- Four ultrasounds in the first year, at one, three, six and twelve months, performed by your radiologist, and after that, one every one or two years.
- At each check-up, the volume is compared with the previous measurement and thyroid function is checked with a blood test. The treated nodule changes in appearance, and your radiologist should know that.
- A follow-up video call is booked when something changes: the volume increases, the symptoms return or your TSH does not return to normal.
Ablation does not end on the day of the procedure. The nodule is reabsorbed over months and its progress has to be checked, not as a formality, but because it is the way to know in time whether it is following the expected course. For those who live abroad, that follow-up has one rule: the ultrasounds are performed there, and Dr. Jacobo reviews them from here.
The four check-ups in the first year
- 01At one monthThis is the first measurement after the procedure. It is the baseline everything else is compared against, and it is also a chance to confirm that no discomfort has lingered.
- 02At three monthsThe nodule has already started to shrink, though it has not reached its final size. The volume is compared with the one-month measurement, and thyroid function is checked with a blood test.
- 03At six monthsThis is when the reduction usually shows clearly and when we confirm that the nodule is progressing as expected. In most cases, the symptoms have already resolved.
- 04At one yearThis is the treatment's reference measurement. From then on, there is a check-up every one or two years, because some nodules regrow later.
- 70.9%median volume reduction at twelve months, and 78.4% of nodules shrink by half or more.Russell JO et al. Surgery. 2024, 175(1): 139-145. 620 nodules.
- 10 to 23%of nodules regrow in long-term follow-up, and about 12% need a second treatment. That is why the check-ups continue after the first year.Shin JH et al. Korean J Radiol. 2025, 26(2): 193-203 · Bernardi S et al. Front Endocrinol. 2020, 11: 582550.
What your radiologist should measure
A nodule treated with radiofrequency does not look like a normal nodule. It changes in appearance: it becomes darker and more heterogeneous, its edges blur and, over time, it shrinks. If the radiologist does not know the nodule was treated, that appearance may be reported as something new or worrying. That is why your radiologist should know about the treatment and what to look for, and why Dr. Jacobo speaks with them directly when needed.
- The nodule's three diameters and, if possible, the volume in milliliters, measured the same way as at the previous check-up.
- Whether any area that looks like viable tissue remains at the edges, and whether it shows blood flow on An ultrasound mode that shows blood flow. Tissue that still has flow after ablation is tissue that was not treated..
- The rest of the gland: that there are no new nodules and that the healthy tissue is unchanged.
- The images, not only the report: comparing two images says more than comparing two numbers.
What you send us and how
After each ultrasound, you send us the report and the images by WhatsApp or email. A photograph of the report taken with your phone is sufficient, and if the center provides the images, even better. Dr. Jacobo compares them with the previous measurements and lets you know how the nodule is progressing. If your radiologist is unsure about what they see, we arrange for the two of them to speak directly. You do not need to book anything for that.
What the blood test checks
Thyroid function, with The pituitary hormone that tells the thyroid how much hormone to produce. It is the first test used to check whether the gland is working. and free T4, is checked at the first-year visits, especially in the first months. The gland almost always keeps producing its hormone normally, and in those with thyroid antibodies or a high TSH to begin with, it is monitored more closely. And if you have a blood test in the first week after the procedure, there is no need to be alarmed by the result: it may come back temporarily abnormal, but in the opposite direction from what people usually fear, because the heated nodule releases the hormone it had stored.
When to book a video call
- When the volume increases compared with the previous check-up, instead of falling or holding steady.
- When the symptoms return: the pressure, the swelling in the neck, the discomfort when swallowing.
- When your TSH does not return to normal at the first-year check-ups.
- Or simply when you wish to speak with the doctor: the follow-up is there for you.
- Russell JO et al. Surgery. 2024, 175(1): 139-145.
- Bernardi S et al. Front Endocrinol. 2020, 11: 582550.
- Shin JH et al. Korean J Radiol. 2025, 26(2): 193-203.
- Wang N et al. Int J Hyperthermia. 2021, 38(1): 1060-1068.
- Li S et al. Changes in thyroid function after thermal ablation of thyroid nodules. Front Endocrinol. 2025, 16: 1557725.
- Kim JH et al. 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology. Korean J Radiol. 2018, 19(4): 632-655.
