Benign thyroid nodules are very common, and in the UK around 70% of people will have at least one. Most of the time, they do not cause too much of a problem. Yet in some people they get bigger and cause pressure on the windpipe or food pipe, and they may look very prominent in the neck. These larger nodules are traditionally treated with surgery – removing half or all of the thyroid gland under a general anaesthetic. While this is a commonly performed operation, it is not without risks. These include a neck scar, damage to the recurrent laryngeal nerves which supply the voice box, and the need for life-long levothyroxine replacement. 

Over the last couple of decades, several techniques have emerged that aim to ablate the thyroid nodule from the inside using a probe. This shrinks the nodule and reduces the symptoms caused by it. Radiofrequency ablation is the most well-known of these techniques. RFA is carried out under ultrasound guidance with local anaesthetic. Studies so far have shown it to be a safe and more cost-effective alternative to surgery.

The UK has slowly been adopting RFA since it was approved by NICE a few years ago, however many centres have had difficulties introducing it. This is due to the lack of high-quality evidence showing it is at least as safe as surgery and that it is less expensive. 

We are therefore pleased that the RABBIT (Radiofrequency ABlation of Benign Intrathyroidal Tumours) trial is starting to recruit in centres across the UK, with more due to open throughout the year. The sites now open for recruitment are:

Buckinghamshire Healthcare NHS Trust Hospital 

Cambridge University Hospitals NHS Foundation Trust

East and North Hertfordshire Teaching NHS Trust

Imperial College Healthcare NHS Trust

Newcastle Hospitals NHS Foundation Trust

Royal Berkshire Hospital, Royal Berkshire NHS Foundation Trust, 

Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust

The BTF is a partner in the trial, which is being run by expert thyroid surgeons, endocrinologists, and radiologists from around the UK. If you have a benign thyroid nodule that you think needs to be treated, then ask your thyroid clinician if they are signed up to the trial, and whether you are eligible.

If so, then you will be randomised to either receive the standard of care treatment, a hemithyroidectomy (removal of half your thyroid gland), or RFA. Whichever treatment you receive, you will be closely followed up and have the opportunity to give your views on how you feel your treatment has affected your symptoms. Taking part in this trial will directly impact what we can offer to patients with thyroid nodules across the country in the future.

Read more about the RABBIT trial

Watch Mr Neil Sharma and colleagues talking about non-surgical treatments for benign thyroid nodules

 

Article first published April 2025

Article updated with information about sites open for recruitment in July 2025