Dong Gyu Na et al
- Radiofrequency ablation can be used to treat benign thyroid nodules.
- RFA is not recommend thyroid RF ablation for follicular neoplasms.
- Caution should be taken in regard to the use of thyroid RF ablation in pregnant women, patients with serious heart problems, and those with contralateral vocal cord palsy.
- Use of bipolar electrode is recommended for pregnant females and pacemaker patients.
- RFA is also recommended for recurrent thyroid cancer lymph nodes.
- Primary micro-papillary thyroid cancer is under study but looks good as a replacement for surgery or active surveillance.
- Large bulky goiters with obstruction can be reduced in size to relieve the symptoms.
- RFA plus tracheal Stint gave relief to severe trachael obstruction.
- Combination RFA and External beam has been used in palliative care of thyroid cancer patients.
Benign thyroid nodules
1.Indications for RF ablation of benign thyroid nodules include patients with nodule-related clinical problems.
2 Symptom (neck pain, dysphasia, foreign body sensation, discomfort, and cough) score can be self-measured by patients using a 10 cm visual analogue scale (grade 0-10).
3. Cosmetic score can be measured by a physician. Cosmetic score (1, no palpable mass; 2, no cosmetic problem but palpable mass; 3, a cosmetic problem on swallowing only; and 4, a readily detected cosmetic problem)
4. Patients with autonomously functioning thyroid nodules (AFTN) causing problems related to thyrotoxicosis.
5.Patients with nodules with a maximum diameter > 2 cm that continue to grow, may be considered for thyroid RF ablation based on symptoms and clinical concerns.
6. Patients with cystic thyroid nodules that re-grow after simple aspiration should be treated first with ethanol ablation (EA) rather than RF ablation.
7. The efficacy and complications were similar in both EA and RF ablation groups, but the number of treatment sessions was fewer in the EA group.
8. EA is a simple and less expensive procedure.
9. EA is done in the USA now. Call Matt if you have a cystic nodule. 310-393-8860.
10. email to [email protected]
Recurrent thyroid cancers
(operation bed and lymph nodes)
- Surgery is a standard treatment for recurrent thyroid cancers, followed by radioactive iodine and thyroid hormone therapy.
- RF ablation, however, can be used in patients at high surgical risk and in patients who refuse to undergo repeated surgery.
Richard Guttler MD,FACE,ECNU