Radiofrequency Ablation for Benign Thyroid Nodules

I was at our interventional oncology conference this morning and learned about new indication for radiofrequency ablation. We had performed a radiofrequency ablation for large thyroid nodules that was causing cosmetic deformity of the neck. The patient had a great cosmetic outcome.

The nodules were previously biopsied and turned out to be benign colloid nodule. Upon literature search, this procedure is commonly performed in Korea and Europe.

I found out the procedure could be performed in an outpatient setting under local anesthesia. It's usually performed as a staged procedure for safety purposes. It's relatively safe as long the proceduralist is mindful of important structures (i.e. recurrent laryngeal and vagus nerves, contents of the carotid sheaths).

The procedure is performed using continuous low voltage using a moving target approach.

Alternatives to the procedure which are usually performed include conservative management versus hemi- or total thyroidectomy depending on which thyroid lobes are involved.

After a literature search, I found out that the procedure is effective for improving cosmetic outcomes

Ultrasound guided Radiofrequency Ablation of Thyroid Nodule (Baek et al. AJR). The cyst component is first aspirated and then, the solid component is 

References:

Baek et al. Benign predominantly solid thyroid nodules: prospective study of efficacy of sonographically guided radiofrequency ablation versus control. AJR 2010 Apr;194(4):1137-42. doi: 10.2214/AJR.09.3372.

Jeaong et al. adiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol. 2008 Jun;18(6):1244-50. doi: 10.1007/s00330-008-0880-6. Epub 2008 Feb 20.