Thyroid Nodule Ablation

January 5, 2025

This page was reviewed under our medical and editorial policy by Jonathan Kessler, M.D., associate clinical professor, Division of Interventional Radiology, Department of Diagnostic Radiology, City of Hope^® Cancer Center Duarte

Thyroid nodules (lumps in the thyroid gland) are common, and they usually are not cancerous (benign). While most of these nodules are not harmful, some might still need treatment if they are growing or causing symptoms.

One potential treatment option for benign nodules is radiofrequency ablation (RFA). RFA can provide results similar to surgery and offer a less invasive way to manage certain types of thyroid nodules.

What Is Thyroid Ablation?

Radiofrequency ablation uses radio waves emitted from a needle tip to target and destroy abnormal cells in the thyroid. RFA is also being researched to treat small, unlikely-to-spread thyroid cancers as well.

During the treatment, a doctor inserts a thin, needle-like probe into the nodule or tumor. This probe is guided into place using imaging techniques like ultrasound. Once the needle is in the appropriate spot, it delivers high-energy radio waves that create intense heat. This heat destroys the targeted cells.

The process is usually brief, but this depends on the size and location of the nodule. The dead cells are not removed, but gradually become scar tissue that shrinks over time. RFA is often used when surgery is not an option or for patients who want to avoid a more invasive procedure.

Benefits of Thyroid Nodule Ablation

Thyroid ablation offers several benefits for patients with thyroid nodules. It is a minimally invasive procedure that allows doctors to treat the problem without removing the entire thyroid. This helps preserve normal thyroid function. When the thyroid remains functional, patients may be able to avoid the need for lifelong medication.

The procedure is typically performed under local anesthesia, meaning the patient stays awake but comfortable. Most people go home the same day without the need for hospitalization. Recovery is usually quick, with little to no downtime and no scarring. Over time, the treated nodule shrinks, helping to improve quality of life. The risk for developing complications is low.

Additionally, RFA may be repeated if the tumor returns or begins to grow again. If appropriate, it may also be combined with other treatments.

Thyroid Ablation Versus Surgery

Thyroid ablation and surgery are different in a few important ways.

Surgery typically requires general anesthesia, meaning the patient is in a deep sleep during the procedure. It involves making a small incision in the neck to remove part or all of the thyroid gland. This incision may leave a scar across the front of the neck, though it usually fades over time. After surgery, patients may experience pain and need pain medication for a short period. They may also be required to take thyroid hormone replacement medications.

Thyroid ablation, on the other hand, is a minimally invasive procedure performed with a needle insertion under local anesthesia. It’s considered a type of interventional radiology service. There is no need for large incisions, which means no scarring, and recovery tends to be faster with less pain.

Both treatments carry some risks, but surgery generally has more potential for complications like voice changes or damage to nearby parathyroid glands.

How Is Thyroid Radiofrequency Ablation Performed?

During a thyroid ablation procedure, patients lie on their back with their neck extended and head on a small pillow. Two grounding pads, which help safely direct electrical energy out of the body during the procedure, are placed on the patient’s thighs.

The doctor cleans the skin around the thyroid and injects local anesthesia to numb the area. The patient remains awake and is able to breathe, swallow and speak throughout the procedure.

The doctor then inserts a thin needle electrode directly into the thyroid nodule. Using the needle, the doctor delivers controlled radiofrequency energy to heat and destroy the targeted tissue. The changes occurring in the nodule are visible on imaging as they happen, allowing the doctor to adjust the electrode as necessary. The procedure typically takes about 30-60 minutes.

After the procedure, the doctor applies a small bandage to the treatment area. The care team may also apply ice packs to reduce swelling.

Side Effects of Radiofrequency Ablation for Thyroid Nodules

Thyroid nodule ablation is generally a safe procedure with a low risk for developing complications, but as with any medical treatment, potential side effects may occur. Mild side effects like bruising (hematoma) and pain are more common, but these usually go away in a few days with basic pain relief measures. Most patients will only need over-the-counter pain medications, such as acetaminophen.

Very rarely, RFA may result in a change in voice. This occurs when the nerve controlling the voice box is affected by swelling or the heat from the procedure. This typically resolves without treatment but may potentially be permanent.

Permanent hypothyroidism, or underactive thyroid, is very unlikely after the procedure. In most cases, if a patient’s thyroid function is affected at all, it resolves on its own within a month.

Recovery and Follow-up

After a thyroid ablation, the patient is monitored for a short time and then discharged. Most people are able to resume their usual activities almost immediately.

Over the following weeks, the body’s immune system will gradually break down the treated thyroid nodule. Most patients begin to notice a reduction in the size of the nodule (if they could previously feel it) within two to three weeks, though some nodules may take longer than others. Eventually, only scar tissue will remain in the treated area.

The patient’s care team will notify them of any necessary follow-up appointments after the procedure.