Thyroid Nodule Clinic

RFA Generator
women holds hands up to neck
Thyroid gland

The Dotter Department of Interventional Radiology, in conjunction with the Thyroid and Parathyroid clinic at OHSU, is now offering radiofrequency ablation of symptomatic benign thyroid nodules. This minimally invasive outpatient procedure is a thyroid preserving alternative to surgery or radioiodine therapy.

What types of nodules are treated?

Thyroid nodule ablation is used to treat benign nodules that cause compression on the airway, cause difficulty swallowing, or are disfiguring. Additionally, nodules that produce thyroid hormone (autonomously functioning nodules) and cause symptoms can be treated with ablation. 

Benefits over surgery:

This minimally invasive outpatient procedure can effectively treat symptomatic thyroid nodules without the need for surgery. The procedure preserves normal thyroid tissue and function.

Thyroid nodule ablation is performed in the outpatient setting and does not require an overnight stay in the hospital. After having the neck cleaned and sterilely draped, the skin and neck around the thyroid gland are numbed with lidocaine. Local anesthetic with lidocaine is adequate for the majority of patients, although moderate sedation can be given if needed. Once the area is numb, the radiofrequency probe (like a needle) is inserted into the nodule from a trans-isthmic approach. Under ultrasound guidance, the nodule is heated to kill the tissue using the moving shot technique. For most patients one or even several nodules can be treated from a single skin puncture. Typically the procedure lasts between 1-2 hours depending on the size and number of nodules treated. At the end of the procedure, the probe is removed and a Band-Aid is applied. Patients are observed for 1 hour, discharged to home and can resume normal activities the next day.

Nodule volume reduction on average at 1 month is 60%, at 3 months 75%, at 6 months 85%, and at 3 years 90%. [1, RFA at 4 yr follow up]

You will follow up in clinic after your procedure at 1, 3, 6, 9, and 12 months, where you will have you will have labs drawn and ultrasounds performed.

Risks and benefits of thyroid nodule RF ablation procedure
Complication Reported rate
Temporary voice change 0.94%
Permanent voice change <0.17%
Nodule rupture 0.17%
Hematoma rare
Hypothyroidism Very rare

If you are interested in learning more about whether this treatment is right for you, contact either the Dotter Department of Interventional Radiology to schedule an appointment with Dr. Huber, or contact the Thyroid and Parathyroid clinic to schedule an appointment. After your consultation, your case will be presented at a multidisciplinary conference where specialists from Interventional Radiology, Head and Neck surgery, Otolaryngology, Surgical Oncology, and Endocrinology will discuss treatment options.

References:

  1. Jeong WK, Baek JH, Rhim H, et al. Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol. 2008;18(6):1244-1250.
  2. Lim HK, Lee JH, Ha EJ, Sung JY, Kim JK, Baek JH. Radiofrequency ablation of benign non-functioning thyroid nodules: 4-year follow-up results for 111 patients. Eur Radiol. 2013;23(4):1044-1049.
  3. Wang JF, Wu T, Hu KP, et al. Complications Following Radiofrequency Ablation of Benign Thyroid Nodules: A Systematic Review. Chin Med J (Engl). 2017;130(11):1361-1370.