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Endocrine

pp 1–6 | Cite as

High-intensity focused ultrasound (HIFU) for benign thyroid nodules: 2-year follow-up results

  • Pierpaolo TrimboliEmail author
  • Federico Pelloni
  • Fabiano Bini
  • Franco Marinozzi
  • Luca Giovanella
Original Article
  • 51 Downloads

Abstract

Background

High-intensity focused ultrasound (HIFU) is the last introduced thermal treatment of thyroid nodules. Here we evaluated the results at 24 months after HIFU.

Methods

Since 2016, HIFU was considered as a therapeutic option at our institute in patients with benign thyroid nodules presenting local symptoms. We searched in our database all patients who had undergone thyroid HIFU and selected for the study only cases followed-up for at least 24 months after the treatment. Volume reduction rate (VRR) was evaluated. A reduction above 50% defined the success of HIFU.

Results

Thirty-one nodules of 31 patients (24 females and 7 males, median age 67 years) with median major diameter from 17 to 34 mm and estimated nodule volume of 5.48 mL were included. HIFU was performed with median power of 42 W/site (interquartile range 25–45) and median energy of 263 J/site (interquartile range 225–273). Median duration of the procedure was 6 min (interquartile range 5–7). At 2 years after HIFU, nodule volume was significantly (p < 0.0001) lower (i.e., 3.40 mL) with VRR of 43.3%, and 26 (83.9%) lesions were reduced. A reduction by at least 50% was observed at 6, 12, and 24 months in 2 (6.4%), 5 (16.1%), and 7 (22.5%) nodules, respectively. Visual analog score showed a significant improvement (p < 0.0001). No complications were recorded.

Conclusions

A reduction of benign thyroid nodule by more than 40% could be reached within 1 year by HIFU. Given the non-significant size increase of some lesions later, a larger study with a longer follow-up is necessary.

Keywords

Thyroid Thermal ablation High-intensity focused ultrasound (HIFU) 

Notes

Acknowledgements

The authors thank Riccardo Ricci CNMT and Cinzia Pezzoli CNMT who significantly contributed for all HIFU treatments.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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.

References

  1. 1.
    E.J. Ha, H.K. Lim, J.H. Yoon, J.H. Baek, K.H. Do, M. Choi et al. Primary imaging test and appropriate biopsy methods for thyroid nodules: guidelines by Korean Society of Radiology and National Evidence-Based Healthcare Collaborating Agency. Korean J. Radiol. 19, 623–631 (2018)CrossRefPubMedGoogle Scholar
  2. 2.
    C. Durante, G. Grani, L. Lamartina, S. Filetti, S.J. Mandel, D.S. Cooper, The diagnosis and management of thyroid nodules: a review. JAMA 319, 914–924 (2018); erratum JAMA. 319, 1622 (2018)CrossRefPubMedGoogle Scholar
  3. 3.
    A. Barile, S. Quarchioni, F. Bruno, A.M. Ierardi, F. Arrigoni, A.V. Giordano et al. Interventional radiology of the thyroid gland: critical review and state of the art. Gland Surg. 7, 132–146 (2018)CrossRefPubMedGoogle Scholar
  4. 4.
    B.R. Haugen, E.K. Alexander, K.C. Bible, G.M. Doherty, S.J. Mandel, Y.E. Nikiforov et al. 2015 American Thyroid Association Management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 26, 1–133 (2016)CrossRefPubMedGoogle Scholar
  5. 5.
    L. Hegedus, Therapy: a new nonsurgical therapy option for benign thyroid nodules? Nat. Rev. Endocrinol. 5, 476–478 (2009)CrossRefPubMedGoogle Scholar
  6. 6.
    S.L. Jung, J.H. Baek, J.H. Lee, Y.K. Shong, J.Y. Sung, K.S. Kim et al. Efficacy and safety of radiofrequency ablation for benign thyroid nodules: a prospective multicenter study. Korean J. Radiol. 19, 167–174 (2018)CrossRefPubMedGoogle Scholar
  7. 7.
    J.H. Kim, J.H. Baek, H.K. Lim, H.S. Ahn, S.M. Baek, Y.J. Choi et al. 2017 Thyroid radiofrequency ablation guideline: Korean Society of Thyroid Radiology. Korean J. Radiol. 19, 632–655 (2018)CrossRefPubMedGoogle Scholar
  8. 8.
    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 59, 506–509 (2018)CrossRefPubMedGoogle Scholar
  9. 9.
    I.A.S. Elhelf, H. Albahar, U. Shah, A. Oto, E. Cressman, M. Almekkawy, High intensity focused ultrasound: the fundamentals, clinical applications and research trends. Diagn. Interv. Imaging 99, 349–359 (2018)CrossRefPubMedGoogle Scholar
  10. 10.
    S. Mihcin, A. Melzer, Principles of focused ultrasound. Minim. Invasive Ther. Allied Technol. 27, 41–50 (2018)CrossRefPubMedGoogle Scholar
  11. 11.
    M. Sennert, C. Happel, Y. Korkusuz, F. Grünwald, B. Polenz, D. Gröner, Further investigation on high-intensity focused ultrasound (HIFU) treatment for thyroid nodules: effectiveness related to baseline volumes. Acad. Radiol. 25, 88–94 (2018)CrossRefPubMedGoogle Scholar
  12. 12.
    L. Giovanella, A. Piccardo, C. Pezzoli, F. Bini, R. Ricci, T. Ruberto et al. Comparison of high intensity focused ultrasound and radioiodine for treating toxic thyroid nodules. Clin. Endocrinol. (Oxf.) 2018, in press.  https://doi.org/10.1111/cen.13738
  13. 13.
    B.H. Lang, A.L.H. Wu, The efficacy and safety of high-intensity focused ultrasound ablation of benign thyroid nodules. Ultrasonography 37, 89–97 (2018)CrossRefPubMedGoogle Scholar
  14. 14.
    P. Trimboli, F. Bini, F. Marinozzi, J.H. Baek, L. Giovanella, High-intensity focused ultrasound (HIFU) therapy for benign thyroid nodules without anesthesia or sedation. Endocrine 61, 210–215 (2018)CrossRefPubMedGoogle Scholar
  15. 15.
    Y. Korkusuz, D. Gröner, N. Raczynski, O. Relin, Y. Kingeter, F. Grünwald et al. Thermal ablation of thyroid nodules: are radiofrequency ablation, microwave ablation and high intensity focused ultrasound equally safe and effective methods? Eur. Radiol. 28, 929–935 (2018)CrossRefPubMedGoogle Scholar
  16. 16.
    R.D. Kovatcheva, J.D. Vlahov, J.I. Stoinov, K. Zaletel, Benign solid thyroid nodules: US-guided high-intensity focused ultrasound ablation-initial clinical outcomes. Radiology 276, 597–605 (2015)CrossRefPubMedGoogle Scholar
  17. 17.
    C.M. Pacella, G. Mauri, R. Cesareo, V. Paqualini, R. Cianni, P. De Feo et al. A comparison of laser with radiofrequency ablation for the treatment of benign thyroid nodules: a propensity score matching analysis. Int. J. Hyperth. 33, 911–919 (2017)Google Scholar
  18. 18.
    B.H.H. Lang, Y.C. Woo, K.W. Chiu, Two-year efficacy of single-session high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules. Eur. Radiol. 29, 93–101 (2019)CrossRefPubMedGoogle Scholar
  19. 19.
    G. Mauri, C.M. Pacella, E. Papini, L. Solbiati, S.N. Goldberg, M. Ahmed, L.M. Sconfienza, Image-guided thyroid ablation: proposal for standardization of terminology and reporting criteria. Thyroid. 2019, in press.  https://doi.org/10.1089/thy.2018.0604
  20. 20.
    E. Papini, C.M. Pacella, L.A. Solbiati et al. Minimally-invasive treatments for benign thyroid nodules: a Delphi-based consensus statement from the Italian minimally-invasive treatments of the Thyroid Group. Int J Hyperthermia. 2019, in press.  https://doi.org/10.1080/02656736.2019.1575482
  21. 21.
    B.H. Lang, Y.C. Woo, K.W. Chiu, Role of second high intensity focused ultrasound (HIFU) treatment for unsatisfactory benign thyroid nodules after first treatment. Eur. Radiol. 29, 1469–1478 (2019)CrossRefPubMedGoogle Scholar
  22. 22.
    S. Spiezia, R. Garberoglio, F. Milone, V. Ramundo, C. Caiazzo, A.P. Assanti et al. Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid 19, 219–225 (2009)CrossRefPubMedGoogle Scholar
  23. 23.
    H.K. Lim, J.H. Lee, E.J. Ha, J.Y. Sung, J.K. Kim, J.H. Baek, Radiofrequency ablation of benign non-functioning thyroid nodules: 4-year follow-up results for 111 patients. Eur. Radiol. 23, 1044–1049 (2013)CrossRefPubMedGoogle Scholar
  24. 24.
    R. Valcavi, F. Riganti, A. Bertani, D. Formisano, C.M. Pacella, Percutaneous laser ablation of cold benign thyroid nodules: a 3year follow-up study in 122 patients. Thyroid 20, 1253–1261 (2010)CrossRefPubMedGoogle Scholar
  25. 25.
    A.P. Mainini, C. Monaco, L.C. Pescatori, C. De Angelis, F. Sardanelli, L.M. Sconfienza, G. Mauri, Image-guided thermal ablation of benign thyroid nodules. J. Ultrasound 20, 11–22 (2016)CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Nuclear Medicine and Thyroid CentreImaging Institute of Southern SwitzerlandBellinzonaSwitzerland
  2. 2.Department of Mechanical and Aerospace Engineering“Sapienza” University of RomeRomeItaly

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