Thyroid RFA for Large Benign Thyroid Nodules 101: One Patient’s Experience in Korea
My patient who was told the only treatment for her large visible thyroid nodule with symptoms was surgery in her home town in North Carolina. She was interested in a therapy approach that was not surgical. After seeing my website she arranged a visit to my center in California. The evaluation and re-biopsy with molecular markers was very likely benign. ( <0-3 % chance of cancer.
This is her pre-RFA neck image. The nodule was 10 cm and has partially cystic. 18 cc of cyst fluid was removed with relief of symptoms. The cyst part was <50% and was not a candidate for ethanol ablation PEI alone.After consultation with Dr.JH Baek in Seoul Korea who said she was a candidate for Thyroid RFA but would need two visit to Korea as it was very large.
The procedure took one hour and she stated the pain was an 8/10 during the procedure and was 5/10 after. Ice and Tylenol were sufficient to relief the pain. The procedure was done with only lidocaine injections of the thyroid capsule without anesthesia or conscience sedation. She was awake the whole time so she could report any untoward effects of the Thyroid RFA treatment.
This image show extensive blood vessels around the capsule that were draining the heat for the RFA electrode, and Needed to be ablated before he could start the nodule ablation.
This image shows the total ablation of the superior section of the nodule. She will return in a few months for the completion of the treatment.
Right after the procedure here is my patient and Professor Baek.
Comments by Dr.Guttler;
- Ethanol ablation PEI is the first line treatment for thyroid and parathyroid cysts.
- Thyroid Radiofrequency Ablation RFA is the first line treatment for large symptomatic or cosmetic benign thyroid nodules.
- Present state is a short visit to centers in Europe and Korea to have RFA. FDA approval and training courses in the USA are pending by American Association of Clinical Endocrinologists AACE and Interventional Radiology societies.
- I can treat cysts without surgery with ethanol PEI in my center.
- I have a network of specialists in Europe and Korea who will take my recommendations for RFA treatment after my extensive evaluation including a repeat biopsy with molecular markers.
- The patient can spend as little as 2-3 days in Italy or Korea just for the treatment without a new complete evaluation in country.
- Call me at 310-393-8860 or email to firstname.lastname@example.org for details and expenses.
- My website was articles om Thyroid RFA to review.
- Richard Guttler MD,FACE,ECNU
- Interventional Thyroidologist.