A Summary of Medical Research from the International Journal of Endocrinology
Radiofrequency Ablation of Thyroid Nodules: The Basic Principles & Clinical Application
Let’s discover the basic principles and clinical applications of radiofrequency ablation of thyroid nodules. As the use of thyroid ultrasonography has increased, so has the visualization of thyroid nodules which couldn’t be felt by palpation. While thyroid nodules are mostly benign and don’t need treatment, some nodules require treatment due to the patient having compressive symptoms. Therefore, radiofrequency ablation has proven to be the most effective and safe option to treat enlarged symptomatic benign thyroid nodules.
Basic Principle Of Radiofrequency Ablation
Radiofrequency ablation for thyroid nodules is a minimally invasive treatment option performed by an Interventional Radiologist, Endocrine Surgeon, Otorhinolaryngologist, or Endocrinologist, as an alternative to surgery. RFA is performed by inserting a needle-like probe into the thyroid nodule while using ultrasound guidance. The tip of the needle uses heat generated from high-frequency oscillating electrical currents. The electrical currents pass through the electrode aggregate tissue ions around the electrode, the increasing temperature within the tumor tissue, creating the destruction of the tumor. This causes the thyroid nodule to shrink.
Who Can Opt For Thyroid Nodule RFA
Patients having enlarged symptomatic benign thyroid nodules can potentially be a candidate for thyroid Radiofrequency ablation. The common indications to ablate benign thyroid nodules using RF ablation include neck pain, foreign body sensation, dysphasia, compressive symptoms, AFTNs, or thyrotoxicosis. It’s not recommended to treat primary thyroid cancer and follicular neoplasms with RFA. Moreover, patients with heart problems and pregnant women shouldn’t go for RFA.
Furthermore, at least two biopsies are essential to validate that the nodule is benign and evaluate the size, margin, shape, proportion of solid component, internal vascularity, calcification, and echogenicity. In addition, a patient’s blood test must be conducted to determine blood count, calcitonin, thyroid hormones, and thyroid autoantibodies, and RFA shouldn’t be performed if any report shows abnormality.
For nodules having less than 10% of solid components, ethanol ablation is encouraged because of its efficacy and safety to those of radiofrequency ablation, its cost-effectiveness, and fewer treatment sessions. For nodules having solid components greater than 10% but less than 50%, radiofrequency ablation is more effective and safe.
Essential Devices And Procedure To Perform RFA
The most crucial device to perform thyroid radiofrequency ablation in thyroid nodules is a thin specific thyroid electrode because it’s easy to control and minimize injury to the thyroid gland. Ground pads, radiofrequency generator, and pump are essential to heat the electrode tip and later to perfuse chilled water.
The procedure begins with the moving shot technique, in which the electrode is inserted in the deepest portion of the nodule, heated up, and small parts of the nodule are ablated. The radiofrequency power is turned off or reduced if the patient experiences any type of pain.
Expected Results For RFA of Thyroid Nodules
RFA of thyroid nodules effectively reduces the nodule size and relieves nodule-related problems. After one month of RFA, the greatest nodule volume reduction is expected from 33% – 58% and 51% – 85% after six months.
RFA for patients with AFTN is effective but may require more treatment sessions to ablate the whole nodule since untreated portions could affect thyroid function, resulting in the regrowth of treated nodules.
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- Ji Hoon Shin, Jung Hwan Baek, Eun Ju Ha, Jeong Hyun Lee, “Radiofrequency Ablation of Thyroid Nodules: Basic Principles and Clinical Application”, International Journal of Endocrinology, vol. 2012, Article ID 919650, 7 pages, 2012. https://doi.org/10.1155/2012/919650
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