Large Nodule RFA - Top Ablation Specialist Los Angeles CA (2023)

Thyroid radiofrequency ablation (RFA) is a non-surgical procedure that uses a special probe to heat up the nodule under the visualization of ultrasound. Ultrasound guided RFA is a good alternative to surgery for many health conditions like thyroid nodules, liver cancer, pain management, and other malignancies.

Using ultrasound-guidance the small RFA probe is placed into the targeted region. The heating mechanism is turned on and the treatment is monitored using ultrasound imaging to make sure the expected tissues are successfully treated. In the experienced hands of our specialist, this technique can administer heat to the target tissues causing tumor death and size reduction with little to no risk of damaging the surrounding tissues.

Advantages of Thyroid RFA

  • No major scar
  • No stitches
  • No anesthesia risks
  • No hormone replacement
  • No radiation
  • No hospital bills
  • Outpatient
  • Fast recovery
  • Spares normal thyroid tissue
  • Less risks than surgery

What is a Thyroid Nodule?

Thyroid nodules are abnormal growths or lumps that originate in the thyroid gland. They can be classified according to the content inside the lump into solid, predominantly solid, cystic (filled with fluid), and, predominantly cystic.

This condition is fairly common. Up to 5 to 10% of the population in the US may develop a palpable nodule in their lifetime. Additionally, thanks to the use of high-resolution ultrasounds, it has been found that 19 to 68% of randomly selected individuals have thyroid nodules.1

Most thyroid nodules are benign and asymptomatic (only 7 to 15% are malignant).1However, they may cause symptoms like difficulty swallowing, pain, and/or tenderness. Additionally, depending on their size, they can become a cosmetic concern.

Indications for Thyroid Nodule RFA

Radiofrequency ablation (RFA) can be applied in patients with a benign thyroid nodule (proven by a biopsy) that cause symptoms or have become a cosmetic issue due to their size.2 This is ideal for someone with a large thyroid nodule who does not want to have surgery.

Symptoms associated with thyroid nodules may include:

  • Difficulty swallowing
  • Pain
  • Tenderness
  • Persistent cough
  • Foreign body sensation in the neck

Radiofrequency ablation has also been used to treat nodules that are actively functioning (Autonomously Functioning Thyroid Nodules). Read more here.

The management of recurrent thyroid cancer is another viable indication for radiofrequency ablation (RFA). Additionally, RFA is proving to be a good alternative to surgery in patients with primary thyroid cancer that either refuses surgery or are not able to tolerate it.2Read more here.

Thousands treated Worldwide Successfully Safely

(Video) Radiofrequency ablation (RFA) of Thyroid Nodules Explained

Thyroid RFA: The Procedure

Thyroid radiofrequency ablation is an outpatient procedure that is performed in the office. It takes approximately 1 hour to perform under local anesthesia. Patient go home with just a Band-Aid.

During the procedure, our doctor will use ultrasound to guide a probe into the thyroid nodule. Using alternating current, the tip of the probe will generate heat that will cause selective burning of the nodule tissue. This is done throughout the nodule while visualizing the process on ultrasound. Having excellent 3D visualization and ultrasound skills is imperative to good results. Eventually, the cauterized tissue will be degraded by the body, achieving size reduction and symptom relief.

Due to its minimally invasive and percutaneous approach, RFA leaves no significant scar.In fact, our specialist does not make an incision of any kind and there are no sutures.

Thyroid RFA: Results

In expert hands, RFA is highly effective to reduce nodule size for solid and predominantly solid nodules (77 to 80% of volume reduction rate after 5 years follow-up).3For cystic and predominantly cystic nodules our specialist will aspirate or remove the fluid first then perform RFA ablation. RFA is also effective at symptom relief and offers a good cosmetic result as well.2

For patients with overactive thyroid nodules (AFTN), RFA has a 53 to 83% volume reduction rate and a return to normal values ranging from 24 to 82%.2

In some studies of RFA in patients with recurrent thyroid cancer, the rate of complete nodule disappearance after RFA is approximately 67%.2According to some studies, regrowth of the thyroid nodule after RFA has been observed in 20% of patients. However, this rate may vary depending on the doctor’s expertise.3

To achieve the best results it is important to have this procedure done by an imaging specialist that performs a high number of ultrasound guided procedures, and has the skills and ability to maneuver the probe in a 3D plane.

Large Nodule RFA - Top Ablation Specialist Los Angeles CA (1)

Large Nodule RFA - Top Ablation Specialist Los Angeles CA (2)

(Video) Thyroid Nodule and STARmed Thyroid RFA

Thyroid RFA: Recovery

Patients leave the office with a Band-Aid after the completion of the procedure.There is no downtime, major incisions or sutures.There may be bruising that usually resolves in 1 or 2 weeks. Even though this procedure is quite painless, some patients may experience mild discomfort.

Patients can typically return to normal activities the next day. However, avoiding heavy lifting and other activities that may cause neck strain is always advised.

Why California Thyroid Center?

Our physician is one of only a few RFA specialists specifically trained in ultrasound-guided procedures performing over 2,000 procedures yearly of different parts of the body. As a double-board certified imaging specialist, he has received 6 years of post-graduate training with specialization in ultrasound guided procedures and ablations, which requires a 3D spatial understanding while viewing a 2D image. In comparison, most other RFA specialist trained by taking a weekend course and only perform 20-100 ultrasound guided procedures yearly. Our specialist performs ablation of not only the thyroid but more complex organs such as cancers of the kidney, liver and lung. These more complex organs require a higher level of skill and understanding of the ablative technology to prevent damage to nerves, bowel and nearby organs. This has allowed many of our patients to undergo the thyroid RFA procedure safely by our specialist with outstanding results, no matter the complexity.

Our practices uses the top RFA system by STARmed. This system was developed over 15 years ago, used worldwideand has perfected the ability to treat thyroids. The STARmed probes are also small and unique in allowing the procedure to be done without making any incisions, minimizing scarring.

What do you need to do next?Request a consultationto meet with our RFA specialist who will review your imaging, labs and history to determine if you are a good candidate for the procedure, and the outcomes you can expect. Each person is an individual and should discuss the potential risks and benefits of thyroid RFA with our doctor to decide if this is the best option.

Consultations are available via an online video telehealth platform or in person in Los Angeles, California.Why should you choose us? Read here.

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Complications of Thyroid RFA

To avoid complications it is necessary to find a specialist who is trained and an expert in ultrasound guided procedures, such as our specialist. In general, this procedure is usually well-tolerated and has a low incidence of complications (2.11% for benign nodules and less than 11% for recurrent thyroid cancer).

The most common minor complaint is pain which is usually tolerable and easily managed with NSAIDs.2Bleeding is also a minor complication of RFA. However, this is easily managed with placing pressure on the treated area.

Nerve damage leading to voice change is the most common major complication associated with this procedure (1.45% incidence for benign nodules and 7.95% for recurrent thyroid cancer). However, permanent voice change is very rare (less than 1%).2Nodule rupture is the second most common major complication associated with RFA (0.17% incidence). This can cause pain and neck bulging and may require treatment with antibiotics.2Other rare complications may include skin burn, transient hypothyroidism (very rare), lidocaine toxicity, and hypertension.2

Keep in mind that these complications are rare and significantly less than the alternative surgery. To minimize risk, it is important to choose a specialist who has experience with performing ultrasound guided procedures. Our specialist performs over 2,000 ultrasound guided procedures a year. Having good technique and experience allows precise placement of the RFA needles to avoid injury to important structures. Good ultrasound technique is also important in achieving a satisfactory result.

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Request a consultationto meet with our RFA specialist who will review your imaging, labs and history to determine if you are a good candidate for the procedure, and the outcomes you can expect. Each person is an individual and should discuss the potential risks and benefits of thyroid RFA with our doctor to decide if this is the best option.

Consultations are available via an online video telehealth platform or in person in Los Angeles, California.Why should you choose us? Read here.

Large Nodule RFA - Top Ablation Specialist Los Angeles CA (3)

1.) Steven K Dankle, M. D. (2021, July 15). Thyroid nodule: Background, clinical outline, diagnostic workup.https://emedicine.medscape.com/article/127491-overview#a1

2.) Kim, J.-hoon, Baek, J. H., Lim, H. K., Ahn, H. S., Baek, S. M., Choi, Y. J., Choi, Y. J., Chung, S. R., Ha, E. J., Hahn, S. Y., Jung, S. L., Kim, D. S., Kim, S. J., Kim, Y. K., Lee, C. Y., Lee, J. H., Lee, K. H., Lee, Y. H., Park, J. S. Guideline Committee for the Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology.2017 thyroid radiofrequency ablation guideline: Korean Society of Thyroid Radiology.https://doi.org/10.3348/kjr.2018.19.4.632

3.) Bernardi, S., Bernardi, A. correspondence to: S., Giudici, F., Mediche, D. di S., Cesareo, R., Metaboliche, U. O. M., Antonelli, G., Ecoguidata, U. O. C. E. e, Cavallaro, M., Radiologia, U. O., Deandrea, M., Endocrinologia, U. O., Giusti, M., Endocrinologia, D. di, Mormile, A., Negro, R., Palermo, A., Bio-Medico, P. U. C., Papini, E.Five-Year results of Radiofrequency and laser ablation of Benign THYROID NODULES: A Multicenter Study from the Italian minimally invasive treatments of the Thyroid Group.https://www.liebertpub.com/doi/10.1089/thy.2020.0202

The above information explains what is involved and the possible risks. It is not meant to be a substitute for informed discussion between you and your doctor but can act as a starting point for such a discussion.

(Video) Survival Rates Are Comparable After Radiofrequency Ablation or Surgery in...

FAQs

Who does radiofrequency ablation of thyroid nodules? ›

UT Southwestern is one of the few health centers in the U.S. to offer radiofrequency ablation (RFA) for benign thyroid nodules. The treatment requires no surgery, scarring, or lifelong hormone therapy. RFA for thyroid nodules is performed by inserting a needle-like probe into the thyroid nodule.

Does insurance cover RFA for thyroid nodules? ›

This is because thyroid RFA is still a new treatment. Insurance covers the cost of your thyroid nodule evaluation, and you may be able to apply for approval for the RFA from your insurance company. Depending on your plan, you may be covered or may have to pay for the procedure out-of-pocket.

Is RFA a major surgery? ›

Radiofrequency ablation (RFA) is a minimally invasive treatment, one of several types of ablation therapy, where surgery is not a good option. Guided by imaging, a thin needle or probe is inserted through the skin and into the tumor.

How much does thyroid RFA cost? ›

The cost of Thyroid RFA can be variable depending on where it is performed. If performed in a hospital or surgical center, the cost can be very high, between $7,000 - $25,000. Using conscious sedation can increase that cost further as payment is needed for the anesthesiologist and the intravenous medications.

How big does a thyroid nodule have to be to be removed? ›

Any nodule that is 4 cm or larger should be removed with thyroid nodule surgery. Thyroid surgery is also very frequently needed for nodules that have atypical or suspicious cells on biopsy. This allows for a definitive diagnosis and cure. Many thyroid nodules that are benign on biopsy may be observed.

What foods reduce thyroid nodules? ›

Here are some of the best foods to shrink thyroid nodules and improve thyroid inflammation: Foods high in zinc and B vitamins like spinach, cashews, lamb, grass-fed beef, chicken, eggs, mushrooms, and asparagus. Foods high in selenium like brazil nuts, sunflower seeds, cashews, spinach, halibut, salmon, and oats.

What is the next step if radiofrequency ablation doesn't work? ›

If a cervical radiofrequency ablation doesn't work, a doctor may recommend the following treatments: medication. physical therapy. surgery.

What can go wrong with radiofrequency ablation? ›

The chief concern is bleeding or infection where the probe in inserted into the body, but this is a rare occurrence. Some people experience temporary weakness or numbness, or swelling or bruising at the insertion site.

How long does it take to heal from RFA? ›

Don't drive or do anything strenuous for 24 hours after the procedure. After a day or two, you can return to your normal activities, including bathing or showering. You may still feel soreness, pain or muscle spasms at the treatment site for a few days.

Is RFA covered by insurance? ›

Radiofrequency ablation is usually covered by insurance, and for those experiencing chronic neck or back pain, RFA can be a welcomed relief. Remember: For the best outcome, follow your doctor's recommendations.

How often can RFA be repeated? ›

If the patient's level of relief is only minimal after undergoing radiofrequency ablation treatment, then it can be repeated two or three weeks later.

Can thyroid grow back after ablation? ›

A follow-up study of up to 7 years after single-session ablation reported that regrowth occurs in 24.1% of cases, at an average of 39 months after RFA [9]. The most common risk factor for marginal regrowth is a large initial nodule volume [18,27].

Is a 2.5 cm thyroid nodule large? ›

Yes, every thyroid nodule larger than 1.0 to 1.5 cm (1/2 inch) in diameter as well as those with a suspicious goiter need to have a fine needle aspiration biopsy to obtain thyroid cells for cytologic evaluation.

Is radiofrequency ablation of thyroid nodules FDA approved? ›

RFA is an FDA approved non-surgical procedure that shrinks the nodules without compromising thyroid function and helps avoid long recovery times of thyroid surgery.

Is green tea good for thyroid nodules? ›

However, when it comes to using green tea for thyroid conditions, it may negatively affect thyroid health. In an animal study, researchers found that a high intake of green tea (equating to 5, 10, and 20 cups of green tea a day) leads to goiters and thyroid gland enlargement in rats.

How big is a large thyroid nodule? ›

Large thyroid nodules (>4 cm) are frequently referred for surgical removal because of concern for cancer, even if they demonstrate no structural impingement upon surrounding neck structures (14–16).

Are large thyroid nodules usually cancerous? ›

Lumps or bumps in the thyroid gland are called thyroid nodules. Most thyroid nodules are benign, but about 2 or 3 in 20 are cancerous. Sometimes these nodules make too much thyroid hormone and cause hyperthyroidism. Nodules that produce too much thyroid hormone are almost always benign.

What type of surgeon removes thyroid nodules? ›

Thyroid surgery is performed by otolaryngologists or general surgeons.

Is banana good for thyroid? ›

Hypothyroid persons can take all fruits including banana in moderation.

Which fruit is good for thyroid? ›

Apples, pears, plums and citrus fruits are abundant with pectins, which help with detoxifying the body of mercury – one of the most critical metals that have been connected to thyroid problems.

What is life expectancy after an ablation? ›

The median time from ablation to death was 11.6 days (interquartile range [IQR] 4.2–22.7).

When did RFA go wrong? ›

Damage to surrounding blood vessels and nerves during needle insertion resulting in excessive bleeding and/or irreversible neurologic damage causing long-term numbness and tingling. Heat damage to structures adjacent to the target nerve. Allergic reaction to the anesthetic used to numb the skin.

What happens if ablation doesnt work? ›

Ablation has serious risks, although they are rare. They include stroke and death. If ablation doesn't work the first time, you may need to have it done again.

Can radiofrequency ablation paralyze you? ›

Conclusions: Postoperative magnetic resonance imaging and physical examination suggest RFA-induced thermal injury as the most likely mechanism of paralysis.

How painful is radiofrequency ablation? ›

The patient experiences minimal discomfort throughout the procedure. The patient remains awake and aware during the procedure to provide feedback to the physician. A light sedative can be used during the procedure. The technique for nerve ablation is similar to that used for diagnostic blocks.

Who is a candidate for radiofrequency ablation? ›

You may be a good candidate for radiofrequency ablation if you have chronic pain that hasn't responded to other treatment options, such as over-the-counter or prescription medications, physical therapy, or regenerative medicine.

Are you put to sleep for nerve ablation? ›

An intravenous (IV) line may be placed in a vein in your arm before the procedure. You will be lying on your stomach and both local anesthesia and a mild sedative may be used to reduce any discomfort during the procedure. You will be awake during the process to aid in properly pinpointing the nerve.

Do nerves grow back after RFA? ›

Most patients experience pain relief lasting from six months to one year after RFA. Some patients are pain-free for much longer. Eventually, the nerve will regenerate, but that may take up to two years to occur.

Is an ablation considered surgery? ›

Catheter ablation is a non-surgical procedure that uses thin, flexible tubes called catheters to reach inside the heart. It does not require a general anesthetic or stopping the heart.

What type of doctor performs nerve ablation? ›

Who performs the procedure? The types of physicians who perform radiofrequency ablation include physiatrists (PM&R), radiologists, anesthesiologists, neurologists, and surgeons.

How long does RFA take to work? ›

It can take three or more weeks for the full effects of radiofrequency ablation to be felt. The pain relief may last six months to a year or even longer. Sometimes, nerves do grow back. In such cases, the radiofrequency ablation may need to be repeated.

Is radiofrequency ablation medically necessary? ›

Conventional (Thermal) Radiofrequency Ablation of facet joint nerves is proven and medically necessary for the following: Initial treatment of chronic cervical (C3-4 joint and below), thoracic and lumbar pain when: o Clinical documentation shows a Functional Impairment due to facet pain; and o Clinical documentation of ...

What is the test before radiofrequency ablation? ›

Before the nerve ablation procedure, you will have a test that uses a nerve block. The nerve block tells the doctor if the ablation will relieve your pain. This test numbs specific nerves to help your doctor find the nerves that are causing your pain.

What is the difference between a nerve block and ablation? ›

Your doctor may also use nerve blocks as a diagnostic tool to determine the source of your pain. Radiofrequency ablation of a nerve is sometimes used to provide longer lasting pain relief after a diagnostic nerve block. Procedure in which an injection of an anesthetic is delivered to a specific nerve to relieve pain.

Can nerve ablation be permanent? ›

Radiofrequency neurotomy isn't a permanent fix for back or neck pain. Studies on the success of treatment have been conflicting. Some people may have modest, short-term pain relief, while others might feel better for several months. Sometimes, the treatment does not improve pain or function at all.

Can a cancerous thyroid nodule shrink? ›

Can Thyroid Nodules Shrink on Their Own? Most solid thyroid nodules will not shrink on their own. In such cases, your doctor may prescribe medicine or recommend surgery to remove the nodules or shrink a nodule by removing fluid from it with a thin needle.

Should thyroid nodules be removed? ›

Even a benign growth on your thyroid gland can cause symptoms. If a thyroid nodule is causing voice or swallowing problems, your doctor may recommend treating it with surgery to remove all or part of the thyroid gland.

Does levothyroxine shrink thyroid nodules? ›

However, a few studies have indicated that levothyroxine therapy that keeps the TSH in the normal range was still able to reduce thyroid or nodule size to some extent in some patients. Some physicians have recommended the addition of iodine for a decrease in goiter and nodule size, especially in Europe.

Is thyroid RFA FDA approved? ›

In 2018, the FDA approved RFA for use on benign compressive thyroid nodules. Indications have since expanded to include malignancies under 1 cm and metastatic tumors of the neck lymph nodes.

How long does thyroid RFA take? ›

Thyroid RFA is routinely performed as an outpatient procedure, typically with local anesthetic only (though some patients may prefer to receive a mild sedative). The procedure typically lasts approximately one hour, depending on the size of the nodule being treated.

How can I shrink my thyroid nodules without surgery? ›

Doctors use radioactive iodine to treat hyperthyroidism. Taken as a capsule or in liquid form, radioactive iodine is absorbed by your thyroid gland. This causes the nodules to shrink and signs and symptoms of hyperthyroidism to subside, usually within two to three months. Anti-thyroid medications.

Can thyroid grow back after ablation? ›

A follow-up study of up to 7 years after single-session ablation reported that regrowth occurs in 24.1% of cases, at an average of 39 months after RFA [9]. The most common risk factor for marginal regrowth is a large initial nodule volume [18,27].

Can a cancerous thyroid nodule shrink? ›

Can Thyroid Nodules Shrink on Their Own? Most solid thyroid nodules will not shrink on their own. In such cases, your doctor may prescribe medicine or recommend surgery to remove the nodules or shrink a nodule by removing fluid from it with a thin needle.

Should thyroid nodules be removed? ›

Even a benign growth on your thyroid gland can cause symptoms. If a thyroid nodule is causing voice or swallowing problems, your doctor may recommend treating it with surgery to remove all or part of the thyroid gland.

Does levothyroxine shrink thyroid nodules? ›

However, a few studies have indicated that levothyroxine therapy that keeps the TSH in the normal range was still able to reduce thyroid or nodule size to some extent in some patients. Some physicians have recommended the addition of iodine for a decrease in goiter and nodule size, especially in Europe.

Is thyroid RFA painful? ›

During the RFA, it's normal to feel pushing and pressure in the neck, but the procedure generally does not cause pain. Patients occasionally feel heat or discomfort in the neck that may radiate to the ear or jaws. Following your procedure, you will be given ice packs and pain medication if needed.

Does thyroid RFA hurt? ›

The procedure is so gentle that most people have little to no discomfort. This is because the thyroid nodule itself is not sensitive to pain. Other than the initial injection of numbing medication, the only remaining sensation is generally pressure.

Is a 2.5 cm thyroid nodule large? ›

Yes, every thyroid nodule larger than 1.0 to 1.5 cm (1/2 inch) in diameter as well as those with a suspicious goiter need to have a fine needle aspiration biopsy to obtain thyroid cells for cytologic evaluation.

Is green tea good for thyroid nodules? ›

However, when it comes to using green tea for thyroid conditions, it may negatively affect thyroid health. In an animal study, researchers found that a high intake of green tea (equating to 5, 10, and 20 cups of green tea a day) leads to goiters and thyroid gland enlargement in rats.

Do thyroid nodules make you tired? ›

Older people with a nodule that produces too much thyroid hormone may have only vague symptoms, including: Fatigue.

What causes thyroid nodules to grow? ›

Hashimoto's disease, a thyroid disorder, can cause thyroid inflammation and result in enlarged nodules. This often is associated with hypothyroidism. Multinodular goiter. The term goiter is used to describe any enlargement of the thyroid gland, which can be caused by iodine deficiency or a thyroid disorder.

How fast do thyroid nodules grow? ›

More importantly, most nodules, whether they are benign or cancerous, either are stable or grown <2 mm/year. This is helpful in the long term management of thyroid nodules.

Does iodine shrink thyroid nodules? ›

Radioactive Iodine

This treatment is mainly used to shrink a goiter or nodule that causes the thyroid to produce too much thyroid hormone. The iodine is given as a capsule or liquid. Once swallowed, it concentrates in the thyroid and destroys some or all of the thyroid tissue, without harming other tissues.

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