Thyroid No surgery: American Endocrinologists Take Control of Thyroid Radiofrequency Ablation RFA of Thyroid Nodules:
A relief for 50,000 patients/year who now can have thyroid RFA instead of surgery.
Endocrinologists throughout the country are gearing up to learn thyroid RFA. After 5 years leading the charge to get FDA approval for thyroid RFA and after years of practice on 3 different generator systems, I am are finally beginning clinical trials. Four centers are taking part in the trial. Two centers including mine have published early results at the Endocrine society meeting that was canceled. Both papers with will published in The journal of Endocrine Society May-June 2020. Early results on small groups of benign nodules done in the office of RFA trained endocrinologists has yielded no major complications. Minor ones included neck pain and bruise. The results were very positive. My study had relief of symptoms in all cases and most also had improved cosmetic scores at 3 months! Early decreases in size at 3 months was amazing.The nodules varied in the decrease in volume at 3 months. However the symptoms and cosmetic scores improved in most cases. Except for local pain after the procedure treated with Tylenol there were no serious complications. One patient needed a Medrol dose pack to help with her tender neck pain. The goal of Thyroid RF is to relieve symptoms and improve cosmetic problems not to make the nodules disappear. Early relief of symptoms and cosmetic problems at 3 months is a good sign that we were approaching our goal in the study. Even large nodule up to 127 ml had a good response at 3 months.
9 patients at 3 months:
Pre-RFA Volumes Mean volume 55 ml ( 16-127 ) Mean Volume decrease 47 % ( 15-75 ml )
Thyroid RF is a procedure easily learned by AACE, ECNU certified endocrinologists who do their own ultrasounds, and biopsies. With their vast knowledge of thyroid disease they seem to be the ideal operator for thyroid RF. Other specialities are also doing thyroid RF including surgeons, ENT and interventional radiologists.
The cost for endocrine office based thyroid RF is less than hospital or imaging centers. The estimates from different sources is Thyroid RF could cost $25-30,000 in the hospital with general or $15,000 with conscious sedation.( Data from Major Medical Centers). Endocrine office based thyroid RF from several sources is $5000-7,500.
These preliminary studies of thyroid patients with benign nodules shows how Thyroid RF can be safely done in the scope of a endocrine office practice in the USA. This is based on the need for any endocrinologist to be trained before doing any thyroid RF procedure on humans. The results of my preliminary study continues on for 12 months.followed by a large clinical trial of 80-120 patients. Several trained endocrinologists doing thyroid RF in their offices are needed to validate the procedure.