Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation

Thyroid. 2009 Mar;19(3):219-25. doi: 10.1089/thy.2008.0202.


Background: Percutaneous radiofrequency thermal ablation (RTA) is a promising new therapeutic approach to manage thyroid nodules (TNs). The aim of this study was to investigate the long-term effectiveness of RTA in inducing shrinkage of TNs as well as in controlling compressive symptoms and thyroid hyperfunction in a large series of elderly subjects with solid or mainly solid benign TNs.

Methods: Ninety-four elderly patients with cytologically benign compressive TNs were prospectively enrolled in the study; 66 of them had nontoxic goiter and 28 had toxic or pretoxic goiter. RTA was performed by using a RITA StarBurst Talon hook-umbrella needle inserted in every single TN under ultrasonographic real-time guidance. TN volume, TN-related compressive symptoms and thyroid function were evaluated at baseline and 12 to 24 months after RTA.

Results: All TNs significantly decreased in size after RTA. The mean decrease in TN volume 12 months after RTA was from 24.5 +/- 2.1 to 7.5 +/- 1.2 mL (p < 0.001), with a mean percent decrease of 78.6 +/- 2.0%. Two years after RTA, a 79.4 +/- 2.5% decrease of TNs size was observed. Compressive symptoms improved in all patients and completely disappeared in 83 of 94 (88%) patients. Hyperthyroidism resolved in most patients allowing methimazole therapy to be completely withdrawn in 79% of patients with pretoxic and toxic TNs (100% with pretoxic TNs and 53% with toxic TNs). The treatment was well tolerated by all patients. No patient needed hospitalization after RTA and no major complications were observed.

Conclusions: RTA is an effective and simple procedure for obtaining lasting shrinkage of TNs, controlling compressive symptoms, and treating thyroid hyperfunction. When performed in experienced medical centers, RTA may be a valid alternative to conventional treatments for nontoxic and pretoxic TNs. It is particularly attractive for elderly people for whom surgery and radioiodine therapy are often contraindicated or ineffective.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antithyroid Agents / therapeutic use
  • Female
  • Goiter, Nodular / diagnostic imaging
  • Goiter, Nodular / physiopathology
  • Goiter, Nodular / surgery
  • Humans
  • Hyperthyroidism / complications
  • Hyperthyroidism / drug therapy
  • Male
  • Prospective Studies
  • Radiosurgery* / adverse effects
  • Radiosurgery* / instrumentation
  • Radiosurgery* / methods
  • Surgery, Computer-Assisted
  • Thyroid Function Tests
  • Thyroid Gland / physiopathology
  • Thyroid Hormones / blood
  • Thyroid Nodule / diagnostic imaging
  • Thyroid Nodule / physiopathology
  • Thyroid Nodule / surgery*
  • Treatment Outcome
  • Ultrasonography


  • Antithyroid Agents
  • Thyroid Hormones