Thyroid radiofrequency ablation is the future of papillary thyroid microcarcinoma (PTMC) and benign thyroid nodule (TN) treatment. A range of clinical studies have demonstrated its efficacy and safety.
In addition, it has several advantages over invasive procedures like thyroidectomies or costly procedures like laser or high-intensity focused ultrasound ablation.
Continue reading to discover how radiofrequency ablation works, and what best practices and proper equipment are for this thyroid nodule therapy.
Radiofrequency ablation of the thyroid nodule uses a radiofrequency power source called a radiofrequency generator. The RF generator delivers enough electric heat via an electrode probe.
This electrode probe is placed into the patient’s thyroid gland. Using algorithmic ablation or heat levels, the physician uses a pump to ablate the patient’s thyroid nodule in small doses. Due to the nature of the electrode probe, the ablation is hyper localized.
This means that only a tiny portion of the thyroid nodule tissue is ablated at one time. This allows for a large degree of precision while performing ablation. Ultimately, this protects the patient’s healthy thyroid gland from being over ablated.
It also ensures that the ablation does not exceed the threshold of the nodule and damage surrounding tissues or critical structures. Therefore, the physician can be sure to avoid under or over ablating the thyroid nodule.
This is one of the reasons why radiofrequency ablation has such minimal complications, risks, and hospitalizations.
This outpatient therapy can be performed in around 45 minutes in total. That means many times the patient will only spend a total of an hour with the doctor or surgeon before receiving an ice pack on the neck and going home afterwards.
It helps reduce strain both on the patient’s schedule and the doctor’s schedule, as well as staffing and other costs.
Thyroid ablation has a minimal rate of recurrence of growth neoplasia. Reduction of the thyroid nodule lasts for several years and is seen to be a permanent or semi-permanent measure to protect against hyperthyroidism.
The best technique for performing thyroid ablation is called the moving shot technique. Let’s discuss how to perform this step by step. First ensure that you have the following tools: Ultrasound dobbler, ultrasound probe, electrode needle, RF generator, grounding pad, and pump.
Place a sterile cover on the ultrasound probe. If available, use a needle guide for the ultrasound probe. This enables the needle to be on the same plane as the ultrasound probe during the procedure. It also enables vision of the entire shaft of the electrode probe.
Then use local anesthesia to numb the area of the neck that you’ll be inserting the probe into. Insert the electrode needle into the patient’s neck and subsequently into the patient’s thyroid nodule.
A series of moving, budding, and blooming will help you identify the parts of the thyroid nodule that have been ablated versus parts of the thyroid nodule that have not died due to high tissue temperature.
Ablate the peripheral portion of the nodule and move back once you see the air bubble bubbles occur. Repeat this line by line, posterior to anterior. Continue to check the ablation section on the longitudinal scan.
Repeat the ablation until everything has been ablated from the lower pole plane to the upper pole plane. After this point, place an ice pack on the neck and then discharge the patient after 30 minutes of light monitoring.
There should be very little to no scarring left behind. This is compared to a thyroidectomy that leaves a large scar in the middle of the neck.
Be careful to avoid critical structures such as jugular veins, recurrent laryngeal nerve, trachea, and common carotid arteries during the procedure.
Complications are minimal, but they typically come down to not using the right tools, not having the right training, or not performing follow-ups appropriately. This procedure can be performed by interventional radiologists, general surgeons, endocrinologists, head and neck surgeons, and doctors.
There are two primary components of thyroid ablation that are crucial.
At RGS HealthCare, we provide you with both pieces of equipment. Our Mygen V-1000 generator provides RF ablation at the right heat levels to avoid over or under ablating the patient’s thyroid nodule. This promotes efficacy and safety.
Furthermore, our E-Cube i7 is one example of an imaging system which provides high resolution ultrasound during the procedure.
This allows you to maintain visibility and ensure the correct positioning of the electrode needle within the thyroid nodule itself. From there, the other minor pieces of equipment can be acquired to ensure you have everything you need for this outpatient therapy.
There are several studies that have demonstrated the efficacy and safety of this procedure. Some of the highlights include:
Clinical evidence for radiofrequency ablation to treat PTMC suggests that radioactive iodine therapy and invasive surgery are not preferable. Additionally, RFA is preferred compared to ethanol ablation or high-intensity focused ultrasound (HIFU).
Radiofrequency ablation was observed in 414 PTMC patients and caused 88.4% of their tumors to disappear completely. This suggests effectiveness long-term on an oncological basis.
Additionally, better quality of life outcomes were observed. RFA is great for PTMC treatment when the patient cannot undergo surgery, prefers not to undergo surgery, or may be at higher risk for surgery.
You no longer have to take the risks of invasive thyroidectomy or less effective thyroid treatments. It’s now possible to treat benign thyroid nodules with a simple outpatient procedure called thyroid radiofrequency ablation.
Of course, as with any medical operation, it’s important to follow the correct guidelines and safety protocols. In order to ensure you have the highest quality safety equipment possible, contact our representatives at RGS Healthcare now.
We are here to help you transition your practice into the new age of thyroid treatment.