Skip to main content
SpringerLink
Log in

Radiofrequency Ablation of Thyroid and Parathyroid Nodules

  • Chapter
  • First Online:
Book cover Interventional Radiology Techniques in Ablation

Part of the book series: Techniques in Interventional Radiology ((TECHRAD))

Abstract

Thyroid nodules are very common in adults, found in 4–8% by palpation, in 10–41% by ultrasonography (US), and in 50% by pathologic examination at autopsy. Most thyroid nodules are benign. Whereas the majority of nodules do not require treatment, some may need it, for various reasons including pressure symptoms and cosmetic problems. Patients with autonomously functioning thyroid nodules (AFTNs) may have subclinical hyperthyroidism, with approximately 4% per year progressing to obvious hyperthyroidism or thyrotoxicosis. These conditions may have detrimental effects on the skeletal (osteoporosis) and cardiovascular (atrial fi brillation) systems. Large AFTNs may result in clinical problems similar to those of benign cold nodules, such as cosmetic problems and pressure symptoms. Repeat surgery in the central or lateral compartments of the neck may be dif fi cult in patients with recurrent thyroid cancer because previous neck dissection may be associated with high rates of morbidity. Hyperparathyroidism is a major problem in patients with parathyroid nodules. Secondary hyperparathyroidism is caused by chronic dialysis in patients with chronic renal failure. Long-standing hyperparathyroidism causes cardiovascular disease, hypertension, renal stones, osteoporosis, and bone pain. Large parathyroid nodules may cause neck discomfort and cosmetic problems.

  • RF ablation is a minimally invasive technique and a valuable alternative to surgery in treatment of benign cold thyroid nodules and AFTNs.

  • RF ablation of recurrent thyroid cancers and in treatment of hyperparathyroidism may be an alternative to surgery in patients at high surgical risk.

  • Use of the trans-isthmic approach and the moving shot technique are essential to ablate ellipsoid thyroid nodules completely, and to avoid thermal damage to surrounding critical structures.

  • Knowledge of critical structures around the targeted lesion, and possible associated complications, is important for safe ablation.

  • RF ablation of benign cold thyroid nodules shows excellent short-term results, reducing nodule volume, nodule-related symptoms, and cosmetic problems

  • RF ablation of AFTNs and functioning parathyroid nodules is effective to improve function and to reduce the volume of treated nodules.

  • RF ablation affords excellent locoregional control of recurrent thyroid cancers.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Baek JH, Kim YS, Lee D, Huh JY, Lee JH. Benign predominantly solid thyroid nodules: prospective study of efficacy of sonographically guided radiofrequency ablation versus control condition. AJR Am J Roentgenol. 2010;194(4):1137–42.

    Article  PubMed  Google Scholar 

  2. Baek JH, Moon WJ, Kim YS, Lee JH, Lee D. Radiofrequency ablation for the treatment of autonomously functioning thyroid nodules. World J Surg. 2009;33(9):1971–7.

    Article  PubMed  Google Scholar 

  3. Lee JH, Kim YS, Lee D, Choi H, Yoo H, Baek JH. Radiofrequency ablation (RFA) of benign thyroid nodules in patients with incompletely resolved clinical problems after ethanol ablation (EA). World J Surg. 2010;34(7):1488–93.

    Article  PubMed  Google Scholar 

  4. Sung JY, Kim YS, Choi H, Lee JH, Baek JH. Optimum first-line treatment technique for benign cystic thyroid nodules: ethanol ablation or radiofrequency ablation? AJR Am J Roentgenol. 2011;196(2):W210–214.

    Article  PubMed  Google Scholar 

  5. Moon WJ, Jung SL, Lee JH, Na DG, Baek J-H, Lee YH, et al. Benign and malignant thyroid nodules: US differentiation – multicenter retrospective study. Radiology. 2008;247(3):762–70.

    Article  PubMed  Google Scholar 

  6. Moon W-J, Baek JH, Jung SL, Kim DW, Kim EK, Kim JY, et al. Ultrasonography and ­ultrasound-based management of thyroid nodules: consensus statement and recommendations. Korean J Radiol. 2012;13(2):117–125.

    Article  PubMed  Google Scholar 

  7. Kwok A, Faigel DO. Management of anticoagulation before and after gastrointestinal endoscopy. Am J Gastroenterol. 2009;104(12):3085–97. quiz 98.

    Article  PubMed  Google Scholar 

  8. Giovagnorio F, Martinoli C. Sonography of the cervical vagus nerve: normal appearance and abnormal findings. AJR Am J Roentgenol. 2001;176(3):745–9.

    PubMed  CAS  Google Scholar 

  9. Ha EJ, Baek JH, Lee JH, Kim JK, Shong YK. Clinical significance of vagus nerve variation in radiofrequency ablation of thyroid nodules. Eur Radiol. 2011;21(10):2151–7.

    Article  PubMed  Google Scholar 

  10. Park JK, Jeong SY, Lee JH, Lim GC, Chang JW. Variations in the course of the cervical vagus nerve on thyroid ultrasonography. AJNR Am J Neuroradiol. 2011;32(7):1178–1181.

    Article  PubMed  CAS  Google Scholar 

  11. Baek JH, Jeong HJ, Kim YS, Kwak MS, Lee D. Radiofrequency ablation for an autonomously functioning thyroid nodule. Thyroid. 2008;18(6):675–6.

    Article  PubMed  Google Scholar 

  12. Jeong WK, Baek JH, Rhim H, Kim YS, Kwak MS, Jeong HJ, et al. Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol. 2008;18(6):1244–50.

    Article  PubMed  Google Scholar 

  13. Kim YS, Rhim H, Tae K, Park DW, Kim ST. Radiofrequency ablation of benign cold thyroid nodules: initial clinical experience. Thyroid. 2006;16(4):361–7.

    Article  PubMed  Google Scholar 

  14. Baek JH, Kim YS, Sung JY, Choi H, Lee JH. Locoregional control of metastatic well-differentiated thyroid cancer by ultrasound-guided radiofrequency ablation. AJR Am J Roentgenol. 2011;197(2):W331–6.

    Article  PubMed  Google Scholar 

  15. Deandrea M, Limone P, Basso E, Mormile A, Ragazzoni F, Gamarra E, et al. US-guided percutaneous radiofrequency thermal ablation for the treatment of solid benign hyperfunctioning or compressive thyroid nodules. Ultrasound Med Biol. 2008;34(5):784–91.

    Article  PubMed  Google Scholar 

  16. Spiezia S, Garberoglio R, Milone F, Ramundo V, Caiazzo C, Assanti AP, et al. Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid. 2009;19(3):219–25.

    Article  PubMed  Google Scholar 

  17. Sung JY, Baek JH, Kim YS, Jeong HJ, Kwak MS, Lee D, et al. One-step ethanol ablation of viscous cystic thyroid nodules. AJR Am J Roentgenol. 2008;191(6):1730–3.

    Article  PubMed  Google Scholar 

  18. Dupuy D, Monchik J, Decrea C, Pisharodi L. Radiofrequency ablation of regional recurrence from well-differentiated thyroid malignancy. Surgery. 2001;130:971–7.

    Article  PubMed  CAS  Google Scholar 

  19. Monchik JM, Donatini G, Iannuccilli J, Dupuy DE. Radiofrequency ablation and percutaneous ethanol injection treatment for recurrent local and distant well-differentiated thyroid carcinoma. Ann Surg. 2006;244(2):296–304.

    Article  PubMed  Google Scholar 

  20. Park KW, Shin JH, Han BK, Ko EY, Chung JH. Inoperable symptomatic recurrent thyroid cancers: preliminary result of radiofrequency ablation. Ann Surg Oncol. 2011;18(9):2564–8.

    Article  PubMed  Google Scholar 

  21. Carrafiello G, Lagana D, Mangini M, Dionigi G, Rovera F, Carcano G, et al. Treatment of secondary hyperparathyroidism with ultrasonographically guided percutaneous radiofrequency thermoablation. Surg Laparosc Endosc Percutan Tech. 2006;16(2):112–6.

    Article  PubMed  Google Scholar 

  22. Hansler J, Harsch IA, Strobel D, Hahn EG, Becker D. Treatment of a solitary adenoma of the parathyroid gland with ultrasound-guided percutaneous Radio-Frequency-Tissue-Ablation (RFTA). Ultraschall Med. 2002;23(3):202–6.

    Article  PubMed  CAS  Google Scholar 

  23. Cooper DS, Doherty GM, Haugen BR, Hauger BR, Kloos RT, Lee SL, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214.

    Article  PubMed  Google Scholar 

  24. Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedus L, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and EuropeanThyroid Association Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract. 2010;16 Suppl 1:1–43.

    Article  PubMed  Google Scholar 

  25. Jang SW, Baek JH, Kim JK, Sung JY, Choi H, Lim HK et al. How to manage the patients with unsatisfactory results after ethanol ablation for thyroid nodules: role of radiofrequency ablation. Eur J Radiol. 2011;81(5):905–910.

    Google Scholar 

  26. Ha EJ, Baek JH, Lee JH. The efficacy and complications of radiofrequency ablation of thyroid nodules. Curr Opin Endocrinol Diabetes Obes. 2011;18(5):310–4.

    PubMed  Google Scholar 

  27. Pacella CM, Bizzarri G, Guglielmi R, Anelli V, Bianchini A, Crescenzi A, et al. Thyroid tissue: US-guided percutaneous interstitial laser ablation – a feasibility study. Radiology. 2000;217(3):673–7.

    PubMed  CAS  Google Scholar 

  28. Papini E, Guglielmi R, Bizzarri G, Graziano F, Bianchini A, Brufani C, et al. Treatment of benign cold thyroid nodules: a randomized clinical trial of percutaneous laser ablation versus levothyroxine therapy or follow-up. Thyroid. 2007;17(3):229–35.

    Article  PubMed  CAS  Google Scholar 

  29. Papini E, Guglielmi R, Bizzarri G, Pacella CM. Ultrasound-guided laser thermal ablation for treatment of benign thyroid nodules. Endocr Pract. 2004;10(3):276–83.

    PubMed  Google Scholar 

  30. Valcavi R, Riganti F, Bertani A, Formisano D, Pacella CM. Percutaneous laser ablation of cold benign thyroid nodules: a 3-year follow-up study in 122 patients. Thyroid. 2010;20(11):1253–61.

    Article  PubMed  CAS  Google Scholar 

  31. Hegedus L. Therapy: a new nonsurgical therapy option for benign thyroid nodules? Nat Rev Endocrinol. 2009;5(9):476–8.

    Article  PubMed  Google Scholar 

  32. Esnault O, Franc B, Chapelon JY. Localized ablation of thyroid tissue by high-intensity focused ultrasound: improvement of noninvasive tissue necrosis methods. Thyroid. 2009;19(10):1085–91.

    Article  PubMed  Google Scholar 

  33. Esnault O, Franc B, Monteil JP, Chapelon JY. High-intensity focused ultrasound for localized thyroid-tissue ablation: preliminary experimental animal study. Thyroid. 2004;14(12):1072–6.

    Article  PubMed  Google Scholar 

  34. Esnault O, Rouxel A, Le Nestour E, Gheron G, Leenhardt L. Minimally invasive ablation of a toxic thyroid nodule by high-intensity focused ultrasound. AJNR Am J Neuroradiol. 2010;31(10):1967–8.

    Article  PubMed  CAS  Google Scholar 

  35. Kovatcheva RD, Vlahov JD, Shinkov AD, Borissova AM, Hwang JH, Arnaud F, et al. High-intensity focused ultrasound to treat primary hyperparathyroidism: a feasibility study in four patients. AJR Am J Roentgenol. 2010;195(4):830–5.

    Article  PubMed  Google Scholar 

  36. Choi JW, Kwak S-H, Yoo SM, Song IS, Lee HY, Lee JB, et al. Ultrasound-guided radiofrequency ablation of thyroid gland: a preliminary study in dogs. J Korean Radiol Soc. 2005;52:333–41.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-gu, Seoul, 138-736, Korea

    Jung Hwan Baek M.D.

Authors
  1. Jung Hwan Baek M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jung Hwan Baek M.D. .

Editor information

Editors and Affiliations

  1. Dept. Radiology, Penn Presbyterian Medical Center, 39th and Market Streets, Philadelphia, 19104, Pennsylvania, USA

    Timothy Clark

  2. St. Thomas' Hospital, Hospital, NHS Trust, Great Maze Pond, London, SE1 7RT, United Kingdom

    Tarun Sabharwal

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Baek, J.H. (2013). Radiofrequency Ablation of Thyroid and Parathyroid Nodules. In: Clark, T., Sabharwal, T. (eds) Interventional Radiology Techniques in Ablation. Techniques in Interventional Radiology. Springer, London. https://doi.org/10.1007/978-0-85729-094-6_7

Download citation

  • DOI: https://doi.org/10.1007/978-0-85729-094-6_7

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-0-85729-093-9

  • Online ISBN: 978-0-85729-094-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation