Radiofrequency Ablation in Nodular Thyroid Diseases

Radiofrequency ablation is a minimally invasive technique that can produce tissue coagulation necrosis effectively and safely in humans with ultrasound or computed tomography guidance. The most frequent treatment site for radiofrequency ablation to date is the liver for hepatocellular carcinoma. Reviewing the history of radiofrequency ablation, we can see the evaluation of electrodes from conventional monopolar electrode to multiprobe arrays, hook expandable electrodes, and internally cooled electrodes. All of these are trying to ablate the tumor more widely and completely. From history, we also notice that the target can range from heart, neurological disorders, and thyroid diseases to a variety of other diseases, in addition to liver malignancy. Studies have already shown that radiofrequency ablation is an excellent alternative treatment for nodular thyroid disease, including benign and malignant lesions. For treatment of recurrent well-differentiated thyroid cancer, radiofrequency ablation has shown good results, such as no recurrence at treatment sites or reduced serum thyroglobulin level. The possible complications include hoarseness, hematoma, severe pain, esophageal perforation, or tracheal perforation. The reported rate for major complications in previous studies is low. Therefore, if the patients have severe comorbidity that is not suitable for reoperation for thyroid malignancy, radiofrequency ablation is a good alternative. Furthermore, radiofrequency ablation can be used for benign thyroid nodules to relieve local compressive symptoms. Some patients who receive such treatment for cosmetic reasons also show a satisfactory outcome. Here, we review previous studies about radiofrequency ablation in nodular thyroid disease in many aspects, such as ablation system, ablation techniques, ablation efficacy, and complications, both in benign thyroid nodules and recurrent thyroid cancer. (C) 2013, Elsevier Taiwan LLC and the Chinese Taipei Society of Ultrasound in Medicine.