Radiofrequency Ablation (RFA)

Benign thyroid nodules are non-cancer growths on your thyroid — a gland in the front of the neck that releases hormones. These nodules can cause speaking, swallowing, and breathing problems.

Radiofrequency ablation (RFA) can provide a less invasive option than surgery to treat thyroid nodules. The treatment shrinks nodules, relieving your symptoms.

An RFA procedure often takes less than an hour, and you can go home the same day.

Make a Thyroid Appointment at UPMC

Our experts can diagnose and treat your thyroid problem.

Call 412-586-9700 to make an appointment or to learn more.

Note: This procedure is currently only offered at our location in the Oakland neighborhood of Pittsburgh.

What Is Radiofrequency Ablation?

RFA uses high-frequency radio waves to create heat that destroys the cells of thyroid nodules. The doctor places a special probe into the thyroid nodule and then turns on the radiofrequency current.

Doctors also use RFA for other reasons.

For instance, RFA can destroy the ends of nerve cells to treat nerve pain (nerve ablation).

Candidates for RFA

Ideal candidates for RFA may include people with large, non-cancerous thyroid nodules that are:

• Causing symptoms such as difficulty swallowing or breathing.
• Producing excess thyroid hormone, or hyperthyroidism.
• Cosmetically concerning.
• Proven benign on biopsy (usually two biopsies recommended).

Radiofrequency Ablation Benefits and Risks

RFA shrinks the thyroid nodule, which can reduce and even stop symptoms like voice hoarseness, pain, and swallowing issues.

Because an RFA procedure:

• Is so targeted, it destroys the nodule while sparing most of the thyroid tissue around it.
• Isn't surgery and doesn't involve cutting through tissue, the recovery time is short. Most people are back to their daily lifestyle in a day or so.

People who get RFA are more likely to maintain their thyroid function versus those who have thyroid nodules surgically removed.

While RFA is a safe and effective treatment option, as with most health treatments, complications can occur with RFAs. Risks include:

• Bleeding.
• Infection.
• Nerve injuries (which can cause a hoarse voice).
• Nodule rupture.
• Skin burns.

Serious side effects with RFA are rare. Centers that do more RFAs tend to have lower rates of complications than centers with less expertise.

And though this treatment may have fewer complications than surgery, it may not be as effective. The thyroid nodules may grow and, in some cases, require another treatment.

Your doctor can help you weigh the pros and cons of RFA based on your symptoms and nodule size.

What to Expect Before, During, and After Your RFA

Preparing for your RFA

You don't need to follow a special diet before your RFA.

If you take blood-thinner medicines, your doctor may tell you to stop them a few days before. This is because, in rare cases, RFA can cause bleeding.

At UPMC, we call everyone about a week before their RFA.

We ask about any medications you currently take to make sure they won't cause a problem with the RFA procedure. We can let you know if you need to stop any drugs. (In most cases, you can restart them the day after your RFA.)

We also answer any questions you may have.

You may be prescribed a medication to help with relaxation before the procedure, if needed. You will be asked to change into a surgical gown for the appointment and remove all items with metal.

Also, it is important to tell your doctor if you have any implants such as pacemakers or defibrillators, or if you may be pregnant.

What to expect during your RFA

You'll lie down for the RFA.

In most cases, doctors give local anesthesia, or pain medicine, rather than general anesthesia. This means you'll be awake and able to talk with your doctor and nurse.

The doctor will:

• Use an ultrasound wand to place the probe or needle right into the thyroid gland.
• Turn on the radiofrequency waves to shrink the nodule.

RFA usually takes no more than an hour.

You may feel slight discomfort, pressure, or tingling. The anesthesia will prevent pain.

After your RFA

You'll get a cold pack to place on the area to reduce swelling.

You'll stay at the clinic for about an hour to make sure you don't have any signs of complications.

Before you leave, we'll tell you how to care for the wound and what signs of problems to look for. If you see any of these signs, you may need to call or visit the clinic.

Minor swelling and pain are common in the first 24 hours. During this time, you should rest and use cold compresses. You can also take over-the-counter pain medicine, such as acetaminophen.

After a day or so, you should find you can resume normal activities. Some pain and swelling may persist over the next week or so.

The immune system takes time to remove the dead cells of the thyroid nodule. It may take weeks or even a couple months before you feel symptom relief or notice that the nodule has shrunk.