MON-456 - Radiofrequency Ablation of Symptomatic Benign Thyroid Nodules: An Interventional Endocrinologist'S Initial Experience

Background: Radiofrequency ablation (RFA) has been performed internationally for more than 20 years but has gained clinical traction in the United States only in recent years. It has emerged as an effective minimally invasive treatment for symptomatic benign thyroid nodules, offering an alternative to surgery or long-term observation. We report our initial experience with thyroid nodule RFA, focusing on early volume reduction outcomes.

Methods: We retrospectively analyzed patients with symptomatic benign thyroid nodules who underwent RFA between March 2024 and July 2025 by a single interventional endocrinologist at our center. Ultrasound-based nodule dimensions and calculated volumes were recorded pre-procedure and at 3-month follow-up. The volume reduction rate (VRR) was calculated. Regrowth was defined as an increase in post-procedural nodule volume compared with baseline.

Results: Of the 13 cases that underwent RFA, 9 were included for analysis as they had at least 3-month post-RFA follow-up. All patients underwent a single treatment session. Median baseline nodule volume was 5.32 mL (IQR 3.65-10.03) and median nodule volume at 3 months was 1.09 mL (IQR 1.03-1.99). The overall median VRR was 70.65%. Five patients (55%) achieved VRR >70%, of whom three had VRR >80% at 3 months. No nodule regrowth was observed during the follow-up period. There was no clinically significant change in TSH before and after RFA, except in one patient with subclinical hyperthyroidism whose TSH normalized post-procedure. One patient on levothyroxine prior to RFA remained on the same dose post-procedure. Median cosmetic and symptom scores decreased from 3 and 7 [6–10] to 0 [0–1] and 1 [0–5], respectively. No major complications occurred.

Conclusions: In this initial endocrinologist-led experience, RFA resulted in significant thyroid nodule volume reduction even in the first 3 months with improvement in compressive symptoms and cosmetic concerns without evidence of regrowth. These outcomes are consistent with those reported in larger, established RFA cohorts. RFA is a safe and effective treatment option that preserves thyroid function with minimal procedural risk.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*