RadFYI: From benign solid nodules to active, AFTNs, thyroid RFA delivers excellent clinical outcomes, significant volume reductions, and functional recovery with minimal patient downtime.
Thyroid radiofrequency ablation (RFA) offers an effective alternative to surgery or radioactive iodine—relieving cosmetic or compressive symptoms and normalizing function without the risk of lifelong hypothyroidism.
Approach & Technique: As Dr. Frank Hao explained during ARRS’ Emerging IR Treatments Online Course, operators utilize a trans-isthmic approach and the moving shot technique to systematically and safely ablate the tissue.
- Agents of Shield: To prevent complications, clinicians must identify and avoid what Hao dubbed the “danger triangle,” protecting critical structures like the recurrent laryngeal nerve, vagus nerve, and cervical sympathetic ganglion.
- Staged Ablations: For exceptionally large nodules, staging the treatment across multiple sessions keeps patients comfortable and prevents lidocaine from wearing off during a tedious procedure.
By the Numbers:
- 90%: The volume reduction rate achieved in a year for a very large mixed cystic nodule, resulting in complete resolution of the nodule on physical exam.
- 40% to 91%: The rate of TSH normalization in patients treated for autonomously functioning thyroid nodules (AFTNs), allowing patients to completely stop thyroid-regulating medications like methimazole.
- <12 cc: The volume threshold below which hot nodules have a significantly higher chance of achieving a euthyroid state post-RFA.
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