The management of thyroid nodules has changed dramatically in the last twenty years worldwide. With the introduction of fine needle biopsy over 40 years ago, we can characterize nodules as either benign, indeterminate, and potentially malignant with an in-office biopsy. A symptomatic nodule determined to be benign now can be treated with multiple options. 

Radiofrequency ablation (RFA) is a minimally invasive procedure used to treat thyroid nodules, which are abnormal growths in the thyroid gland. This innovative technique uses heat generated by radiofrequency energy to destroy the target tissue, offering patients a non-surgical alternative to traditional treatment options. 

Surgery eliminates the entire nodule completely so that the entire thyroid lobe is removed, including functional thyroid tissue, thus predisposing to hypothyroidism and a lifetime of medication. The hospital charges alone for this procedure are approximately $30,000-$40,000. Add to this, the costs of additional surgeon’s, anesthesiologist’s, and pathologist’s charges. In addition, the long term costs for management of permanent hypothyroidism are not factored in these charges.  Although surgical risks for thyroidectomy are low, complications are frequent enough to increase the morbidity to the patient and create considerable cost for management and therapy. Most of the thyroid surgery in the United States is performed by low volume surgeons, who have a higher complication rate compared to high volume surgeons.

Fortunately, nonoperative approaches are now available for which the complication rate for is easily one tenth or less than for open surgery. The indications for thyroid RFA are the same as for thyroid surgery. Visual deformity and compressive symptoms (such as foreign body sensation, pressure, dysphagia, hoarseness, and choking sensation) are relieved within weeks of RFA as the ablated nodule shrinks in volume. 

Additionally, RFA thyroid has completely changed the management of autonomous thyroid nodules. No longer is costly radioactive iodine exposure necessary. Radioactive iodine not only destroys the specific lesion, but also the adjacent healthy thyroid tissue, more often rendering the recipient hypothyroid. The surgical option of thyroid lobectomy requires removal of healthy thyroid tissue around the toxic nodule.

With RFA thyroid nodules, only the abnormal tissue is treated, thus allowing for prompt restoration of normal thyroid function.​