Thyroid Radiofrequency Ablation (RFA)

During thyroid RFA, a physician inserts a thin needle electrode through the skin of the neck directly into the thyroid nodule, guided by real-time ultrasound imaging. Radiofrequency energy is delivered through the needle, generating heat at the tip. This heat destroys the nodule tissue from the inside out. The procedure requires only local anesthetic (numbing the skin and neck), takes approximately one hour, and involves no cuts or stitches. Patients leave with a small bandage.

Nodule shrinkage begins approximately one month after the procedure and continues progressively. Published clinical studies report an average volume reduction of 50–80% at 12 months for benign solid nodules. Complete disappearance of the nodule is not expected, but symptomatic relief and cosmetic improvement are typically significant. Very large nodules may require more than one RFA session.

No — this is one of the primary advantages of RFA over surgery. Because the procedure destroys only the target nodule and preserves the surrounding thyroid tissue, thyroid hormone production is maintained. Patients undergoing thyroid RFA at UCLA Health typically do not need to start thyroid replacement medication as a result of the procedure.

Thyroid RFA is an outpatient procedure. Patients are discharged the same day and most return to normal daily activities within 24–48 hours. Some mild discomfort, neck soreness, or bruising at the needle site may occur and can be treated with over-the-counter pain medication (such as acetaminophen or ibuprofen). There is no surgical incision and no scar.

Thyroid RFA is considered safe when performed by experienced physicians. Major complications are uncommon. Potential risks — which are reviewed in detail during your consultation — include temporary voice changes (if the nerve to the vocal cord is irritated), skin burns, infection, or incomplete ablation requiring a second treatment. The UCLA program performs more than 500 thermal ablation procedures per year across multiple organs, reflecting a high level of institutional experience.

Insurance coverage for thyroid RFA varies by plan and is evolving as the procedure becomes more widely adopted. UCLA Health's billing team can verify your specific coverage prior to your procedure. Call (310) 267-7838 or contact the Endocrine Center for a pre-authorization review.

An autonomously functioning thyroid nodule (also called a "hot nodule") produces thyroid hormone independently of the body's normal regulatory signals, sometimes causing hyperthyroidism. Traditional treatments include surgery or radioactive iodine. Thyroid RFA is an effective alternative for eligible patients who prefer to avoid these options. Eligibility is determined on a case-by-case basis at UCLA Health.

Surgery remains the standard of care for the large majority of thyroid cancers. However, thyroid RFA may be appropriate for a carefully selected subset of patients: those with small primary thyroid cancers or small recurrent thyroid cancers (typically in lymph nodes) who are not surgical candidates due to other medical conditions, or who have declined surgery after thorough counseling. These cases are reviewed by the full multidisciplinary team at UCLA Health before RFA is recommended.

Call (310) 267-7838 to schedule a consultation with UCLA's endocrine surgery team, or request an interventional radiology consultation through the UCLA Interventional Radiology department. Patients are evaluated by a multidisciplinary team — an interventional radiologist, an endocrinologist, and an endocrine surgeon — to determine whether RFA is the best option. A referral from your primary physician is helpful but not always required.