Radiofrequency
In radiofrequency ablation, the alternating electrical current applied to the tissue causes ions to move back and forth. The friction generated by this movement produces heat, and this heat destroys tumor cells. Radiofrequency is one of the oldest and most commonly used ablation methods in medicine. Today, it is widely used on cancer patients, especially for tumors in the liver, lung, kidney, and bone. Radiofrequency is also one of the most commonly used ablation methods for distant metastases of thyroid cancer in other organs.
In the benign thyroid nodules, RF ablation was first reported by Dr Kim in 2006, and since then, it has been successfully used by many other investigators especially in Asia. Many studies performed in thousands of patients report that RF ablation is very successful in the treatment of benign thyroid nodules. After RF ablation, like laser, the nodules become smaller, cosmesis is improved and the complaints such as hoarseness, shortness of breath and swallowing difficulty improve or disappear completely.
How to perform RF ablation?
First, an ultrasound examination is done and the nodule(s) to be ablated are visualized. Then, local anesthetic is injected into the skin and the RF needle is placed into the nodule under ultrasound guidance. After the RF machine is activated, heat is produced at the tip of the needle. By moving the RF needle continuously in different directions (moving shot technique), the whole nodule is destroyed completely with RF energy. After the procedure, the RF needle is removed and the patient may be discharged one hour later.
How is it done?
After the thyroid nodule to be ablated is identified on ultrasound, local anesthesia will be applied to numb the entry site on the skin. Then, under ultrasound guidance, a radiofrequency needle is advanced into the nodule. Once the radiofrequency generator is turned on, the needle is directed to different parts of the nodule so that the entire nodule is exposed to the heat produced by radiofrequency. Similar to laser ablation, the heated (ablated) areas appear white on ultrasound. After the procedure is completed, the radiofrequency needle is removed, and the patient is observed for a few hours before being discharged.
In our patient with a 57x50x49 mm solid nodule in the right lobe, the nodule was treated with percutaneous radiofrequency ablation under ultrasound guidance. The 6 months and 1 year ultrasound examinations demonstrated 60% and 90% volumetric reduction respectively.
Radiofrequency Ablation Treatment for Thyroid Nodules
When is it used?
Radiofrequency ablation, like laser, is a technique that destroys tissue by heating it. Although it has been widely used on other organs for many years, its use in the thyroid has become increasingly common over the last decade. Similar to laser and alcohol ablation, radiofrequency is primarily used for non-surgical treatment of benign thyroid nodules. However, in recent years, this method has also been tried in thyroid cancers that recur in the neck after surgery, and successful outcomes have been reported. In one study, radiofrequency was shown to have the same success as surgery in controlling recurrent tumors, while having a lower complication rate.
In our patient with a single, large (53x45x47 mm) solid nodule in the istmus, percutaneous radiofrequency ablation was done to treat the nodule. The six months control ultrasound examination showed over 80% volume reduction of the treated thyroid nodule.
What are its advantages?
Like laser ablation, radiofrequency is performed with a thin needle. It leaves no scar on the skin, is painless, and the patient can go home shortly after the procedure. As with the laser ablation procedure, the complication rate is very low.
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