The efficacy and safety of high-intensity focused ultrasound ablation of benign thyroid nodules

Abstract

High-intensity focused ultrasound (HIFU) is a promising form of thermal ablation of benign thyroid nodules, but evidence supporting its use is scarce. The present review evaluated the efficacy and safety of single-session HIFU treatment of benign thyroid nodules. As reported in the literature, the extent of nodule shrinkage following treatment ranged from 48.8% to 68.8%. Like other forms of ablation, the shrinkage rate was greatest in the first 3-6 months, and the best responders were patients with small (≤10 mL) nodules. Complications were uncommon, but temporary vocal cord palsy occurred in 3%-4% of patients, and was related to the distance between the HIFU beam and the recurrent laryngeal nerve. Despite being safe and efficacious, a larger-scale prospective trial is required.

Safety and efficacy of thermal ablation (radiofrequency and laser): should we treat all types of thyroid nodules?

“…HIFU indications are still being debated. It is mainly performed to treat smaller nodules ( < 5 ml) that are inaccessible to other techniques or when patients refuse other minimally invasive techniques, but several studies have shown effective results [33,[39][40][41][42][43][44].…”

Changes in serum thyroglobulin and antithyroglobulin shortly following high-intensity focused ablation of benign thyroid nodules in patients with positive antithyroglobulin status

“…Therefore, at this time, nether one is probably to be involved in immune-modulation of nodule shrinkage. To date, the nodule shrinkage is believed to due to the thermal effect of HIFU and not its mechanical effect [30].…”

Current and Future Treatments for Graves’ Disease and Graves’ Ophthalmopathy

“…This experimental approach involves the application of a high-energy focused ultrasound beam for thermal tissue ablation within a targeted zone. Its use has been reported in benign thyroid nodules [73] and a trial in relapsed GD was recently completed (ClinicalTrials.gov Identifier: NCT02685514). The investigators Lang et al postulate that the heat energy generated from HIFU could be used to ablate the thyroid parenchyma, making this approach the non-radioactive equivalent of RAI therapy.…”