Radiofrequency ablation is a procedure performed in the office to ablate (destroy) thyroid nodules using heat generated by a radiofrequency electrode inserted into your thyroid nodule.

The procedure is performed in the office under local anesthesia. The nodule is then accessed using an RFA probe which is guided under ultrasound to destroy tissue within the thyroid nodule. Depending on the size of the nodule, the ablation may be as short a 20 minutes or up to an hour if the nodule is very large.

The idea candidate for RFA would have a benign biopsy of a thyroid nodule. Typically, these nodules are either symptomatic, visible, progressively enlarging, or otherwise bothersome to the patient. Sometimes they can produce too much thyroid hormone. The nodule should be in a location that can be easily visualized by ultrasound.

Patients with implanted cardiac devices such as pacemakeres and defibrillators, on blood thinners, with significant anxiety, or with atypical pathology on biopsy are not good candidates for this procedure.

RFA is an effective tool for significantly decreasing the size of thyroid nodules. In our practice, we have found that over the 6-12 months following ablation, thyroid nodules have decreased between 60-80% by volume, with a range of 45-95%. The effect appears to be reasonably durable, with approximately 5% of patients experiencing regrowth in the nodule over the 2-1/2 years that we have been performing this procedure.

All of our patients with normal thyroid function before RFA and without any functional disorder of the thyroid gland have had preserved thyroid function after ablation of the thyroid nodule. None of these patients have needed to start on thyroid hormone.

The actual cost of RFA is substantially less that surgery, although since RFA is currently not covered by insurance (or just partly covered), the cost to you may vary depending on your insurance coverage, deductible, and current level of expenditure in for the year.

If you decide to proceed with RFA, our office will help to guide you through the financial details of payment prior to scheduling the procedure.

While it is certain that this procedure will eventually be covered by insurances, when that will be, and how much insurance will cover is not currently known. A procedure code for thyroid RFA is likely to be released in 2025.