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New Procedure Uses Ultrasound-Guided Heat to Shrink Thyroid Nodules

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Radiofrequency ablation clinic is a joint program, launched by the Thyroid and Parathyroid Endocrine Surgery Division and Department of Radiology at Mass Eye and Ear, that shrinks small thyroid growths without surgery.

People with thyroid nodules may benefit from a new non-surgical treatment option called radiofrequency ablation.

The procedure, recently introduced to Mass Eye and Ear, involves using focused heat from a probe to shrink the size of a thyroid growth. Radiofrequency ablation provides a more minimally-invasive option to removing the nodule and part of the thyroid gland with surgery. Primarily used for thyroid nodules, the technique also treats small cancer recurrences.

The new radiofrequency ablation program is co-led by Gregory W. Randolph, MD, director of the Thyroid and Parathyroid Endocrine Surgical Division, and Mary Beth Cunnane, MD, chief of Radiology and a specialist in head and neck ultrasound. Both experts perform the procedure together to ensure the best outcome and combine their knowledge in thyroid care and imaging, they told Focus.

“People with benign thyroid nodules and small tumors now have a new treatment option that avoids surgery in the operating room,” said Dr. Randolph. “With our surgical and radiology experience here at Mass Eye and Ear, we feel there is no better environment to provide this procedure.”

Dr. Mary Beth Cunnane (L) guides the ultrasound as Dr. Greg Randolph (R) looks on during a radiofrequency ablation procedure

Thyroid nodules a common complaint

Thyroid nodules are abnormal growths or lumps that occur in the thyroid gland, which is located in the lower front of the neck, according to the American Thyroid Association. These nodules are extremely common, with some studies suggesting that more than 50 percent of the general population has them.

With thyroid nodules, an individual might notice a lump on his or her neck. In most cases, however, there are no symptoms. Once found, yearly monitoring of a nodule is recommended.

“Typically, we monitor these nodules with an ultrasound annually to observe the size and whether or not there is any growth,” Dr. Cunnane told Focus. “If a patient starts to feel a lump when swallowing, or experiences symptoms and discomfort, she or he would be referred to a thyroid surgeon who may offer radiofrequency ablation as an option.”

If cancer is suspected, which is less common, a biopsy is performed. During this procedure, a needle is inserted into the thyroid nodule, also guided by ultrasound, and cells are captured to be studied by a pathologist.

How radiofrequency ablation works

Dr. Randolph looks at the ultrasound on the monitor as he ablates the nodule.

During radiofrequency ablation of a thyroid nodule, an ultrasound is used to obtain an image inside the thyroid and neck in order to guide the placement of an electric probe. The probe generates high-frequency radio waves, which create heat. The focused temperature ablates the tissue and reduces the nodule’s size. This is an outpatient procedure which is performed in a radiology suite. Recovery is minimal; usually there is some minor swelling, redness or bruising around the needle.

Before this technique was introduced, a thyroid nodule had to be removed through surgical incision in the OR under general anesthesia. This surgery, called a hemithyroidectomy, would involve removing half or part of the thyroid gland, and often requires supplemental hormone treatment afterwards. This method is well-studied and effective, but as with all surgeries, there are risks and a longer recovery may be required.

Radiofrequency ablation has been used in medical care for years, most commonly as a treatment for back pain and heart problems like atrial fibrillation. The procedure has been used extensively to treat thyroid nodules in Europe and Asia prior to its recent introduction into the U.S. in late 2019. Dr. Cunnane was trained on the procedure in Italy last year, and noted its similarities to an ultrasound-guided biopsy of the thyroid, which is a procedure commonly performed at Mass Eye and Ear by her and Dr. Randolph. Dr. Randolph and Dr. Cunnane are currently writing a global radiofrequency ablation consensus paper with a consortium of six surgical and endocrine organizations around the world.

Patients interested in the procedure can make an appointment directly with the Thyroid and Parathyroid clinic to determine their candidacy.

About Our Experts

Gregory W. Randolph, MD is Division Chief of General Otolaryngology and Thyroid and Parathyroid Endocrine Surgery at Mass Eye and Ear. He sees patients at the Main Campus (243 Charles Street).

 

 

Mary Beth Cunnane, MD is the Chief of Radiology at Mass Eye and Ear. She sees patients at the Main Campus (243 Charles Street).

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  1. Avatar

    Betty

    To confirm, the patient is awake during this procedure? Because that would be amazing!

    • Avatar

      Ryan Jaslow

      Hi Betty, thanks for reading. We also think it’s amazing! Yes, the patient is awake, it is a local anesthetic and they can leave right after the procedure.

  2. Avatar

    Judith

    Very interesting article. Since one of the nodules near my thyroid has been diagnosed to be a slow growing cancer, could the ablation treatment be used on that? One of the complications existing in my neck is an abundance of scar tissue due to surgery done on my cervical spine 9 years ago. (Dr.Randolph’s Patient)

    • Avatar

      Ryan Jaslow

      Hi Judith, thanks for reading and your comment. You should call Dr. Randolph’s office to arrange an appointment to see if you’re a candidate for the procedure based on your specific case. The number is 617-573-4115. You can mention you saw the story on the new radiofrequency ablation procedure on the Mass Eye and Ear blog. Thank you.