Minimally Invasive Thyroid Nodule Ablation for Benign Thyroid Nodules

The University of Kansas – Neuro-interventional Radiology

What is Image-Guided Thyroid Nodule Ablation?

Image-guided thyroid nodule ablation is a minimally invasive procedure used to treat benign thyroid nodules (non-cancerous growths) that may be causing symptoms or concerns. This treatment uses advanced imaging technology, such as ultrasound, to guide the placement of a needle or probe into the thyroid nodule to deliver targeted treatment, which can shrink or eliminate the nodule.

Why is Thyroid Nodule Ablation Used?

Thyroid nodules are common, especially in adults. While most are benign and do not cause symptoms, some may lead to issues like:

• Difficulty swallowing or breathing
• Neck discomfort or pain
• Cosmetic concerns due to nodule size
• Hyperthyroidism (overactive thyroid)

If you have been diagnosed with a benign thyroid nodule that is causing any of these issues, image-guided thyroid nodule ablation may be an effective minimally invasive treatment option. It can help reduce the size of the nodule and relieve symptoms, often without the need for surgery.

How Does Image-Guided Thyroid Nodule Ablation Work?

1. Consultation and Evaluation: During your consultation, your doctor will assess your thyroid nodule and discuss treatment options. Imaging studies, like ultrasound, may be used to evaluate the size, location, and characteristics of the nodule.
2. Preparation: Before the procedure, you may be asked to avoid eating or drinking for a few hours. The procedure is typically done in an outpatient setting, meaning you can go home the same day.
3. Anesthesia: A local anesthetic will be applied to numb the area around the thyroid nodule. You will also receive moderate sedation to help relax you and relieve any pain you feel.
4. Procedure: Using ultrasound imaging, a fine needle or probe will be carefully inserted into the thyroid nodule. Depending on the technique used, treatments such as radiofrequency ablation (RFA), laser ablation (LA), or microwave ablation (MWA) may be applied to destroy or shrink the nodule.
5. Post-Procedure Care: After the procedure, you may experience mild discomfort or swelling in the area. You can resume most activities the next day, though you should avoid strenuous exercise for a short period.

Benefits of Image-Guided Thyroid Nodule Ablation

• Minimally Invasive: No surgical incision is required, which means a faster recovery and reduced risk of complications.
• Targeted Treatment: The procedure is precisely guided by imaging, ensuring that only the thyroid nodule is treated.
• Quick Recovery: Most patients can resume normal activities within a day or two.
• Preservation of Thyroid Function: The procedure preserves the normal thyroid tissue, which means there’s minimal risk of affecting thyroid hormone production.
• Effective Symptom Relief: Many patients experience a significant reduction in nodule size and symptoms, improving their quality of life.

Potential Risks and Side Effects

While image-guided thyroid nodule ablation is generally safe, as with any medical procedure, there are some risks to consider:

• Pain or Discomfort: Mild pain or tenderness at the treatment site.
• Swelling or Bruising: Minor swelling or bruising around the thyroid area.
• Infection: A small risk of infection at the needle insertion site.
• Nodule Recurrence: In some cases, the nodule may regrow, and additional treatment may be needed.
• Damage to Surrounding Tissue: Very rarely, there may be accidental injury to nearby structures like blood vessels or the recurrent laryngeal nerve (which controls the vocal cords).

How Effective is the Treatment?

Image-guided thyroid nodule ablation has been shown to be highly effective in treating benign thyroid nodules. Studies indicate that the procedure can significantly reduce nodule size and relieve symptoms in majority of patients. The results typically begin to show within a few weeks, and the full effect can be seen within a few months.

Post-Treatment Follow-Up

After your procedure, your doctor will schedule follow-up appointments to monitor the progress and evaluate the nodule’s response to treatment. This may include additional ultrasound exams to check the size and appearance of the nodule over time.

Frequently Asked Questions

1. Is the procedure painful? The procedure is performed under local anesthesia and moderate sedation, so you should not feel pain during the treatment. Some mild discomfort may be experienced afterward, which typically resolves quickly.
2. Will I need surgery after the ablation? In most cases, image-guided ablation reduces the need for surgery. However, in rare instances, surgery may be necessary if the nodule does not respond to treatment.
3. How long does the procedure take? The procedure typically lasts between 30 to 60 minutes, depending on the size and number of nodules being treated.
4. What happens if my nodule comes back? If the nodule regrows or symptoms return, further treatment options, including additional ablation or surgery, may be considered.