Radiofrequency Ablation (RFA) for Thyroid Nodules

Radiofrequency Ablation (RFA) for Thyroid Nodules

What is radiofrequency ablation?

Radiofrequency ablation, or RFA, is a minimally invasive technique that shrinks the size of tumors, nodules or other growths in the body. Radiofrequency ablation for the treatment of thyroid nodules is a procedure performed by a team of endocrinologists. RFA uses radio waves to create heat that reduces the size of thyroid nodules. It is a less invasive alternative to surgery or radioactive iodine therapy (RAI). RFA is a safe way to treat patients with symptomatic thyroid nodules.

What are the benefits of treating thyroid nodules with RFA?

RFA protects other parts of the thyroid more than surgery or RAI. This means RFA lowers risk of developing a permanent condition called primary hypothyroidism (low thyroid hormone). Recovery is much faster than surgery, and you can also avoid surgical scars.

What type of thyroid nodules does radiofrequency ablation treat?

RFA is used to treat:

  • Solid (or mostly solid) thyroid nodules that are proven to be benign by biopsy.
  • Thyroid nodules that cause pressure or cosmetic problems.
  • Over-functioning thyroid nodules.

Thyroid nodules that are mostly filled with fluid are better treated with ethanol (alcohol) ablation.

What can I expect during the RFA procedure and recovery?

Thyroid RFA is performed as an outpatient procedure which means you will be able to go home after the procedure. Most patients are given local anesthetic (medicine to block pain in one small area of the body). The ultrasound is used to place the tip of the probe in the correct location. Some patients may prefer to receive a mild sedative (medicine to make you sleepy).

The procedure usually lasts about 30 minutes to 1 hour, depending on the size of the nodule being treated. Patients leave the clinic the same day with only a small bandage. After the procedure, some patients experience minor discomfort and bruising which may be treated with over-the-counter pain medications. There is no scar from the procedure.

Is radiofrequency ablation safe?

All procedures have risks, and your doctor will talk to you about the risks. Thyroid RFA is considered a safe procedure, with a permanent complication rate of less than 0.1%.

How does RFA compare to laser, cryo (freezing), or ethanol ablation?

These are all minimally invasive methods of destroying tissue. For solid or complex thyroid nodules, RFA is considered better than these other methods of treatment. For most cystic nodules (nodules filled with fluid), ethanol ablation is a good option.

What can I expect after radiofrequency ablation of a thyroid nodule?

For benign nodules, when the primary goal is to reduce the size of the nodule, patients usually notice a reduction in size about 1 month after the procedure. This shrinkage will continue until the nodule is much smaller. However, we do not expect that the nodule will completely go away. The goal is to treat these nodules in a single RFA session. Very large nodules or nodules not well controlled with 1 treatment may need additional RFA treatments to reduce them to an optimal size.

Is the cost of radiofrequency ablation covered by insurance?

There are an increasing number of insurance companies now covering radiofrequency ablation for thyroid nodules. Still, some cases are not covered. Your clinical team will reach out to your insurance to determine if the procedure can be financially covered. If not, there are options for both self-pay or contacting financial assistance to determine if you might qualify.

To apply for financial assistance, visit https://www.uwmedicine.org/patient-resources/billing-and-insurance.

If you have a thyroid nodule and are interested in the RFA procedure, contact a UW Medicine expert today for a consult. Our physicians work with you to develop the most appropriate and advanced treatments and care.

Meet our specialists

Mayumi Endo, MD

Mayumi Endo, MD

Dr. Endo is board-certified in both Internal Medicine and Endocrinology and specializes in treating thyroid nodules and thyroid cancer.

Tracy Tylee, MD

Tracy Tylee, MD

Dr. Tylee is board certified in both Internal Medicine and Endocrinology/Diabetes/Metabolism and specializes in treating thyroid nodules and thyroid cancer.