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High intensity focused ultrasound in the therapy of benign thyroid nodules—first German bicentric study with long-term follow-up

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Abstract

Purpose

The study evaluated high-intensity-focused ultrasound (HIFU) for benign thyroid nodules in terms of efficiency, complication rate, influence of preablative nodule size, parameters influencing the therapeutic success and hormonal-thyroid-function.

Methods

Seventy-two patients with 75 nodules were treated with HIFU at 2 centers from 2014–2019. Median nodule volume was 4.4 ml (range 0.33–53). The therapeutic ultrasound probe (EchoPulse THC900888-H) generated 80–90 °C in the target tissue with 87.6–320.3 J per sonication. Nodal volume was measured at baseline and over 12 months after therapy in a retrospective bicentric-study with long-term follow-up. Hormonal-thyroid function (TSH, T3, T4) was measured before and after ablation. Complications were assessed.

Results

Significant volume reduction (p < 0.05 Wilcoxon-signed-rank test) of thyroid nodules was 38.98% at 3 months, 37.32% at 6 months, 61.54% at 9 months and 60.66% at 12 months. Volume reduction of nodules <3 ml did not differ significantly from nodules >3 ml (p > 0.05 Mann–Whitney test). At 3 months solid nodules had a significant volume reduction of 52.08%, complex nodules of 32.57%, nodules treated under regional anesthesia of 33.07% and under general anesthesia of 49.47%. Hormonal-thyroid function was not influenced significantly by HIFU therapy (p > 0.05 Wilcoxon-signed-rank test). Complication rate was 3.8%. No long-term complications occurred.

Conclusion

Significant volume reduction of thyroid nodules up to 12 months after HIFU was shown. All complications were reversible. Therapy was more efficient in solid than complex nodules and in nodules treated under general anesthesia than with regional anesthesia. Hormonal-thyroid-function was not affected.

Trial registraftion number

2020-1728-evBO. Date of registration: 16.06.2020. Agency: Ethik-Kommission bei der Landesäztekammer Hessen

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Author information

Authors and Affiliations

  1. Bürgerhospital Frankfurt, Nibelungenallee 37, 60318, Frankfurt am Main, Hessen, Germany

    Christian Vorländer

  2. DZTA - Deutsches Zentrum für Thermoablation e.V., Nibelungenallee 37-41, 60318, Frankfurt am Main, Hessen, Germany

    Anne Fischer

  3. Afyonkarahisar Sağlık Bilimleri Üniversitesi, Zafer Sağlık Külliyesi, Dörtyol Mahallesi 2078 Sokak No: 3, Afyonkarahisar, Turkey

    Hüdayi Korkusuz

Authors
  1. Christian Vorländer
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  2. Anne Fischer
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  3. Hüdayi Korkusuz
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by C.V., A.F. and H.K. The first draft of the manuscript was written by C.V., A.F. and H.K. and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Anne Fischer.

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Conflict of interest

The authors declare no competing interests.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University B (Date 16.06.2020/No. 2020-1728-evBO).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Vorländer, C., Fischer, A. & Korkusuz, H. High intensity focused ultrasound in the therapy of benign thyroid nodules—first German bicentric study with long-term follow-up. Endocrine 77, 112–120 (2022). https://doi.org/10.1007/s12020-022-03058-z

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  • DOI: https://doi.org/10.1007/s12020-022-03058-z

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