A thyroid nodule is an area of thyroid tissue that has developed abnormally. It can be solid or liquid (cystic). Typically, most nodules are benign, although they should be evaluated for cancer if the ultrasound suggests the need. Thyroid nodules come in varying sizes. Some may cause alterations in your thyroid hormone levels. Occasionally they present with symptoms of pressure, compression, or hoarseness.
Thyroid nodule radiofrequency ablation is a minimally invasive, non-surgical method for treating benign thyroid nodules. Typically, nodules have to be proven benign by sampling, must be within an ideal size range, and preferably solid. Under ultrasound guidance, with injection of local anesthetic around the thyroid, a small needle is inserted into the nodule. The tip of the needle generates an electrical current which causes it to form a small circular area of heat. This is used to precisely ablate the inside of the nodule, under continuous ultrasound guidance. Once the nodule is treated, it will begin to shrink over time.
Thyroid nodule treatment is highly dependent on the workup of the nodule and whether it is benign or malignant. Malignant nodules are typically treated with surgery (patient specific circumstances may change this). Benign nodules have multiple options ranging from surveillance to treatment depending on patient preferences and symptoms.
Often thyroid nodules can present with loss of cosmesis or symptoms. Until now, the typical approaches to treatment were continued surveillance, in cystic (liquid containing nodules) injection of ethanol to close the nodule, or surgical removal. A new, safe option that is now available is thyroid nodule radiofrequency ablation.
During the procedure, a thin needle-like electrode is inserted into the thyroid nodule under ultrasound guidance, after numbing the overlying skin. The electrode delivers radiofrequency energy to the nodule, heating the tissue while watching it live under ultrasound to make sure the nodule is accurately treated. After treatment, the nodule will begin to shrink over time.
Recovery after RFA is relatively quick. Most patients can resume their regular activities within a day or two. Mild pain, swelling, and bruising at the needle insertion site are common but usually subside quickly.
The procedure is usually well-tolerated. Local anesthesia is typically used to numb the area, reducing discomfort. Some patients may experience mild discomfort or pressure during the procedure. If needed, mild anti-anxiety medication can be provided at the patient’s request.
Thyroid nodule RFA has been shown to be effective in reducing the size and symptoms of benign thyroid nodules. In general, the procedure provides 50-70% reduction in size of the nodules and often allows the patients to achieve their symptom goals without undertaking surgery. However, not all nodules may respond equally to the treatment; this can be due to the size and location of the nodule. Choosing the right type of nodule is the key to success.
Insurance coverage varies depending on the insurance company, policy and the specific medical situation. It’s recommended to check with your insurance provider before undergoing the procedure to understand your coverage.
Interventional radiologists are the pioneers of image guided intervention. The interventional radiologists at Fairfax Vascular Center (FVC) have the largest organ ablation experience in the region and are proud to pioneer the thyroid ablation program in the DMV area.
We work in a multidisciplinary fashion with our subspecialized thyroid imaging radiologists as well as our endocrinologists and endocrine surgeons to make sure that our patients not only get the best care, but the best outcomes possible.