Two-year efficacy of single-session high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules
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Assessing the efficacy of single high-intensity focused ultrasound (HIFU) ablation in benign thyroid nodules beyond 12 months.
One hundred and eight patients underwent single HIFU treatment. Extent of nodule shrinkage [by volume reduction ratio (VRR)] and obstructive symptom score [by 0-10 visual analogue scale (VAS)] were evaluated for 24 months after treatment. VRR (%) was calculated based on the formula: [baseline volume – volume at visit] / [baseline volume] × 100. Binary logistic regression was performed to evaluate factors associated with 24-month treatment success (VRR ≥ 50%).
After treatment, the mean (± SD) VRR at 3, 6, 12 ,18 and 24 months were 51.32 ± 20.71%, 62.99 ± 22.05%, 68.66 ± 18.48%, 69.76 ± 17.88% and 70.41 ± 17.39%, respectively, while the median (IQR) VAS at baseline, 6, 12 and 24 months was gradually lowered from 4.0 (2.0), 2.0 (1.0), 2.0 (1.0) to 1.0 (2.0), respectively. Sixty-three (58.3%) nodules had a further volume reduction (i.e. > 4.5%) from 12 to 24 months, while 22 (20.4%) nodules had a volume increase of > 4.5% from 12 to 24 months. Small pre-ablation nodule volume was a significant determinant for treatment success at 24 months (OR=1.045, 95% CI=1.021–1.092, p = 0.038).
A majority of nodules had further volume reduction beyond 12 months after single HIFU ablation, but since one-fifth of nodules had a notable volume increase beyond 12 months, a longer period of surveillance would be necessary. Small pre-ablation nodule volume was a significant factor determining 24-month treatment success.
• Small but significant nodule shrinkage continues beyond 12 months after single treatment.
• Obstructive symptom continues to improve beyond 12 months after single treatment
• Smaller-sized nodules have a greater chance of treatment success at 24 months
KeywordsInterventional ultrasonography High-intensity focused ultrasound ablation Treatment efficacy Ultrasound imaging Ablation techniques
High-intensity focused ultrasound
Thyroid stimulating hormone
Vocal cord palsy
Volume reduction ratio
We would like to thank Mr. Hill Yu for conducting all the symptom assessments for the entire study period and Professor Stephen Cheng (Head of Department of Surgery, University of Hong Kong) for agreeing to be the guarantor of this paper.
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Professor Stephen Cheng (Head of Department).
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
Study subjects or cohorts overlap
The 6- and 12-month outcomes of 22 patients were previously reported in a small prospective study .
• Single institution
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