- At twelve months, the nodule shrinks by about 70 % on median, and solid ones somewhat less than cystic ones.
- Between 10 and 23 % regrow in long-term follow-up, and about 12 % need a second session.
- Ultrasound follow-up is part of the treatment: it is what makes it possible to see it in time and decide calmly.
With a treatment without surgery, it is worth explaining its limits as well. This article sets them out with the figures from the literature, because it is information a patient should know before deciding, and for someone travelling from abroad it also has a bearing on cost.
How much it shrinks, and when
The treated nodule does not disappear immediately: the body reabsorbs it gradually over months. Most of the reduction happens in the first six and continues up to a year. The symptoms, pressure, discomfort when swallowing, the visible swelling, improve before the final figure.
- 70.9 %median volume reduction at 12 months. 78.4 % of nodules shrink by half or more.Russell JO et al. Surgery. 2024, 175(1): 139-145. 620 nodules.
- 71.8 %mean reduction in solid nodules at final follow-up, y in cystic ones, 91.1 %.Cesareo R et al. Rev Endocr Metab Disord. 2019, 20(1): 37-44. 21 pooled studies.
There are two nuances worth adding. The starting volume matters: nodules over 20 mL shrink less and may need more than one session. And there are published figures worth reading carefully, such as a «98.8 % at ten years» that comes from 29 nodules out of a cohort of 267: at ten years the only patients still in follow-up are those with the best outcomes.
What regrowth means
An increase in nodule volume of more than 50 % over the minimum reached after treatment. has a precise definition: the volume increases by more than half over the minimum it had reached. It is not that the nodule «comes back»: it is that the part not fully treated, almost always at the edge, grows over time. It is seen on the follow-up ultrasound before it is noticed.
- 10 to 23 %of nodules regrow in long-term follow-up: 15 % at five years and 10.3 % at ten in one series, and 23 % in another.Shin JH et al. Korean J Radiol. 2025, 26(2): 193-203 · Bernardi S et al. Front Endocrinol. 2020, 11: 582550.
- 12 %need a second treatment, approximately.Bernardi S et al. Front Endocrinol. 2020, 11: 582550.
What is done then
It is decided with the ultrasound in hand, and the options are explained to you: a second session, whose cost is given in writing and in advance, or, in some cases, surgery. A nodule treated with radiofrequency can be operated on later without difficulty, whereas surgery cannot be undone. Hence the usual sequence.
The follow-up calendar
- 01At one monthFirst follow-up ultrasound. The volume is measured and compared with the starting one.
- 02At three and six monthsThis is when most of the reduction is seen. Thyroid function is checked too.
- 03At one yearIt is the reference measurement of the treatment. From then on, the ultrasound is repeated every one or two years, depending on the case.
- 04If you live abroadThe ultrasounds are done in your country, with your radiologist, and Dr. Jacobo reviews them. There is no need to travel again for that.
- Russell JO et al. Surgery. 2024, 175(1): 139-145.
- Cesareo R et al. Rev Endocr Metab Disord. 2019, 20(1): 37-44.
- Shin JH et al. Korean J Radiol. 2025, 26(2): 193-203.
- Bernardi S et al. Front Endocrinol. 2020, 11: 582550.
- Kim JH et al. 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology. Korean J Radiol. 2018, 19(4): 632-655.
