thyroid removed or destroyed by RAI as suggested by endocronologist here.
    Would RFA radiofrequency ablation be a possibility for my condition?
    Kind Regards
    M Blackman

    • Dr Guttler February 26, 2018 11:07 am

      Hi Marie,
      This is not Matt.This is Dr.G.
      We still are waiting FDA approval in the states.
      I have a referral channel for my patients to have
      thyroid RFA after my evaluation.
      Yes Ethanol and RFA are alternatives to radiation
      or surgery. Best results with RFA but only with a true expert.
      You would need to take the Drugs forever as there is no remission with toxic nodules compared to Graves’.
      Most all RFA patients do not need Thyroid Hormone after the treatment as your thyroid gland except the toxic mnodules is still working.
      I am going to Korea in May to study under the world expert.Several of my US patients will be treated while I am there.
      You could be another. After my evaluation of your records including recent biopsies I could refer you for RFA.

      If you send me all your information including CD of ultrasounds iodine scans and actual slides from recent biopsies
      and pay $1750 US for my evaluation, I could have you on your way to have Thyroid RFA in the end of May.
      Weather will be better that at the Olyimpics!
      My Secure email is thyroid.manager@protonmail.com

      Dr.G.

      • M Blackman February 27, 2018 8:04 pm

        Apologise for the mistake Dr G.
        Sorry can you clarify after RFA will I still need to be on some sort of medication or does the hot nodule get cooked which in turn no longer produces the overload of iodine and therefore no more medication and hopefully no more hyperthyroid?
        Kind Regards
        M Blackman

        • Dr Guttler February 28, 2018 8:14 am

          No medication needed after RFA for Hot nodules.
          Dr.G.

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