Thyroid Radiofreqeuncy Ablation

Thyroid RFA is a minimally invasive medical procedure that treats thyroid nodules. Using ultrasoundguided imaging, the nodule is located, allowing the treatment to focus solely on the targeted nodular area. Using a radiofrequency generator, your doctor allows a carefully controlled amount of energy to flow through the electrode into the tissue to ablate the nodule. With the sustained RFA thermal heat, the nodule is degenerated, allowing the degenerated tissue to flow through your body naturally as waste over the course of a few months.

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Minimally Invasive Thyroid Procedures

Interventional endocrinology is an emerging field that uses percutaneous (pinhole through the skin) image-guided procedures to treat endocrine diseases. These are minimally invasive techniques that will prevent a more invasive procedure like surgery, and thus preventing hospital stays and major complications.

Thyroid Gland: Why is it Important?

Our brains, hearts, and digestive and metabolic systems function normally with the help of one small gland: the thyroid gland.

Your butterfly-shaped thyroid gland is located at the front of your neck near the base of your throat, wrapping around your windpipe. The thyroid gland is part of your endocrine system, where it secretes hormones to regulate your body’s heart rate, blood pressure, temperature, and metabolism.

Thyroid Nodules and Common Treatment

The majority of nodules are benign and not life-threatening. However, they can still cause problems, including discomfort, difficulty or pain when swallowing, production of excess thyroid hormones, swelling, and enlargement in the neck.

While surgery can be effective, it can leave unsightly scarring and the long-term effects of removing the thyroid can be problematic for patients. You may develop hypothyroidism following partial thyroid surgery, requiring life-long medication to supply enough thyroid hormone for your body. This is especially true if you had your entire thyroid gland removed.

Symptoms Include






Why choose thyroid RFA?

Thyroid RFA is a minimally invasive, non-surgical treatment for undesirable thyroid nodules. This procedure is a quick and safe option that enables patients to resume normal daily activity with minimal recovery periods.

The term radiofrequency (RF) refers to an alternating electric current oscillating between 200 kHz and 1200 kHz. Application of Radiofrequency agitates tissue ions as they attempt to follow the changes in the direction of the alternating current, thus creating frictional heat around the electrode. Although heat creates immediate damage to the tissue, this is significant only in regions within a few millimeters of the electrode.

Benefits of Thyroid RFA

 Preserves your healthy thyroid tissue

 Allows your thyroid to function normally without the need for a lifetime of medication

 Minimally invasive procedure

 Performed under local anesthesia

 Performed as an out-patient procedure, which means no downtime or hospitalization

 Shorter recovery times

 No scarring

 Nodule volume reduction overtime

 Low complication rate

 Quality of life


Preserves your healthy thyroid tissue, helping the thyroid to function normally without the need for lifetime medication.


A thin needle is used to avoid any surgical scars. No general anesthesia is required, which means no downtime or hospitalization.


A major clinical study showed that non-functioning benign nodules shrunk 73% in the first 6 months and up to 93% within 4 years.


Tens of thousands of patients across the globe have chosen STARmed Thyroid RFA to successfully treat their thyroid disease.


75-year-old female with a history of multinodular goiter presented with concerns of neck fullness and discomfort, with a cosmetic score of 3/4. Biochemically euthyroid. US findings suggest multinodular goiter with the largest nodule measuring 2.8×1.13x3cm (volume:4.96 ml), cystic and solid, hypochoic, wider than tall, ill-defined margins, TIRADS 6 in the left inferior lobe. Two FNA biopsies were benign. Since she declined surgery, PLA was scheduled. A total of 1550 Joules were delivered using one fiber. Six months post-ablation, the nodule measured 1.44×1.03×1.55cm (1.21ml) with 75% volume reduction, and a cosmetic score of 1/4 plus improved symptomatology.



Frequently Asked Questions

  • Percutaneous ethanol injections (PEI) for recurrent simple thyroid cysts
  • Ultrasound guided Laser ablation (LA)
  • Ultrasound guided Radiofrequency ablation (RFA)

At Miami Diabetes and Endocrinology, we are proud to offer the most advanced therapies for the treatment of thyroid nodular disease. We are the only practice in South Florida that combines extensive procedural image-guided expertise and vast research and clinical expertise when it comes to managing thyroid nodular disease. Cases are methodically reviewed to tailor the most appropriate treatment plan for the patient. You will feel comfortable before, during and after the procedure as you will be carefully guided through the process, making sure that your expectations are met.

After injecting local anesthetic into the skin, a very small needle is introduced through the skin into the thyroid nodule under ultrasound image guidance. A laser fiber is then advanced though the hollow needle and the tip of the laser exposed inside the nodule. A generator then delivers laser energy into the tissue which results in localized heat that destroys the cells in the nodule, inducing progressive reduction of its size and consequently the resolution of symptoms.

  • Performed as an out-patient procedure, which means no downtime or hospitalization.
  • Minimally invasive procedure.
  • Performed under local anesthesia.
  • Shorter recovery times.
  • No scarring.
  • Volume reduction of the nodule.
  • Low complication rate.
  • Preserves your healthy thyroid tissue.
  • Allows your thyroid to function normally without the need for a lifetime of medication.

Although risks or complications are very unlikely, your doctor will review them in length before any intervention. Below are some key points:

The main risks are: bleeding, hoarse voice due to nerve bruising, skin burns and infection. Infection can be a delayed problem and present with swelling, pain and redness.

Rare serious complications can include: damage to the food pipe (esophagus), air pipe (trachea) and nerves to the voice box (vocal cords). The risk of permanent injury to the voice box nerve leading to alteration in the voice is less than 1% (less than 1 in 100).

Larger nodules could require more than one treatment for effective nodule shrinkage. Your doctor will discuss the likelihood of needing additional treatments with you during your initial consultation.

During the initial consultation, your doctor will review any current medications you are taking and provide further instructions, if needed. Other than blood thinners, which you will likely need to stop taking a few days prior to the procedure, most medications do not interfere with the procedure.

This is an office-based procedure, with a short recovery period. Because local anesthesia is administered before the procedure, very few patients experience any pain at all. Following your treatment, over the counter pain control agents can help with any discomfort. Local icepacks will be used right after the procedure has concluded.

Since each case is different, your doctor will determine your expected size reduction on your initial consultation. The average size reduction is 40-60% reduction after 3 months and approximately a 60-90% reduction after one year.

The procedure is FDA approved. There is a vast number of articles predominantly in Europe and Korea. However, the scientific evidence is growing very fast in the rest of the world including the US. Laser ablation is covered by Medicare and most private insurances. Some private insurances do not cover the procedure. However, the cost of the procedure is not prohibitive, and we offer payment plans for your convenience.

Percutaneous Ethanol Injection (PEI) should preferentially be considered as the first-line treatment for releasing thyroid cysts. This is done by introducing a small needle into the cyst cavity under ultrasound image guidance and filling it with absolute alcohol. The alcohol then destroys the fluid producing cells lining the inside of the cyst, thus preventing the cyst to fill again with fluid and eventually disappear.

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