High-intensity focused ultrasound (HIFU) therapy for benign thyroid nodules without anesthesia or sedation
- 219 Downloads
Thermal ablation of thyroid nodules has gained momentum due to the possibility to avoid surgery. High-intensity focused ultrasound (HIFU) allows thermal treatment by energy ultrasound beam inside the targeted zone. Aim of our study was to evaluate the effects of HIFU treatment using Beamotion mode without anesthesia.
Since 2016, patients with normal thyroid function, benign thyroid nodules with diameter no larger than 4 cm, and presenting local discomfort and/or compressive symptoms were treated by HIFU. We performed Beamotion HIFU and did not use anesthesia. Nodule size and thyroid function were evaluated before HIFU and 6 and 12 months later. Complications to therapy and tolerability of patients were also recorded. According to local ethical committee, for this retrospective study formal consent was not required.
The final series included 26 nodules from 26 patients with estimated volume of 2.81 ± 2.04 mL, treated by a power of 33.3 ± 10.3 W/site and energy of 2.1 ± 1.1 kJ. Nodules volume was significantly (p < 0.0001) reduced at 6 months of follow-up (1.83 ± 1.63 mL), and further at 1 year (1.57 ± 1.47 mL). Mean percentage of reduction over time of nodules was 48%. A 73% of patients described good comfort during treatment, 100% experienced good comfort just after therapy, and tolerability was high. No complications were recorded. At one 1 year of follow-up, 85% of subjects reported a reduction of local symptoms.
HIFU therapy is effective in reducing size of thyroid nodules with major diameter below 4 cm and can be performed without anesthesia.
KeywordsThyroid thermal ablation high-intensity focused ultrasound (HIFU)
We thank a lot Riccardo Ricci CNMT and Cinzia Pezzoli CNMT who have significantly contributed for all HIFU planning and treatments.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Also, for this retrospective study, formal consent was not required.
- 17.F. Bini, P. Trimboli, F. Marinozzi, L. Giovanella, Treatment of benign thyroid nodules by high intensity focused ultrasound (HIFU) at different acoustic powers: a study on in-silico phantom. Endocrine (2017). https://doi.org/10.1007/s12020-017-1350-1
- 25.R. Cesareo, V. Pasqualini, C. Simeoni, M. Sacchi, E. Saralli, G. Campagna, R. Cianni, Prospective study of effectiveness of ultrasound-guided radiofrequency ablation versus control group in patients affected by benign thyroid nodules. J. Clin. Endocrinol. Metab. 100, 460–466 (2015)CrossRefPubMedGoogle Scholar
- 26.S.U. Park, J.H. Baek, N.D. Gyu, Benign thyroid nodules treatment using percutaneous laser ablation (PLA) and radiofrequency ablation (RFA). Int. J. Hyperth. 33, 953–954 (2017)Google Scholar
- 27.H. Gharib, E. Papini, R. Paschke, D.S. Duick, R. Valcavi, L. Hegedüs, P. Vitti, AACE/AME/ETA Task Force on Thyroid Nodules, American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. J. Endocrinol. Invest. 33, 51–56 (2010)CrossRefPubMedGoogle Scholar