Which Ablation is best for Treating Thyroid Nodules? RFA or Microwave? with Dr. Bülent Çekiç

Which Ablation is best for Treating Thyroid Nodules? RFA or Microwave? with Dr. Bülent Çekiç

Dr. Çekiç is well-known for not only treating patients but also training other doctors in the field of ablation. 

Thyroid nodules can cause discomfort, pain, and even serious health issues if left untreated. Fortunately, ablation therapy offers a non-invasive solution to treating these nodules. Two popular types of ablation are radiofrequency ablation (RFA) and microwave ablation (MWA). But which one is best for treating thyroid nodules?

To help answer this question, we sat down with Dr. Bülent Çekiç, an interventional radiologist from Turkey who has treated over 4,000 cases of thyroid ablation. Dr. Çekiç is well-known for not only treating patients but also training other doctors in the field of ablation.

Dr. Çekiç explained that both RFA and microwave ablation aim to achieve a similar goal: to raise the temperature of the nodule to between 60 and 100 Celsius. However, there are some key differences between the two techniques.

In RFA, the heat causes frictional and conductive heat, and the antenna used is thinner at 18 or 19 gauge. The machine automatically stops above 800 ohms to prevent carbonization, which can lead to a lower volume reduction rate. However, in selected patients, RFA can offer a slightly higher volume reduction rate.

Microwave ablation, on the other hand, doesn’t use ground pads, so patients don’t experience any electrical current passing through their bodies. This makes it a suitable option for patients with pacemakers, joint prostheses, or dental implants. Patients also typically experience less pain with microwave ablation, and the technique can be used on larger tissue volumes in the same amount of time.

Dr. Çekiç shared that he primarily uses microwave ablation for his patients, as it is faster and causes less pain, making it an appealing option for patients with large nodules. However, he stressed that the most important factor in determining which ablation technique to use is the experience and skill level of the operator.

In some cases, Dr. Çekiç has used both RFA and microwave ablation on the same patient. For example, if a patient has a large nodule with a hypervascular or bleeding component, he may use microwave ablation first to avoid thermal injury and then follow up with RFA to ensure complete ablation of the peripheral margins of the nodule.

Dr. Çekiç emphasized that when it comes to offering ablation therapy, the most important thing is the experience and skill level of the operator. He recommended that any doctors interested in offering ablation therapy should prioritize training and developing their skills before treating patients.

In conclusion, both RFA and microwave ablation are effective treatments for thyroid nodules. Ultimately, the best technique to use depends on the specific case and the experience and skill level of the operator. Patients should consult with an experienced ablation therapist to determine the best course of treatment for their individual needs.

The Doctor Thyroid and RFAMD podcast with Philip James is listened to in 100+ countries. It is a preferred patient resource for information related to thyroid cancer, RFA, hypothyroidism, pathology, and radiation therapy.

Contact Philip at


About Dr. Bülent Çekiç

Dr. Bülent Çekiç is a leading expert in thyroid thermal ablation, specifically microwave and radiofrequency ablation. He has treated over 3500 cases using these methods since 2013, and has published 8 articles on the topic in Pubmed.

In addition to his clinical work, Dr. Çekiç has also organized 14 workshops on thyroid thermal ablation in his own clinic and 7 workshops in various countries. These workshops have been attended by a total of 40 local and 70 international doctors.

Dr. Çekiç has also presented on thyroid thermal ablation at international interventional radiology congresses such as CCMA, CIRSE, TRD, TGRD, and PAIRS. 

In recent years, he has also begun offering thyroid artery embolization as a non-surgical treatment option for Plonjuan goiter and diffuse goiter, and has treated nearly 70 cases using this method.

Dr. Bulent Cekic is currently working as a chief at the Antalya Research and Training Hospital. He has received his MD from Ataturk University. He specialized in Interventional Radiology.

Language Spoken: Turkish, German, English

View Full Profile: Dr. Bülent Çekiç

About Philip James

In 2013, his laryngeal nerve was severed, shoulder nerve damaged, parathyroids ruined, and residual cancer left behind — all for a 1 cm thyroid nodule.
Later, a vocal cord implant was inserted to help him speak.

The word he uses to describe his work as patient advocate is, ‘tonglen’. Or, using his pain and hardship to help others.

Content on the RFAMD and Doctor Thyroid with Philip James websites and podcasts is for informational purposes only and not a substitute for professional medical advice. See our full Legal Disclaimer for details.