Focused Ultrasound Therapy
Focused ultrasound is an early-stage, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with thyroid nodules. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue.
How it Works
Where the beams converge, focused ultrasound produces precise ablation (thermal destruction of tissue) enabling thyroid nodules to be treated without surgery.
The primary options for treatment of thyroid nodules include medication and invasive surgery.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary.
At the present time, there are no clinical trials recruiting patients for focused treatment of thyroid nodules.
Regulatory Approval and Reimbursement
The Echopulse system manufactured by Theraclion is approved in Europe, Russia and Korea for treating thyroid nodules. Some European insurance companies are paying for focused ultrasound treatment of thyroid nodules.
Lang BHH, Woo YC, Chiu KW. Combining high-intensity focused ultrasound (HIFU) ablation with percutaneous ethanol injection (PEI) in the treatment of benign thyroid nodules. Eur Radiol. 2020 Sep 24. doi: 10.1007/s00330-020-07317-3.
Cheng Z, Liang P. Advances in ultrasound-guided thermal ablation for symptomatic benign thyroid nodules. Adv Clin Exp Med. 2020 Sep;29(9):1123-1129. doi: 10.17219/acem/125433.
Negro R, Trimboli P. Thermal ablation for benign, non-functioning thyroid nodules: A clinical review focused on outcomes, technical remarks, and comparisons with surgery. Electromagn Biol Med. 2020 Aug 17:1-9. doi: 10.1080/15368378.2020.1809448.
Spartalis E, Karagiannis SP, Plakopitis N, Theodori MA, Chrysikos D, Paschou SA, Boutzios G, Schizas D, Spartalis M, Troupis T, Nikiteas N. Single-session high-intensity focused ultrasound (HIFU) ablation for benign thyroid nodules: a systematic review. Expert Rev Med Devices. 2020 Aug 18:1-13. doi: 10.1080/17434440.2020.1806053.
Lang BHH, Woo YC, Chiu KW. Identifying predictive factors for efficacy in high intensity focused ultrasound (HIFU) ablation of benign thyroid nodules - a retrospective analysis. Int J Hyperthermia. 2020;37(1):324-331. doi: 10.1080/02656736.2020.1747646.
Chung SR, Baek JH, Suh CH, Choi YJ, Lee JH. Efficacy and safety of high-intensity focused ultrasound (HIFU) for treating benign thyroid nodules: a systematic review and meta-analysis. Acta Radiol. 2020 Mar 22:284185120909339. doi: 10.1177/0284185120909339.
Tumino D, Grani G, Di Stefano M, Di Mauro M, Scutari M, Rago T, Fugazzola L, Castagna MG, Maino F. Nodular Thyroid Disease in the Era of Precision Medicine. Front Endocrinol (Lausanne). 2020 Jan 23;10:907. doi: 10.3389/fendo.2019.00907. eCollection 2019.
Trimboli P, Pelloni F, Bini F, Marinozzi F, Giovanella L. High-intensity focused ultrasound (HIFU) for benign thyroid nodules: 2-year follow-up results. Endocrine. 2019 Mar 28. doi: 10.1007/s12020-019-01909-w.
Lang BHH, Woo YC, Chiu KW. Effect of perithyroidal lignocaine infusion (PLI) to pain experienced during high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules. Eur Radiol. 2019 Mar 27. doi: 10.1007/s00330-019-06160-5.
Prakash PS, Oh HB, Tan WB, Parameswaran R, Ngiam KY. The Efficacy and Safety of High-Intensity Focused Ultrasound(HIFU) Therapy for Benign Thyroid Nodules-A Single Center Experience from Singapore. World J Surg. 2019 Mar 12. doi: 10.1007/s00268-019-04976-2.
Lang BHH, Woo YC, Chiu KW. Two sequential applications of high-intensity focused ultrasound(HIFU) ablation for large benign thyroid nodules. Eur Radiol. 2019 Feb 18. doi: 10.1007/s00330-019-06021-1.
Kotewall N, Lang BHH. High-intensity focused ultrasound ablation as a treatment for benign thyroid diseases: the present and future. Ultrasonography. 2018 Nov 9. doi: 10.14366/usg.18040.
Lang BHH, Wong CKH, Ma EPM, Woo YC, Chiu KW. A propensity-matched analysis of clinical outcomes between open thyroid lobectomy and high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules. Surgery. 2018 Nov 1. pii: S0039-6060(18)30617-2. doi: 10.1016/j.surg.2018.05.080.
Lang BHH, Woo YC, Chiu KW. Changes in serum thyroglobulin and antithyroglobulin shortly following high-intensity focused ablation of benign thyroid nodules in patients with positive antithyroglobulin status. Int J Hyperthermia. 2018 Oct 10:1-7. doi: 10.1080/02656736.2018.1516302.
Lang BHH, Woo YC, Chiu KW. Two-year efficacy of single-session high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules.
Eur Radiol. 2018 Jun 19. doi: 10.1007/s00330-018-5579-8.
Giovanella L, Piccardo A, Pezzoli C, Bini F, Ricci R, Ruberto T, Trimboli P. Comparison of high intensity focused ultrasound and radioiodine for treating toxic thyroid nodules. Clin Endocrinol (Oxf). 2018 May 9. doi: 10.1111/cen.13738.
Lang BHH, Woo YC, Chiu KW. Sequential high intensity focused ultrasound (HIFU) ablation in the treatment of benign multinodular goitre: an observational retrospective study. Eur Radiol. 2018 Aug;28(8):3237-3244. doi: 10.1007/s00330-018-5333-2. Epub 2018 Mar 19.
Trimboli P, Bini F, Marinozzi F, Baek JH, Giovanella L. High-intensity focused ultrasound (HIFU) therapy for benign thyroid nodules without anesthesia or sedation. Endocrine. 2018 Feb 16. doi: 10.1007/s12020-018-1560-1.
Lang BHH, Woo YC, Chiu KW. Evaluation of pain during high-intensity focused ultrasound ablation of benign thyroid nodules. Eur Radiol. 2018 Jun;28(6):2620-2627. doi: 10.1007/s00330-017-5200-6. Epub 2018 Jan 12.
Lang BHH, Woo YC, Chiu KW. Significance of hyperechoic marks observed during high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules. Eur Radiol. 2018 Jun;28(6):2675-2681. doi: 10.1007/s00330-017-5207-z. Epub 2018 Jan 8.
Click here for additional references from PubMed.