Omar Hasan, MD; Steve Steer, MD; Michael Petroziello, and Garin Tomaszewski, MD
Patients with troublesome thyroid nodules now have a treatment option that doesn’t involve surgery. With radiofrequency ablation, interventional radiologists at Roswell Park Comprehensive Cancer Center can treat the nodule in a brief outpatient procedure that results in significant reduction in size and symptoms, without incisions, scars or affecting thyroid function.
Nodules in the thyroid are quite common, especially among the aging population. As many as 70% of people have at least one. While most are benign and do not need treatment, some nodules do grow large, causing noticeable enlargement of the thyroid, or compressive symptoms such as difficulty swallowing or breathing, pain or pressure, hoarseness or other voice changes.
How radiofrequency ablation works
Radiofrequency ablation (RFA) uses an electrical current to generate heat which destroys tissue. Using ultrasound imaging for guidance, a needle is inserted into the nodule to precisely ablate or destroy the abnormal tissue, resulting in significant volume reduction over several months.
RFA procedures are used for many conditions, including treating tumors, managing chronic neck, back, knee or peripheral nerve pain, and some cardiac rhythm problems. At Roswell Park, to her types of ablation procedures, such as microwave ablation, cryoablation, and NanoKnife irreversible electroporation, are used to treat tumors in the lung, liver, kidney and pancreas.
Indications for RFA treatment
Radiofrequency ablation may be an optimal choice for patients with thyroid nodules that are:
- Benign, symptomatic solid or cystic thyroid nodules
- Malignant thyroid nodules in patients unable to undergo surgery
- Of any size (no size limitation)
Patients are evaluated in the Interventional Radiology clinic and undergo testing that may include ultrasound exam, CT scan, thyroid function tests and core needle biopsy. The procedure is performed under light sedation and typically takes about 30 minutes. (Multiple nodules generally require multiple sessions.) Patients remain in recovery for about an hour and are then discharged home. Some may experience soreness at the site for 1 to 2 days which is usually relieved with ice and Tylenol. Some patients may have a raspy voice for a few days.
Radiofrequency ablation offers a nonsurgical, minimally invasive way to relieve symptoms posed by some large thyroid nodules, without incisions or scars, or affecting normal thyroid. Compared to surgery, RFA is associated with reduced complications and improved quality of life score.
Outcomes for RFA treatment
- Volume reduction of nodule of 65-75% at 1 year
- Minor complication rate of 4%
- Major complication rate < 1%
At Roswell Park, these procedures are performed by a team of four fellowship-trained interventional radiologists: Garin Tomaszewski, MD; Steve Steer, MD; Omar Hasan, MD; and Michael Petroziello, MD, with more than 45 years of combined experience in interventional radiology procedures. Roswell Park is the only center in the region to offer radiofrequency ablation for thyroid nodules and thyroid malignancy in patients unable to tolerate surgery.
Refer a patient: Call 716-845-RPMD (716-845-7763)