How do we decide which patient is a candidate for thyroid RFA?

How do we decide which patient is a candidate for thyroid RFA?

How do we decide which patient is a candidate for thyroid RFA?

                         How do we decide which patient is a candidate for thyroid RFA?

In 2012, the Korean Society of Thyroid Radiology made a consensus statement regarding the treatment of thyroid nodules with RFA.

D. G. Na, J. H. Lee, S. L. Jung et al., “Radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: consensus statement and recommendations,” Korean Journal of Radiology, vol. 13, no. 2, pp. 117–125, 2012.

Thyroid RFA is indicated either for patients with nodule-related symptoms or with hyperfunctioning nodule(s) which is causing thyrotoxicosis.

Confirmed to be benign with at least two separate US-guided fine-needle aspiration cytology and/or core biopsies.

Y. C. Oertel, L. Miyahara-Felipe, M. G. Mendoza, and K. Yu, “Value of repeated fine needle aspirations of the thyroid: an analysis of over ten thousand FNAs,” Thyroid, vol. 17, no. 11, pp. 1061–1066, 2007. View at Publisher · View at Google Scholar · View at Scopus
J. Y. Kwak, H. Koo, J. H. Youk et al., “Value of US correlation of a thyroid nodule with initially benign cytologic results,” Radiology, vol. 254, no. 1, pp. 292–300, 2010

In general, RFA is a safe procedure. However, we should be cautious in application of RFA in patients who are either pregnant or having history of serious heart problems.. Since there had been reports of cardiac complication during RFA for liver tumors, patients with serious heart disease should have continuous cardiac monitoring during and after RFA of thyroid nodules.

A. A. Nemcek Jr., “Complications of radiofrequency ablation of neoplasms,” Seminars in Interventional Radiology, vol. 23, no. 2, pp. 177–187, 2006.

 

Richard Guttler MD,FACE,ECNU

Clinical Professor of Medicine Keck/USC school of Medicine

Director, Santa Monica Thyroid Center, Santa Monica Ca 90404

Member, American Association of Clinical Endocrinologist’s task force on the introduction of thyroid radiofrequency ablation RFA of thyroid nodules to the United States.

dr.guttler@thyroid.com

www.thyroid.com

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