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Hyperactive thyroid nodules treated by radiofrequency ablation: a Dutch single-centre experience.
H de Boer1, W Bom, P Veendrick
1Departments of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands.
The Netherlands Journal of Medicine
|April 26, 2020
Summary
Radiofrequency ablation (RFA) offers a safe alternative to radioactive iodine for hyperactive thyroid nodules. This study found RFA achieved euthyroidism in 52% after one treatment, rising to 71% after a second, with low hypothyroidism risk.
Area of Science:
- Endocrinology
- Interventional Radiology
Background:
- Radioactive iodine (RAI) is a common treatment for hyperactive thyroid nodules (HTN).
- RAI carries a significant risk (30-60%) of permanent hypothyroidism.
- Radiofrequency ablation (RFA) presents a potential alternative treatment for HTN.
Purpose of the Study:
- To evaluate the efficacy of RFA in achieving euthyroidism in patients with symptomatic HTN.
- To assess the safety profile of RFA for HTN treatment.
Main Methods:
- Ultrasound-guided RFA using a trans-isthmic approach and moving-shot technique was performed in an outpatient setting.
- Twenty-one patients with symptomatic HTN were treated under local anesthesia.
- Follow-up extended to at least one year post-treatment.
Main Results:
- Euthyroidism (TSH normalization) was achieved in 52% of patients after the first RFA session.
- A further 29% experienced partial response with normalized FT4 and FT3 levels.
- Complete remission rates increased to 71% after a second RFA session, with no significant adverse effects reported.
Conclusions:
- RFA is a safe and effective treatment option for symptomatic hyperactive thyroid nodules.
- RFA demonstrates a lower risk of permanent hypothyroidism compared to RAI.
- Further long-term studies are required to assess the recurrence rate of hyperthyroidism post-RFA.
