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Review
. 2017 Jul-Aug;18(4):615-623.
doi: 10.3348/kjr.2017.18.4.615. Epub 2017 May 19.

Thyroid Radiofrequency Ablation: Updates on Innovative Devices and Techniques

Hye Sun Park  1 , Jung Hwan Baek  1 , Auh Whan Park  2 , Sae Rom Chung  1 , Young Jun Choi  1 , Jeong Hyun Lee  1
Affiliations
Review

Thyroid Radiofrequency Ablation: Updates on Innovative Devices and Techniques

Hye Sun Park et al. Korean J Radiol. 2017 Jul-Aug.

Abstract

Radiofrequency ablation (RFA) is a well-known, effective, and safe method for treating benign thyroid nodules and recurrent thyroid cancers. Thyroid-dedicated devices and basic techniques for thyroid RFA were introduced by the Korean Society of Thyroid Radiology (KSThR) in 2012. Thyroid RFA has now been adopted worldwide, with subsequent advances in devices and techniques. To optimize the treatment efficacy and patient safety, understanding the basic and advanced RFA techniques and selecting the optimal treatment strategy are critical. The goal of this review is to therefore provide updates and analysis of current devices and advanced techniques for RFA treatment of benign thyroid nodules and recurrent thyroid cancers.

Keywords: Radiofrequency ablation; Technique; Thermal ablation; Thyroid nodules; Ultrasound.

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Figures

Fig. 1
Fig. 1. Unidirectional ablation electrode.
A. Longitudinal view. B. Transverse view. Active tip is partially insulated, so that it creates half-moon-shaped ablation zone. Red: ablation zone, white: non-insulated portion, black: insulated portion.
Fig. 2
Fig. 2. Perithyroidal lidocaine injection.
Collected lidocaine appears as anechoic band (arrows) separating thyroid gland and strap muscle.
Fig. 3
Fig. 3. Ablation of feeding artery.
A. Before thyroid RFA, main feeding artery from superior thyroid artery is identified on Doppler study. B. After ablation of main feeding artery, no more vascular signal is seen on Doppler study, suggesting complete ablation of vessels. RFA = radiofrequency ablation
Fig. 4
Fig. 4. Artery-first ablation technique.
Intranodular linear echogenicities (arrows) spreading to periphery of target nodule can be seen, which may be microbubbles filling arterioles.
Fig. 5
Fig. 5. Artery-first ablation technique.
After ablation of feeding artery, wedge-shaped hypoechoic change (arrows) can be seen. This wedge-shaped hypoechoic area represents infarction in area supplied by feeding artery.
Fig. 6
Fig. 6. Hydrodissection technique.
A. Needle of syringe with 5% dextrose (arrow) is inserted posterior to recurrent tumor. B. 5% dextrose is slowly injected (arrows) between target tumor and adjacent critical structures including trachea, esophagus and recurrent laryngeal nerve.
See this image and copyright information in PMC

References

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