Single-session high-intensity focused ultrasound (HIFU) ablation for benign thyroid nodules: a systematic review

ABSTRACT

Background

Thyroid nodules are common; the majority of them are benign and asymptomatic. Thyroidectomy might be an option; however, the frequency of post-operative complications mandates the development of alternative approaches, such as high-intensity focused ultrasound ablation (HIFU). HIFU induces thermal destruction without penetrating the skin. The present systematic review aims to synthesize all available data, evaluating studies with single-session HIFU therapy and investigating its efficacy.

Materials and methods

This systematic review was conducted in accordance with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and MetaAnalyses). Eligible articles were identified by a search of Medline bibliographic database (PubMed) and Cochrane Library. Out of 39 results, 11 articles were considered to meet the inclusion criteria.

Results

All eligible studies included patients with solid or predominantly solid benign thyroid nodules. All patients were treated with the same HIFU device. The success rate of the method was defined in the majority, with the volume reduction rate (VRR) over 50% from baseline. The mean or median VRR ranged from 48.7 to 70.41%, depending on the last follow-up date. No major complications were observed.

Conclusion

Single-session HIFU is safe and effective for the treatment of benign thyroid nodules.

KEYWORDS:

• HIFU
• ultrasound
• ablation
• benign
• thyroid
• nodules

Article Highlights

• Single-session HIFU is relatively safe and effective for the treatment of solid or predominantly solid benign thyroid nodules of certain size, location and echogenicity.

• The volume reduction ranged from 48.7% to 70.41%, depending on the last follow-up date, rendering the treatment successful.

• No major complications were observed.

• More studies with a longer follow-up period should be conducted.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.