Final Words on Thyroid RFA by Dr.Guttler
Main weaknesses is in using RFA on the thyroid gland include the lack of definitive histology, possibility of incomplete nodule ablation, and surveillance problems for the residual thyroid mass after RFA.
However, RFA is an an effective nonsurgical option to improve pressure and toxic symptoms in benign thyroid nodules. Volume reduction, pressure symptoms, and cosmetic symptoms, can be improved and appear last long term. Therefore, proper selection of patient with benign nodule for RFA and subsequent monitoring were needed.
New developments in Thyroid RFA
Needletracker system for teaching Thyroid RFA.
1/2 hot tip for close danger objects
Ablation of sinking arterioles before the Thyroid RFA.
Bipolar electrode for pregnant and pacemaker patients.
No grounding pads.
Microdissection method (Dextrose avoidance) when the target nodule is too close to a dangerous structure
Thanks to Dr. JH Baek at Asan MC Seoul Korea for his input and images.
and Dr. Kai-Pun Wong and Brian Hung -Lin Lang of Queen Mary Hospital Hong Kong for their review article
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.