Interventional Procedures for Thyroid Nodules & Cancers

Doctors at NYU Langone鈥檚 Thyroid Program specialize in performing minimally invasive interventional procedures to treat thyroid nodules and some thyroid cancers. These procedures may be good alternatives to surgery or radioactive iodine therapy for some patients.

Please speak with your doctor to see if you qualify for any of the following nonsurgical procedures.

Thyroid Radiofrequency Ablation

Our specialists may recommend radiofrequency ablation, or RFA, a minimally invasive treatment, for large, benign thyroid nodules that press on surrounding structures and cause undesirable or uncomfortable bulging in the neck.

We also use RFA to treat nodules that cause hyperthyroidism, some thyroid cancers, and thyroid cancer that comes back in area lymph nodes.

VIDEO: Dr. Kepal N. Patel explains how radiofrequency ablation is used to treat benign thyroid nodules.

For this procedure, our doctors use ultrasound guidance to place a thin needle electrode through the skin and into the thyroid nodule or cancer. The needle then heats and shrinks unwanted tissue, while avoiding surrounding healthy structures. Radiofrequency ablation is an in-office or outpatient procedure. It only requires local anesthesia, but our doctors typically recommend a light sedative to help you relax.

Radiofrequency ablation is often a reasonable alternative for patients who wish to avoid or cannot tolerate more conventional thyroid surgery. The procedure offers a faster recovery, fewer complications, and no scarring. Most people can return to normal activities the day after the procedure and do not require thyroid medication.

Nanosecond Pulsed Field Ablation

Nanosecond pulsed field ablation (nsPFA) is a form of irreversible electroporation that delivers short electrical pulses to disrupt cell membranes, interfere with cell function, and cause the breakdown of unwanted thyroid tissue. Our doctors may use this technique to treat benign thyroid nodules without destroying the surrounding thyroid tissue, helping to preserve normal thyroid function.

The treatment, delivered through a probe placed through the skin and into the thyroid under ultrasound guidance is nonthermal, meaning it does not use heat. This reduces the risk of destroying surrounding healthy tissue. The highly precise treatment targets nodules and helps protect area nerves, muscles, and blood vessels, and preserves nearby structures such as the trachea and esophagus.

Like RFA, nsPFA is an in-office or outpatient procedure that only requires local anesthesia. However, our doctors usually recommend a light sedative to help you relax.

The treatment may be a preferred alternative to surgery and works faster than RFA.

Thyroid Artery Embolization

Our doctors may use thyroid artery embolization to treat extremely large goiters, which can sometimes grow below the collarbone, protrude into the chest, or cause the neck to swell.

Thyroid artery embolization may require an overnight stay at the hospital and is done with either twilight anesthesia or general anesthesia that puts you fully to sleep. Thyroid artery embolization is performed under X-ray imaging guidance, and our doctors use a catheter inserted through a small puncture in the groin to reach the neck to access the blood supply of the enlarged thyroid. Tiny treatment particles injected through the catheter are then used to block the blood vessels feeding the thyroid. Once the enlarged thyroid no longer has an adequate blood supply, it shrinks. Shrinking the goiter usually relieves symptoms and improves the appearance of the neck.

In rare cases, doctors may use thyroid artery embolization to first shrink a massive goiter, easing the surgical removal of remaining goiter tissue.

Ethanol Ablation

Patients who have a fluid-filled thyroid nodule, also known as a cyst, may benefit from ethanol ablation. The treatment involves the ultrasound-guided injection of ethanol, a type of alcohol, into the cyst to fuse it shut and stop fluid accumulation. Our doctors may sometimes use this office-based procedure to destroy lymph nodes containing cancer cells that have spread from the thyroid.

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