Skip to main content
SpringerLink
Log in

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

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  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)

    Article  PubMed  PubMed Central  Google Scholar 

  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)

    Article  PubMed  Google Scholar 

  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)

    Article  PubMed  PubMed Central  Google Scholar 

  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)

    Article  PubMed  PubMed Central  Google Scholar 

  5. L. Hegedus, Therapy: a new nonsurgical therapy option for benign thyroid nodules? Nat. Rev. Endocrinol. 5, 476–478 (2009)

    Article  PubMed  Google Scholar 

  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)

    Article  PubMed  PubMed Central  Google Scholar 

  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)

    Article  PubMed  PubMed Central  Google Scholar 

  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)

    Article  CAS  PubMed  Google Scholar 

  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)

    Article  PubMed  Google Scholar 

  10. S. Mihcin, A. Melzer, Principles of focused ultrasound. Minim. Invasive Ther. Allied Technol. 27, 41–50 (2018)

    Article  PubMed  Google Scholar 

  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)

    Article  PubMed  Google Scholar 

  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. 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)

    Article  PubMed  Google Scholar 

  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)

    Article  CAS  PubMed  Google Scholar 

  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)

    Article  PubMed  Google Scholar 

  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)

    Article  PubMed  Google Scholar 

  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. 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)

    Article  PubMed  Google Scholar 

  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. 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. 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)

    Article  PubMed  Google Scholar 

  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)

    Article  PubMed  Google Scholar 

  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)

    Article  PubMed  Google Scholar 

  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)

    Article  CAS  PubMed  Google Scholar 

  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)

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

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

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine and Thyroid Centre, Imaging Institute of Southern Switzerland, Bellinzona, 6500, Switzerland

    Pierpaolo Trimboli, Federico Pelloni & Luca Giovanella

  2. Department of Mechanical and Aerospace Engineering, “Sapienza” University of Rome, Rome, 00184, Italy

    Fabiano Bini & Franco Marinozzi

Authors
  1. Pierpaolo Trimboli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Federico Pelloni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fabiano Bini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Franco Marinozzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luca Giovanella
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pierpaolo Trimboli.

Ethics declarations

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.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Trimboli, P., Pelloni, F., Bini, F. et al. High-intensity focused ultrasound (HIFU) for benign thyroid nodules: 2-year follow-up results. Endocrine 65, 312–317 (2019). https://doi.org/10.1007/s12020-019-01909-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-019-01909-w

Keywords

Search

Navigation