What is RFA?
A common practice in other countries, radiofrequency ablation (RFA) is finally now available in the United States. Developed over fifteen years ago, this non-surgical alternative shrinks the nodules without compromising thyroid function and helps avoid long recovery times of thyroid surgery.
Using radio frequency waves, radiofrequency ablation cauterizes thyroid nodules and cysts. Performed under local anesthesia, radiofrequency ablation is relatively painless and does not require general anesthesia. Doctors use guided ultrasound to insert a thermal probe into the thyroid nodule. Through selective heating of the probe tip, the nodule is destroyed. The cauterized tissue is then broken down by the body.
How Effective is this procedure
Clinical trials measured the rate of reduction, therapeutic success, changes in symptoms and cosmetic improvement of benign thyroid nodules.
For “cold” benign nodules (those that do not produce excess thyroid hormone), clinical trials have shown a mean reduction rate of 32.7 to 58.2% at one month, and 50.7 to 84.8% at six months. In most patients, nodule related symptoms and cosmetic problems also significantly improved or disappeared. In a long term follow-up study, radiofrequency ablation was effective over a four year period with the nodules consistently decreasing to 93.5%.
For “hot” benign thyroid nodules (those that do produce excess thyroid hormone) clinical trials have shown volume reduction rates of 52.6 to 70.7% at six months, and improved or normalized thyroid function in most patients. In a multi-center study, hyperthyroidism caused by “hot” nodules improved in all patients and was completely normalized in 81.8% of patients. This led to the conclusion that radiofrequency ablation can be considered an alternative to thyroid surgery or radioactive iodine therapy.
As of now (and for the near future) there isn’t any CPT code nor it’s covered by insurance. This is basically a cash based revenue source for the practice.
Right now, there are patients from the USA going to Europe (Italy in particular) to get this procedure done. They are paying 3k EUROS plus airfare, hotel (for 3 days) and meals. The nationwide range that private practices and institutions are charing out of pocket is $5,000-$10,000 per procedure.
a physician regarding RFA
– Interview with Dr. Kathleen Hands, Thyroid Center of South Texas, by RFA Patient Advocate Jennifer Cummins
RFA Video Explaing It As In-Office Procedure
– Dr. Jonathan Russell, Johns Hopkins
Case Studies Videos
– Dr. Roberto Valcalvi
– Dr. Ralph Tufano, Johns Hopkins
– Dr. Ketal Patel, NYU