Location in Graz
Thyroid, Endocrine and Osteoporosis
Institute Dobnig GmbH
Electoral institute
Location in Vienna
Practice for thyroid
radiofrequency ablation

Univ.Prof.Dr.Harald Dobnig
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Radiofrequency ablation
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Thyroid, Endocrine and Osteoporosis Institute Dobnig GmbH
ORF contribution and publication
of RFA results in "Thyroid"

  ORF contribution Dec 2018 "Bewußt Gesund"  
ORF contribution

Dec 2018
"Bewußt Gesund"
RFA position paper of 4 Austrian medical societies  
RFA position paper of 4 Austrian medical societies

published in September 2018 in the Journal of Clinical Endocrinology & SW
  ORF documentation on radiofrequency ablation in our institute (Oct 20, 2015)  
 
ORF contribution
Oct 2015
Ergebnisse der RFA Behandlungen aus Graz, erschienen in der renommierten Fachzeitschrift "Thyroid", März 2018  
 
"Thyroid" (Mar 2018)
Publication of our own RFA results from Graz in the renowned scientific medical journal
  Video about the radiofrequency ablation of thyroid nodules (from 18.05.2018)
created by credoweb, duration: 9 minutes

  Video about the radiofrequency ablation of thyroid nodules (from 18.05.2018)
Ablation of nodules and cysts
  BACK TO - Special services, conservative treatment options   BACK TO - Special services, conservative treatment options
 
  on average 60% volume reduction of solid and cystic nodules after 3 months and 80% after 1 year.
  out-patient procedure, 30 to 60 min
  under local anesthesia
  best possible protection of
surrounding (healthy) thyroid tissue
  preservation of thyroid function
  no scar-formation
  no hospital stay
  no convalescence
  very low complication rate
 
    nodules causing symptoms
(difficulty swallowing, sensation of "lump in throat", hoarseness, pain)
    visual nodules causing cosmetic issues
    restricted suitability for general anesthesia
    treatment of “hot” nodules that cause hyperthyroidism when patients refuse radioactive iodine treatment or surgery
    treatment of papillary microcarcinomas (under certain conditions)
    primary hyperparathyroidism (when there is increased risk of anesthesia)
  High-frequency thermal ablation (Radiofrequency ablation, RFA)

Instead of surgical removal, many nodules and cysts can be ablated in situ by heat treatment using a special needle. This technique was developed in 2002 by Prof.Dr.Baek from Seoul (South Korea) and first adopted for the treatment of thyroid nodules and cysts. Since then, he and others have further refined the method and many scientific papers have been published showing it to be both efficacious and safe. In Europe, the RFA procedure is offered in special thyroid clinics in countries such as Italy, Denmark and Spain. In Germany there are very few centres offering RFA.

In April 2016, the Austrian Thyroid society (OSDG) designated the radiofrequency ablation of nodules/cysts or "hot" nodules a "highly-effective out-patient treatment option with a low complication rate" for patients who have rejected surgery or radioiodine treatment, or for whom these treatments are contraindicated (link to article).
RFA results from our institution have been published in the renowned medical scientific journal "Thyroid" In March 2018 . The paper is "open access" and can be read here.

Ablation is accomplished by dissipation of heat (produced by high-frequency radio waves) from the tip of a special water-cooled needle. Specialized white blood cells subsequently remove the dead nodule tissue in the weeks and months following RFA, which causes the nodule or cyst to shrink considerably. Large-scale studies have shown an average reduction in nodule volume of approximately 60% after 3 months, and of 80% after one year, depending on the original nodule size and composition. A small amount of scar tissue within the thyroid lobe is often the only vestige of the treated nodule.

As the volume of the nodule decreases, common clinical complaints (swallowing problems, pressure sensation, a feeling of throat constriction) are reduced in parallel and the visible bulge in the neck disappears.

The RFA procedure is performed in a specially adapted room in our institute. We ask patients to allow a total of 2 hours time, 30 to 60 minutes of which are required for the procedure itself, depending on nodule size. The treatment is performed using local anaesthesia and pain is usually not a problem. Most patients tell us that they felt no pain at all, or that it was acceptable. As a rule we, moreover, don't administer any intravenous analgesic or other medications, and patients are responsive at all times.

Generally speaking, regular Austrian health insurance does not cover the costs of RFA treatment. That said, partial reimbursement can be obtained in some individual cases from some insurers. If you have supplementary insurance, please let us know so that we can assist you with the reimbursement process.

This is how radiofrequency ablation of the nodule/cyst is performed:
Illustration of a transverse section of the neck and thyroid region:
  Illustration of a cross section through the cervical and thyroid region

The "black tunnel" in the middle of the picture is the trachea with the horseshoe-shaped thyroid gland wrapped around it. The "serrated sleeve" behind it is the oesophagus. The yellow lines mark the areas that are treated with a local anaesthetic. The needle tip heats up a small portion of the surrounding tissue, allowing the nodule or cyst to be treated bit-by-bit.

Am I a suitable candiate for radiofrequency ablation?

This is how you should proceed in case you think of an radiofrequency ablation or alcohol ablation in your case: please send me your most important clinical reports (usually this is ultrasound, thyroid scan, laboratory tests) preferably by email (or also mail or fax) and let me briefly know whether you have had a fine needle aspiration before (!) RFA can only be done in case the result of the fine needle aspiration (FNA) is benign. With these results I should be able to make a meaningful prognosis on whether you are a candidate for RFA or alcohol ablation.

In case you decide for a trip to Graz we can propose to you the "Augarten Art Hotel" (http://www.augartenhotel.at) which is a 1 Min walk from our Institute. It is advisable if you stay here on the day of the RFA, but we have had patients returning home in the afternoon on the same day. RFAs are usually performed on thursdays (from 8 am to 3 pm). In case you need help with anything please let us know!

Costs for radiofrequency ablation

Current costs for radiofrequency ablation for patients outside the EU are € 2860.- and for EU patients € 2300.- (including VAT of 10%).

 
Besucherzähler
 seit 8.10.2012
 
  Thyroid, Endocrine and Osteoporosis Institute Dobnig GmbH
Univ.Prof.Dr.H.Dobnig
Jakob-Redtenbachergasse 10, 8010 Graz
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