High intensity focused ultrasound (HIFU) ablation of benign thyroid nodule is safe and efficacious in patients who continue taking an anti-coagulation or anti-platelet agent in the treatment period

Figures & data

Table 1. A comparison of patient baseline characteristics, treatment parameters and extent of nodule shrinkage between those who were taking an anti-coagulation or anti-platelet agent during treatment (Group 1) and those who did not take any anti-coagulation or anti-platelet agent during treatment (Group 2).

Variable	Group 1 (n = 12)	Group 2 (n = 291)	p-value
Patient characteristics
- Age at treatment (years)	66.75 ± 8.81	48.08 ± 9.77	.001
- Sex (Male:Female)	5:7	62:229	.165
- Body weight (kg)	61.32 ± 9.20	58.23 ± 11.06	.277
- Body height (m)	1.64 ± 0.10	1.62 ± 0.078	.767
- Body mass index (kg/m^2)	25.90 ± 11.71	21.99 ± 2.83	.201
Characteristics of the index nodule
- Side of the nodule (Right:Left)	8:4	140:151	.283
- Longest nodule diameter (cm)	4.1 ± 1.8	4.0 ± 1.5	.800
- Nodule volume at baseline (mL)	25.2 ± 28.1	23.4 ± 24.1	.853
- Distance from skin to center of nodule (cm)	1.7 ± 0.4	1.7 ± 0.4	.712
Baseline blood tests
- Serum TSH (mIU/L)	0.94 ± 0.73	1.37 ± 0.92	.073
- Serum free T4 (pmol/L)	16.23 ± 2.55	17.54 ± 1.58	.098
- Anti-Tg autoantibody (IU/mL)	68.3 ± 14.1	91.5 ± 80.8	.076
- Anti-TPO autoantibody (IU/mL)	184.2 ± 223.6	163.8 ± 374.1	.879
Treatment parameters
- Total energy delivered (KJ)	12.92 ± 4.39	14.79 ± 5.39	.416
- Total ‘on-beam’ treatment time (minutes)	43.75 ± 38.10	38.74 ± 11.45	.895
- Energy per each pulse (J)	300.39 ± 16.82	311.44 ± 26.59	.783
6-month volume reduction ratio (%)	55.96 ± 14.04	61.29 ± 17.93	.073

Continuous variables are expressed in mean ± standard deviation. Abbreviations: TSH: thyroid stimulating hormone; Anti-Tg: Anti-thyroglobulin; TPO: thyroid peroxidase. Nodule volume at baseline: (width × depth × length)×(π/6) where π was taken as 3.14159.

Table 2. Medical comorbidities and type/dose of anticoagulation or antiplatelet agent during treatment in group 1.

Patient number	Age/Sex	Medical comorbidities at the time of ablation	Type and dose of anticoagulation or antiplatelet agent during ablation	Nodule volume (mL)		Treatment-related complications
				Initial	6-month
1	57/Male	Aortic value replacement	Warfarin 3 mg daily	16.8	9.5	None
2	76/Female	IHD, hyperlipidemia, DM, PVD with toe ulcers	Aspirin 80 mg daily	8.4	4.6	None
3	51/Female	IHD, 1st-degree heart block, HT	Aspirin 100 mg daily	7.8	2.8	None
4	59/Male	IHD with PCI, hyperlipidemia	Aspirin 80 mg daily	13.5	5.4	None
5	77/Female	IHD, DM, PVD with foot ulcers	Aspirin 80 mg daily	16.5	5.9	None
6	80/Female	HT, AF, chronic heart block	Rivaroxaban 15 mg daily	108.7	62.9	None
7	67/Female	HT, AF	Rivaroxaban 15 mg daily	11.3	2.1	None
8	68/Female	IHD, DM, hyperlipidemia	Aspirin 80 mg daily	9.3	3.4	None
9	59/Male	Aortic valve replacement	Warfarin 2.5 mg daily	17.3	5.3	None
10	69/Male	DM, HT, hyperlipidemia, IHD with PCI	Aspirin 100 mg daily	23.2	11.3	None
11	71/Female	PE / DVT	Warfarin 3 mg daily	28.4	12.5	None
12	67/Male	IHD, DM, HT	Aspirin 80 mg daily	42.1	29.3	None

Abbreviations: IHD: ischemic heart disease; DM: diabetes mellitus; PVD: peripheral vascular disease; HT: hypertension; PCI: percutaneous cardiac intervention; PE: pulmonary embolism; DVT: deep vein thrombosis. Nodule volume = (width × depth × length)×(π/6) where π was taken as 3.14159.