High-intensity focused ultrasound (HIFU) for benign thyroid nodules: 2-year follow-up results
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ORIGINAL ARTICLE
High-intensity focused ultrasound (HIFU) for benign thyroid nodules: 2-year follow-up results Pierpaolo Trimboli
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Federico Pelloni1 Fabiano Bini2 Franco Marinozzi2 Luca Giovanella1 ●
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Received: 20 February 2019 / Accepted: 18 March 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
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) ●
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Introduction Thyroid nodule is a frequent condition being diagnosed in up to 70% of subjects who had undergone thyroid ultrasound (US) [1–3]. Fortunately, 90–95% of nodules turn out to be benign and, when they do not determine compressive symptomatology or esthetic problems, do not need specific therapy and are addressed to clinical follow-up. On the other hand, the surgical removal of thyroid nodule is traditionally offered to those patients with large goiter with compressive symptoms and, notably, thyroidectomy still
* Pierpaolo Trimboli [email protected] 1
Department of Nuclear Medicine and Thyroid Centre, Imaging Institute of Southern Switzerland, Bellinzona 6500, Switzerland
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Department of Mechanical and Aerospace Engineering, “Sapienza” University of Rome, Rome 00184, Italy
remains the standard of care of malignant tumors [4]. In order to avoid surgery and the related possible complications, non-invasive options treatments, such as laser, radiofrequency, microwaves, ethanol ablation, and highintensity focused ult
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