Thyroid Tumor RFA 101: What Went Wrong in 2001 That Has Delayed RFA Development in the USA?
Comments: This early study was done with the Liver Electrode which was too thick and long for careful delicate thyroid neck treatments. 1/8 patients in the study developed vocal cord paralysis. 12.5% and 1/8 had a skin burn. The proof was that there was no more studies with the big electrode and it set the US back in development of alternative tumor ablation treatment alternatives for almost 2 decades.
In 2017 we still do not have FDA approval for Thyroid RFA with a thyroid friendly small length 7 cm, narrow gauge #18,19 electrode. You can thank the narrow minded suits at the major medical device companies for failure to fund thyroid RFA studies over the new hot ablation system of microwave ablation MWA.
This is a #16 gauge antenna used in MWA. It is massive and is not acceptable for the thyroid cancer work in the neck.
Richard Guttler MD,FACE,ECNU
Thyroid Tumor Ablation Thyroidologist
Radiofrequency ablation of regional recurrence from well-differentiated thyroid malignancy*
Surgery December 2001Volume 130, Issue 6, Pages 971–977
Background. Regional recurrence of well-differentiated thyroid cancer (WTC) is primarily detected with ultrasonography (US), and current treatment is surgical. Radiofrequency ablation (RFA) has been used primarily for liver tumors as an alternative to a surgical procedure. We have applied RFA to a group of patients with locally recurrent WTC. Methods. Eight patients underwent percutaneous RFA for biopsy-proven recurrent WTC in the neck (mean size, 2.4 cm; range, 0.8-4.0 cm) while under intravenous conscious sedation and with US guidance. The RF electrode was inserted into the site of recurrence and treated with the maximum allowable current for between 2 and 12 minutes. Follow-up consisted of US in 8 patients, thyroglobulin levels in 6 patients, biopsy in 4 patients, and surgical treatment in 2 patients. Results. All 8 patients with no bleeding or infectious complications were treated as outpatients. A minor skin burn and 1 vocal cord paralysis occurred. No recurrent disease at the treatment site was detected, with a mean follow-up of 10.3 months. Histological examination showed no evidence of a tumor in the treated lymph nodes in 6 patients. Follow-up US examinations showed disappearance of previously detected color Doppler flow, as well as mass shrinkage and internal cystic change, or both. Conclusions. US-guided RFA is an exciting new treatment modality that appears to have a future role in treating locally recurrent WTC. (Surgery 2001;130:971-7.)
The left is the large bore #17 gauge lone electrode used in this 2001 study.
The right is the Thyroid RF mini-probe that is short for work in the neck
and has smaller bore of #18 and 19 gauge.
The Thyroid RF mini probe come in different size burn areas. The picture shows a 10 mm burn area