New Thyroid Nodule Treatment Opportunities without Surgery

New innovative radio frequency equipment has been acquired by the ARS Medical Centre enabling removal of thyroid nodule without surgery.

The new method is presented by P. Prieditis, diagnostic radiologist, Doctor of Medicine, associate professor.

Thyroid gland nodules are found in more than 50 per cent of adults. Although these nodules are mostly benign, they can cause various unpleasant sensations and may result in a cosmetic defect.

Until now, thyroid nodules were removed surgically by operating on the thyroid gland. New innovative radio frequency equipment has been acquired by the ARS Medical Centre, enabling radio frequency thermoablation of thyroid nodules. This method is a novelty, the first and the only one of its kind available in Latvia. This is a new treatment method for the Baltic States in general.

Radio frequency ablation has been successfully used in the treatment of various malignant tumours elsewhere in the world for more than 20 years. This method is normally used in hospital conditions. Thermoablation of the thyroid gland, which is performed in a day-care clinic, is used in many countries as an alternative to a thyroid nodule surgery; it is an optional method in Korea.

What is radio frequency ablation?

Radio frequency ablation is a minimally invasive radiological method which provides new and effective treatment options. It is well suited for the treatment of benign thyroid nodules and for patients who cannot undergo surgical treatment of thyroid nodules. This procedure is performed at the ARS Day Surgery. Thanks to this method, patients do not need a surgical operation, avoiding the need to stay at the hospital

This procedure is based on the use of high-frequency electric current which is delivered precisely to the tumour thus destroying it.

Recommendations regarding thyroid gland thermoablation?

This method is used to eliminate benign nodules only. This method may only be used to eliminate nodules that should be removed in situations where the patient does not want to undergo a surgery or where the nodules cannot be operated on by surgical means. Thermoablation may be used to eliminate:

Problematic nodules: nodules which exert pressure on the vocal cords and/or the oesophagus, cause pain, are disturbing, cause discomfort etc.
Nodules which cause cosmetic defects by outward bulging.
Hot nodules causing metabolic disorders.
In case of a recurring thyroid cancer, i.e. if new nodules are found in the thyroid gland after a surgery which are difficult to remove by surgical means. Currently, primary thyroid gland tumours are not operated on yet.

Getting prepared for the procedure

A referral by the treating physician is required for the procedure. This method is a matter of choice made jointly by the physician and the patient. Prior patient examination is required: a thyroid gland puncture and tests are to be carried out in order to confirm that the nodule is benign. An electrocardiogram (ECG) test is also required to be completed.

Course of the procedure

The patient is in a supine position (lying down) during the procedure. To reduce the discomfort, a local anaesthetic is administered, similar to that at the dentist’s. An intravenous analgesic injection is available if necessary.
A special needle is inserted into the thyroid gland under ultrasound guidance. It is thinner than the needle inserted in the vein for a blood test.
A radio frequency generator generates an oscillating electromagnetic field at a predetermined frequency which, when discharged through the human body, causes local heat. It heats the tip of the needle up to about 60-70 degrees Celsius and burns the nodule. During the planning stage of the procedure, the thyroid nodule is divided into several zones which are treated step by step by changing the position of the needle.
The length of the procedure depends on several factors; normally it takes 2 to 20 minutes to complete
FYI: in the event that several nodules are present in the thyroid gland, one nodule is eliminated at a time. One nodule can be eliminated during a procedure.

Advantages:

This radio frequency procedure does not reduce the functional abilities of the thyroid gland. This is the main advantage of this method, compared to a surgery.
No scars, no wide incisions. Visually, a minute spot left by a single needle puncture is visible only.
The procedure is performed the ARS Day Surgery. The patient may go home after a few hours.
After the procedure

There are no restrictions to observe after the procedure; a more careful recommendation is just to live your life.

The most common complication may be transient hoarseness of the voice. The voice may remain hoarse even up to a few weeks. A bruise may be visible at the needle puncture site in the neck which will disappear just like any other bruise.

What to expect in terms of results of the procedure?

The purpose of thermoablation is to reduce the mass and volume of the thyroid nodule. Reduction continues for about 6 months after the procedure, the most marked reduction takes place during the first month after the procedure. On the whole, the results of the procedure can be assessed after 6-12 months.

Thyroid nodule thermoablation is performed by P. Prieditis, diagnostic radiologist, Doctor of Medicine, associate professor.

Medical Centre ARS
Skolas Street 5, Rīga
Ph. +371 67201007
www.arsmed.lv