Localized Thyroid Tissue Ablation by High Intensity Focused Ultrasound: Volume Reduction, Effects on Thyroid Function and Immune Response

Korkusuz, H.; Sennert, Michael; Fehre, Niklas; Happel, Christian; Grünwald, Frank

doi:10.1055/s-0035-1553348

Cited by 33 publications

(47 citation statements)

References 8 publications

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“…The treatment did not affect thyroid function and no serious immune reaction was observed, despite the significant rise in serum Tg level 1 day after the ablation. 27,35 Patients received either local anesthesia Schematic presentation of all sites intended to treatment; excluded sites are red in color, the sites that will be treated are white in color, and after they receive the pulse, they become green. (C) visualization of hyperechoic mark (white spot) on the point of the treatment cone after the first sonication.…”

Section: Clinical Efficacymentioning

confidence: 99%

High-intensity focused ultrasound for thyroid nodule ablation: the evidence to date

Кovatcheva¹,

Zaletel²

2017

RMI

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Thyroid nodules are common in occurrence and most of them are benign in nature. Some of these nodules are to be treated as they continue to grow or cause undesirable symptoms. Recently, several minimally invasive thermal ablation techniques have been introduced to overcome the complications of traditional methods such as surgery. High-intensity focused ultrasound (HIFU) is the latest advance in treatment modalities, which is a noninvasive procedure that permits localized target destruction without affecting the surrounding tissues. HIFU is currently used in the treatment of various solid malignant and benign tumors. The purpose of this review is to provide an introduction to the literature, principles, and advances of HIFU therapy of benign thyroid nodules, as well as to provide a discussion on its efficacy, complications, and future.

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Section: Clinical Efficacymentioning

confidence: 99%

High-intensity focused ultrasound for thyroid nodule ablation: the evidence to date

Кovatcheva¹,

Zaletel²

2017

RMI

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“…In terms of country of origin, the first published article came from France [15]. This was followed by 3 studies from Germany [19, 21, 22], 1 study from Bulgaria [23] and 1 from Hong Kong, China [24]. …”

Section: Resultsmentioning

confidence: 99%

“…of nodulesNodule volume (mL)Type of device and probeTotal amount of DIAE to each nodule (KJ)Treatment time (minutes)ComplicationsEfficacy (% reduction from baseline)Esnault (2011) [15]220.5–2.6US-guided HIFU/3 MHz extracorporeal probe35–94 J/pulse a Pain, skin burn, cough, blistersFeasibility study. Ablated nodules were examined on histology after 2 weeksKorkusuz (2014) [19]10Median: 3.19 (range: 0.8–7.67)US-guided HIFU/3 MHz extracorporeal probeMedian: 8.4 (range: 5.65–12.46)Not reportedPainNot reportedKorkusuz (2015) [21]9Median: 3.5 (range: 0.8–7.7)US-guided HIFU/3 MHz extracorporeal probeMedian: 9.9 (range: 5.7–12.5)Median: 62 (range: 42–96)Pain during treatment, reddening of skinMedian: 48.8 (range: 11.4–75.0) at 3-monthKorkusuz (2015) [22]12Median: 3.4 (range: 0.6–5.0)US-guided HIFU/3 MHz extracorporeal probe--None reportedMedian: 55 at 3-monthKovatcheva (2015) [23, 22]20Mean: 4.96 ± 2.79 (range: 1.56–9.35)US-guided HIFU/3 MHz extracorporeal probeMean: 16.4 ± 7.7 (range: 5.5–31.7)Mean: 86.8 ± 31.7 (range: 37–152)Subcutaneous edema, skin rednessMean: 48.7 ± 24.3 at 6-month (after single ablation)Lang (2017) [24]22Mean: 6.98 ± 4.04 (range: 1.68–16.76)US-guided HIFU/3 MHz extracorporeal probeMean: 15.17 ± 6.90 (range 5.88–28.35)Mean: 75.71 ± 34.20 (range: 48.75 153.25)Pain, skin redness, minor neck swellingMean: 68.87 ± 15.27 at 12-month (following single ablation) Abbreviations : US- guided HIFU ultrasound-guided high intensity focused ultrasound, DIAE depth-independent acoustic energy a only power was provided. Total energy was not available…”

Section: Resultsmentioning

confidence: 99%

“…also looked at volume reduction, effects on thyroid function and immune response after HIFU treatment in a different study [22]. Twelve patients with an average age of 56.7 years old were treated with single-session HIFU.…”

Section: Resultsmentioning

confidence: 99%

“…Twelve patients with an average age of 56.7 years old were treated with single-session HIFU. A volume reduction of more than 30% was recorded in 9 of the 12 patients, whilst the others did not achieve a 30% of reduction in nodule volume [22]. Triiodothyronine, thyroxine, thyrotropin and thyroglobulin were measured pre and post HIFU ablation.…”

Section: Resultsmentioning

confidence: 99%

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High intensity focused ultrasound (HIFU) ablation of benign thyroid nodules – a systematic review

Lang

2017

J Ther Ultrasound

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BackgroundWith an increasing number of imaging studies being done nowadays, the number of incidentally discovered thyroid nodules is expected to rise. Although many of these nodules are small and benign in nature, some do grow and may cause pressure and/or thyrotoxic symptoms. Surgical resection has traditionally been recommended for symptomatic nodules but is associated with risk of hypothyroidism, bleeding, infection, and nerve damage. High intensity focused ultrasound (HIFU) is one of the non-surgical thermal ablation techniques that may serve as an alternative in the treatment of benign thyroid nodules. The present review is to systematically evaluate the efficacy and safety of HIFU ablation.MethodsWe comprehensively searched all studies that evaluated the use of HIFU ablation as a treatment of benign thyroid nodules from Medline (PubMed) and Cochrane Library electronic databases using specific keywords. All titles identified by the search strategy were independently screened by two authors. Case reports, animal studies, editorials, expert opinions, reviews without original data and studies on pediatric population were excluded. Multiple reports of the same dataset were assessed and the most representative and updated report of a study was included.ResultsFive original studies were found. All treated thyroid nodules were confirmed to be benign cytologically and either appeared solid or predominantly (>70%) solid on ultrasonography. Only one type of commercially available US-guided device with an extracorporeal probe (3 MHz) was used in all the reported treatments. No major complications including recurrent laryngeal nerve injury, skin burn or haematoma were reported in all of the studies. The overall nodule volume reduction after single session of HIFU ablation ranged between 45 and 68%, depending on nodule size and length of follow-up.ConclusionsDespite the few number of studies, our review appeared to suggest that HIFU is a safe and efficacious method of treating symptomatic benign thyroid nodules. However, larger-scale, prospective trials with longer follow-up period are indeed required to confirm this. In terms of the ablation itself, relative to other ablation techniques, there are still much room for improvements in shortening treatment duration and expanding the range of treatable nodules.

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Image‐guided chemical and thermal ablations for thyroid disease: Review of efficacy and complications

et al. 2018

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Image-guided ablation of thyroid disease is increasingly being commonly reported. Techniques including ethanol injection and thermal ablation using radio-frequency, laser, and microwave devices have been described. Minimally invasive approaches to the management of benign cystic, solid, and functional thyroid nodules as well as both primary and recurrent thyroid malignancy have been reported. The purpose of this article is to review the current evidence relating to image-guided ablation of thyroid disease with a focus on clinical outcomes and complication rates for patients treated with this minimally invasive approach.

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Localized Thyroid Tissue Ablation by High Intensity Focused Ultrasound: Volume Reduction, Effects on Thyroid Function and Immune Response

Cited by 33 publications

References 8 publications

High-intensity focused ultrasound for thyroid nodule ablation: the evidence to date

High-intensity focused ultrasound for thyroid nodule ablation: the evidence to date

High intensity focused ultrasound (HIFU) ablation of benign thyroid nodules – a systematic review

Image‐guided chemical and thermal ablations for thyroid disease: Review of efficacy and complications

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