Radiofrequency Ablation of Toxic Thyroid Nodules: An Early Experience of a Single Institution in the United States

Abstract

Objective

The field of endocrine surgery has been expanding its minimally invasive techniques to treat a wide range of thyroid pathologies. Radiofrequency ablation (RFA) is one targeted thermal therapy that has been identified as safe and effective for the treatment of benign pathologies as an alternative to surgery. We have employed RFA at our institution and are reporting our experience with this techniques safety, efficacy, and considerations in the treatment of toxic adenomas and multinodular goiters.

Methods

Forty-one patients with symptomatic hyperthyroidism from toxic nodules who elected to receive ultrasound-guided RFA in the office were followed with imaging, laboratory studies, and clinical questionnaires. Volume of thyroid nodules was recorded by ultrasound at intervals approximately 1, 3, 6, and 12 months after the procedure.

Results

Solitary and multinodular lesions responded with a mean volume reduction of 80.57% by 12 months following RFA. Patients achieved significant improvement in cosmetic and clinical symptoms with 35 of 41 patients sustaining remission from hyperthyroid state. Pain was the most frequently reported complication of this procedure, although it did not result in early termination of procedure of affect treatment outcomes.

Conclusion

In our early experience, RFA is a safe and effective method for treating hyperfunctioning thyroid nodules of benign etiologies. To further validate and support these findings, expansion of this cohort and more extensive follow-up will allow us to better characterize the outcomes of RFA and compare this approach to both surgical and other minimally invasive thermal ablative approaches.