Thyroid radiofrequency ablation is an option for the treatment of benign nodules with cosmetic or compressive symptoms1–9 that is rapidly growing and acquiring new adopters worldwide. The perspective of treating the thyroid nodule without jeopardizing the function regardless of the percentage of the nodule's solid component is disruptive and may change the way we approach nodular thyroid diseases.10–15 Although extensive literature regarding indication, complications, and results is available, little is available regarding the procedure methods and steps.16–32
Materials and Methods:
Our group summarized the equipment, supplies, and room disposition necessary for a safe, reproducible, and effective thyroid nodule ablation.
Results:
Thyroid nodule can be effectively and safely ablated with a routine evaluation before the procedure is associated with meticulous technique. This allows seamless tissue destruction that will inevitably develop nodule reduction and fibrotic tissue formation.
Conclusion:
The items included in this video allow us to comprehensively understand the routine of nodule evaluation, procedure execution, and follow-up.
HaEJ, BaekJH. Advances in nonsurgical treatment of benign thyroid nodules. Future Oncol, 2014; 10:1399–1405.
2.
CrileG, Jr. Treatment of thyroid cysts by aspiration. Surgery, 1966; 59:210–212.
3.
EdmondsCJ, TellezM. Treatment of thyroid cysts by aspiration and injection of sclerosant. Br Med J, 1987; 295:529.
4.
ShinJH, BaekJH, HaEJ, LeeJH. Radiofrequency ablation of thyroid nodules: Basic principles and clinical application. Int J Endocrinol, 2012; 2012:919650.
5.
JeongWK, BaekJH, RhimH, et al.Radiofrequency ablation of benign thyroid nodules: Safety and imaging follow-up in 236 patients. Eur Radiol, 2008; 18:1244–1250.
6.
PapiniE, PacellaCM, MisischiI, et al.The advent of ultrasound-guided ablation techniques in nodular thyroid disease: Towards a patient-tailored approach. Best Pract Res Clin Endocrinol Metab, 2014; 28:601–618.
7.
KimJH, BaekJH, LimHK, et al.2017 Thyroid radiofrequency ablation guideline: Korean society of thyroid radiology. Korean J Radiol, 2018; 19:632–655.
AhnHS, KimSJ. Radiofrequency ablation of benign thyroid nodules: Evaluation of the treatment efficacy using ultrasonography. Ultrasonography, 2016; 35:244–252.
10.
YooRE, KimJH, PaengJC, ParkYJ. Radiofrequency ablation for treatment of locally recurrent thyroid cancer presenting as a metastatic lymph node with dense macrocalcification: A case report and literature review. Medicine (Baltimore), 2018; 97:e0003.
11.
DuranteC, CostanteG, LucisanoG, et al.The natural history of benign thyroid nodules. JAMA, 2015; 313:926–935.
12.
BaekJH, JeongHJ, KimYS, KwakMS, LeeD. Radiofrequency ablation for an autonomously functioning thyroid nodule. Thyroid, 2008; 18:675–676.
13.
LeeJH, KimYS, LeeD, ChoiH, YooH, BaekJH. Radiofrequency ablation (RFA) of benign thyroid nodules in patients with incompletely resolved clinical problems after ethanol ablation (EA). World J Surg, 2010; 34:1488–1493.
14.
KimC, LeeJH, ChoiYJ, KimWB, SungTY, BaekJH. Complications encountered in ultrasonography-guided radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers. Eur Radiol, 2017; 27:3128–3137.
15.
HaugenBR, AlexanderEK, BibleKCet al. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid, 2016; 26:1–133.
16.
SpieziaS, GarberoglioR, MiloneF, et al.Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid, 2009; 19:219–225.
17.
HamidiO, CallstromMR, LeeRA, et al.Outcomes of radiofrequency ablation therapy for large benign thyroid nodules: A Mayo Clinic case series. Mayo Clin Proc, 2018; 93:1018–1025.
18.
SimJS, BaekJH. Long-term outcomes following thermal ablation of benign thyroid nodules as an alternative to surgery: The importance of controlling regrowth. Endocrinol Metab (Seoul), 2019; 34:117–123.
19.
SimJS, BaekJH, ChoW. Initial ablation ratio: Quantitative value predicting the therapeutic success of thyroid radiofrequency ablation. Thyroid, 2018; 28:1443–1449.
20.
DeandreaM, TrimboliP, GarinoF, et al.Long-term efficacy of a single session of RFA for benign thyroid nodules: A longitudinal 5-year observational study. J Clin Endocrinol Metab, 2019; 104:3751–3756.
21.
KimJH, BaekJH, LimHK, NaDG. Summary of the 2017 thyroid radiofrequency ablation guideline and comparison with the 2012 guideline. Ultrasonography (Seoul, Korea), 2019; 38:125–134.
22.
BaekJH, LeeJH, SungJY, et al.Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: A multicenter study. Radiology, 2012; 262:335–342.
23.
BoniG, BoccuzziA, BianchiF, et al.Successful radiofrequency ablation strategies for benign thyroid nodules. Clin Endocrinol, 2019; 64:316–321.
24.
BoniG, BoccuzziA, BianchiF, et al.Management strategy for nerve damage during radiofrequency ablation of thyroid nodules. Clin Endocrinol, 2019; 36:204–210.
25.
ChoiY, JungSL. Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: A single-center propensity score matching study. Int J Hyperthermia, 2019; 36:359–367.
CesareoR, NaciuAM, IozzinoM, et al.Nodule size as predictive factor of efficacy of radiofrequency ablation in treating autonomously functioning thyroid nodules. Int J Hyperthermia, 2018; 34:617–623.
32.
DobrinjaC, BernardiS, FabrisB, et al.Surgical and pathological changes after radiofrequency ablation of thyroid nodules. Int J Endocrinol, 2015; 2015:576576.
