Radiofrequency Ablation of Thyroid Nodules: Basic Principles and Clinical Application

Radiofrequency (RF) ablation has been gaining popularity as a minimally invasive treatment for benign thyroid nodules regardless of the extent of the solid component. RF ablation of benign nodules demonstrated volume reductions of 33–58% after one month and 51–85% after six months, while solving nodule-related clinical problems. RF ablation has recently shown positive short-term results for locoregional control as well as symptom improvement in patients with recurrent thyroid cancers. This paper reviews the basic physics, indications, patient preparation, devices, procedures, clinical results, and complications of RF ablation.

[1]  S. Goldberg,et al.  Radiofrequency tumor ablation: principles and techniques. , 2001, European journal of ultrasound : official journal of the European Federation of Societies for Ultrasound in Medicine and Biology.

[2]  Dong Gyu Na,et al.  Radiofrequency Ablation of Benign Thyroid Nodules and Recurrent Thyroid Cancers: Consensus Statement and Recommendations , 2012, Korean journal of radiology.

[3]  Dongyook Kim Sonography-Guided Ethanol Ablation of a Remnant Solid Component after Radio-Frequency Ablation of Benign Solid Thyroid Nodules: A Preliminary Study , 2012, American Journal of Neuroradiology.

[4]  H. Rhim,et al.  Radiofrequency ablation of benign cold thyroid nodules: initial clinical experience. , 2006, Thyroid : official journal of the American Thyroid Association.

[5]  W. Lau,et al.  Hepatocellular carcinoma treated with radiofrequency ablation with or without ethanol injection: a prospective randomized trial. , 2007, Radiology.

[6]  G. Gazelle,et al.  Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. , 2000, AJR. American journal of roentgenology.

[7]  Jeong Hyun Lee,et al.  Symptomatic benign thyroid nodules: efficacy of additional radiofrequency ablation treatment session--prospective randomized study. , 2012, Radiology.

[8]  L. Hegedüs Therapy: A new nonsurgical therapy option for benign thyroid nodules? , 2009, Nature Reviews Endocrinology.

[9]  Jeong Hyun Lee,et al.  Radiofrequency Ablation (RFA) of Benign Thyroid Nodules in Patients with Incompletely Resolved Clinical Problems after Ethanol Ablation (EA) , 2010, World Journal of Surgery.

[10]  Dong Gyu Na,et al.  Ultrasonography and the Ultrasound-Based Management of Thyroid Nodules: Consensus Statement and Recommendations , 2011, Korean journal of radiology.

[11]  Jung Hwan Baek,et al.  Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients , 2008, European Radiology.

[12]  Dong Gyu Na,et al.  Thermal Ablation for Benign Thyroid Nodules: Radiofrequency and Laser , 2011, Korean journal of radiology.

[13]  Jeong Hyun Lee,et al.  How to manage the patients with unsatisfactory results after ethanol ablation for thyroid nodules: role of radiofrequency ablation. , 2012, European journal of radiology.

[14]  J. Shin,et al.  Inoperable Symptomatic Recurrent Thyroid Cancers: Preliminary Result of Radiofrequency Ablation , 2011, Annals of Surgical Oncology.

[15]  J. Chapelon,et al.  High-intensity focused ultrasound ablation of thyroid nodules: first human feasibility study. , 2011, Thyroid : official journal of the American Thyroid Association.

[16]  D. Na,et al.  Core-needle biopsy is more useful than repeat fine-needle aspiration in thyroid nodules read as nondiagnostic or atypia of undetermined significance by the Bethesda system for reporting thyroid cytopathology. , 2012, Thyroid : official journal of the American Thyroid Association.

[17]  D. Na,et al.  Diagnostic accuracy of fine-needle aspiration versus core-needle biopsy for the diagnosis of thyroid malignancy in a clinical cohort , 2012, European Radiology.

[18]  E. Strong,et al.  Complications after Total Thyroidectomy , 1989, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[19]  Jeong Hyun Lee,et al.  The efficacy and complications of radiofrequency ablation of thyroid nodules , 2011, Current opinion in endocrinology, diabetes, and obesity.

[20]  F. Liu,et al.  Ultrasound-guided percutaneous microwave ablation of benign thyroid nodules: experimental and clinical studies. , 2012, European journal of endocrinology.

[21]  Jung Yin Huh,et al.  Benign predominantly solid thyroid nodules: prospective study of efficacy of sonographically guided radiofrequency ablation versus control condition. , 2010, AJR. American journal of roentgenology.

[22]  Dong Wook Kim,et al.  Differentiation between Benign and Malignant Solid Thyroid Nodules Using an US Classification System , 2011, Korean journal of radiology.

[23]  Jeong Hyun Lee,et al.  Unidirectional ablation electrode to minimize thermal injury during radiofrequency ablation: an experimental study in an ex vivo bovine liver model. , 2011, Journal of vascular and interventional radiology : JVIR.

[24]  C. Martinoli,et al.  Sonography of the cervical vagus nerve: normal appearance and abnormal findings. , 2001, AJR. American journal of roentgenology.

[25]  H. Rhim,et al.  Does Artificial Ascites Induce the Heat-Sink Phenomenon during Percutaneous Radiofrequency Ablation of the Hepatic Subcapsular Area?: an in vivo Experimental Study Using a Rabbit Model , 2009, Korean journal of radiology.

[26]  Jihoon Cha,et al.  Radiofrequency Ablation Zones in Ex Vivo Bovine and In Vivo Porcine Livers: Comparison of the Use of Internally Cooled Electrodes and Internally Cooled Wet Electrodes , 2009, CardioVascular and Interventional Radiology.

[27]  C. W. Cummings,et al.  Cummings otolaryngology--head & neck surgery , 2010 .

[28]  P. Macchia,et al.  Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. , 2009, Thyroid : official journal of the American Thyroid Association.

[29]  R. Valcavi,et al.  Percutaneous laser ablation of cold benign thyroid nodules: a 3-year follow-up study in 122 patients. , 2010, Thyroid : official journal of the American Thyroid Association.

[30]  Jeong Hyun Lee,et al.  Radiofrequency Ablation for the Treatment of Autonomously Functioning Thyroid Nodules , 2009, World Journal of Surgery.

[31]  W. Moon,et al.  One-step ethanol ablation of viscous cystic thyroid nodules. , 2008, AJR. American journal of roentgenology.

[32]  L Solbiati,et al.  Essential techniques for successful radio-frequency thermal ablation of malignant hepatic tumors. , 2001, Radiographics : a review publication of the Radiological Society of North America, Inc.

[33]  F. Molinari,et al.  US-guided percutaneous radiofrequency thermal ablation for the treatment of solid benign hyperfunctioning or compressive thyroid nodules. , 2008, Ultrasound in medicine & biology.

[34]  Jeong Hyun Lee,et al.  Radiofrequency ablation of benign non-functioning thyroid nodules: 4-year follow-up results for 111 patients , 2013, European Radiology.

[35]  Ozlem Saraydaroglu,et al.  Role of Duplex Power Doppler Ultrasound in Differentiation between Malignant and Benign Thyroid Nodules , 2010, Korean journal of radiology.

[36]  S. Mulier,et al.  Complications of radiofrequency coagulation of liver tumours , 2002, The British journal of surgery.

[37]  H. Gharib,et al.  Ultrasound-guided laser ablation of incidental papillary thyroid microcarcinoma: a potential therapeutic approach in patients at surgical risk. , 2011, Thyroid : official journal of the American Thyroid Association.

[38]  P. Macchia,et al.  EFFICACY AND SAFETY OF RADIOFREQUENCY THERMAL ABLATION IN THE TREATMENT OF THYROID NODULES WITH PRESSURE SYMPTOMS IN ELDERLY PATIENTS , 2007, Journal of the American Geriatrics Society.

[39]  Jeong Hyun Lee,et al.  Optimum first-line treatment technique for benign cystic thyroid nodules: ethanol ablation or radiofrequency ablation? , 2011, AJR. American journal of roentgenology.

[40]  Giancarlo Bizzarri,et al.  Treatment of benign cold thyroid nodules: a randomized clinical trial of percutaneous laser ablation versus levothyroxine therapy or follow-up. , 2007, Thyroid : official journal of the American Thyroid Association.

[41]  Jeong Hyun Lee,et al.  Cystic versus predominantly cystic thyroid nodules: efficacy of ethanol ablation and analysis of related factors , 2012, European Radiology.

[42]  Jeong Hyun Lee,et al.  Locoregional control of metastatic well-differentiated thyroid cancer by ultrasound-guided radiofrequency ablation. , 2011, AJR. American journal of roentgenology.

[43]  D. Dupuy,et al.  Radiofrequency ablation of regional recurrence from well-differentiated thyroid malignancy. , 2001, Surgery.

[44]  J. Baek,et al.  Radiofrequency ablation for an autonomously functioning thyroid nodule. , 2008, Thyroid : official journal of the American Thyroid Association.

[45]  D. Dupuy,et al.  Radiofrequency Ablation and Percutaneous Ethanol Injection Treatment for Recurrent Local and Distant Well-Differentiated Thyroid Carcinoma , 2006, Annals of surgery.

[46]  Jeong Hyun Lee,et al.  Benign and malignant thyroid nodules: US differentiation--multicenter retrospective study. , 2008, Radiology.

[47]  Jeong Hyun Lee,et al.  Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study. , 2012, Radiology.