Can I Be Treated With Radiofrequency Ablation?
The Korean Society of Thyroid Radiology (KSThR) introduced its first guidelines in 2012, with a revision in 2017. According to the 2017 guidelines, radiofrequency ablation for treating benign thyroid nodules is recommended for patients with:
• Benign thyroid nodules that produce symptoms or cause cosmetic concerns.
• Nodules that produce excess thyroid hormone. These are known as autonomously functioning, or “hot” thyroid nodules (AFTN).
Radiofrequency ablation is not recommended for patients with:
• Thyroid cancer, thyroid nodules with a biopsy result that is uncertain as to whether there is cancer present
• A nodule that meets U.S. criteria of cancer, despite FNAb (fine needle aspiration biopsy) or CNB (core needle biopsy) results.Before undergoing radiofrequency ablation, doctors will want to make sure your thyroid nodule is benign. This is confirmed through ultrasound guided fine-needle aspiration (FNA) or core needle biopsies (CNB). In some cases, a single benign diagnosis may be sufficient, while other nodules require two treatments. Surgery is currently the standard treatment for primary thyroid cancer. However, in patients with primary thyroid cancer who refuse surgery or who are unsuitable for surgery, radio-frequency ablation may be considered as an alternative to surgery. For those patients who refuse surgery or who are at high surgical risk, radio-frequency ablation can also be performed for recurrent thyroid cancers in the thyroid gland area or lymph nodes located in the neck.
Radiofrequency ablation is not an absolute alternative to thyroid surgery, however. Your
physician will first rule out thyroid cancer and will need to determine if you’re a suitable candidate.
The following thyroid conditions are generally considered to be treatable with radiofrequency ablation:
• Benign or “hot” nodules (those that produce excess thyroid hormone)
• Thyroid cysts that produce excess thyroid hormone• Rapidly growing benign nodules or cysts
• Visually disturbing nodules or cysts
• “Hot” nodules when radioactive iodine therapy is not preferred
• Patients who refuse surgery
• Patients who are at high risk for anesthesia Radiofrequency ablation is not performed during pregnancy or on patients with implanted pacemakers or defibrillators.