What Happens After You Have the RF Ablation for Your Nodule in the Long Run?
Traditionally the treatment for benign thyroid nodules consists of surgery and levothyroxine medication, however both have many drawbacks. Radiofrequency ablation (RFA) is a method of thermal ablation to induce thyroid tissue necrosis and has been applied to various benign and malignant tumors with good results (2-6). In the thyroid gland, RFA has been applied to a recurrent thyroid cancer.
4 types of benign nodules for RFA.
The best nodule for RFA is one with micro-cysts
call spongiform. Also rarely a cancer.
Cystic Nodules can be treated today in the USA at my center by ethanol ablation.
Mixed cysts with >50-75% fluid can also be treated by ethanol as well as RFA.
The solid nodules have the least reduction but still enough to relieve symptoms
or cosmetic factors.
Long term results in many studies
The mean volume reduction of treated nodules at 1, 3 and 6 month after RFA was 58.2%, 74.4% and 84.8%, respectively. A volume reduction greater than 50% was
observed in 91.1% (n=275), and 84 (27.8%) index nodules had disappeared on the follow-up
ultrasonography (US).A 2-year follow-up experience with 94 elderly patients (66 nontoxic nodules and 28 toxic/pretoxic nodules). Sixty patients were treated in a single session and
thirty-four patients required more than one session (two sessions in 25 patients, three sessions in 7 patients). The mean volume reduction of treated nodules at 1-month, 1-year and 2-year after RFA was 54%, 78.6% and 79.4%, respectively. 88 patients had pressure
symptoms in the neck, 68 had difficulty in swallowing, and 75 patients had aesthetic complaints. The symptom score improved significantly from 3.4±0.2 at baseline to 0.3±0.08 at 12 months after RTA (p<0.001) and symptom control was well maintained during the second year in all patients. A complete disappearance of all symptoms was obtained in 83 of 94 patients.
What about complications?
The complication rate was about 3% in Dr.Baek’s center from 2002 t0 2007. institution from 2002 to 2007 (voice change,hematoma, tumor rupture, first degree skin burn,
transient thyrotoxicosis etc.). Most common complaint was pain. During the ablation, most of the patients complained of various degrees of pain at the ablated site, or pain radiating to the head, ear, shoulder, or teeth. The pain decreased when the generator output was reduced or turned-off during ablation and was easily controlled by oral analgesics during admission. All of the complications were recovered spontaneously. So there was no permanent complication case.Others reported mild edema and cervical pain in several patients,and some patients complained of slight transient cervical pain that spontaneously disappeared Milf fever was recorded that spontaneously regressed 24–36 hours after RTA.
In conclusion, thyroid RFA is effective and safe method for treating benign thyroid nodules.
Comments: This review in 2010 by Professor Baek looks at the long term effects (2 years) of RFA for thyroid nodules. Recent articles extend the results to 4 years with continued good results.
They are the leaders on RFA for thyroid. We do not have RF thyroid mini-probes for the USA today. We need to send all interested patients who do not want surgery to my fellow ablation specialists in Europe or Korea. for treatment of their large symptomatic benign thyroid nodule.
Call Matt at 310-393-8860 for details of our referral system to get you a 2-3 day in and out treatment only visit to Roberto Valcavi (Italy)or Professor Baek (Korea).
Richard Guttler MD,FACE,ECNU
Thyroid Ablation Specialist
Proceeding of 2010 Annual Convention TSUM
Radiofrequency Ablation (RFA) for Benign Thyroid Nodules:
Long-term Follow-up Results
Jung Hwan Baek
Clinical Associate Professor
Department of Radiology and Research Institute of Radiology, University of Ulsan College of
Medicine, Asan Medical Center, Seoul, Korea