Thyroid Nodules

Background

Outside Approval SquareThyroid nodules are lumps that form in the thyroid gland. In many cases they are benign, but they can be the first sign of thyroid cancer.

According to the National Cancer Institute, thyroid cancer was expected to account for more than 60,000 new cases and over 1,800 deaths each year. It is more common in women than in men. In many cases, thyroid cancer can be cured. 

Current Treatment

Treatment options for thyroid nodules include careful monitoring, surgery, and radioactive iodine. Radiation, chemo-, hormone, and targeted therapy are additional options if nodules prove to be cancerous.

Clinical Trials Square

Focused Ultrasound Therapy

Focused ultrasound allows the physician to direct a focused beam of acoustic energy to destroy the tumor without harming adjacent tissue. Focused ultrasound is completely non-invasive, and it is performed while the patient is awake. A follow-up imaging and blood test can determine whether the entire lesion has been removed; if necessary, focused ultrasound can be repeated. Focused ultrasound may offer the following additional benefits in treating thyroid nodules:

  • It is non-invasive and therefore may be associated with fewer complications such as infection or scarring of the neck.
  • It involves a shorter recovery time; thus patients can return to work and normal activities more quickly.
  • It does not use ionizing radiation.

Initial reports on US-guided focused ultrasound for benign solid thyroid nodules have shown significant size and volume reductions at 6 months. Nodules with increased blood flow showed less volume reduction than the less-vascularized nodules displayed. The conclusion was that early data shows US-guided focused ultrasound to be safe and effective for benign, solid thyroid nodules.

Clinical Trials

At present, there is one clinical trial evaluating focused ultrasound for the treatment of thyroid nodules, being carried out at the Sofia Endocrinology University Hospital in Bulgaria. Sofia – Endocrinology University Hospital "Ivan Penchev Academia" (Bulgaria)

Contact information:
University Hospital of Endocrinology »Acad. Ivan Penchev »
Department of Thyroid and Mineral Bone Diseases 2,
Zdrave Street - 1431 Sofia – Bulgaria
Secretariat: + 359 (0) 2 895 62 21
Contact: Pr. Roussanka Kovatcheva via email at

Regulatory & Reimbursement

The Echopulse system manufactured by Theraclion is appoved in Europe for treating thyroid nodules. Some European insurance companies are paying for focused ultrasound treatment of thyroid nodules.

Notable Papers

Lang BH, Wu ALH. High intensity focused ultrasound (HIFU) ablation of benign thyroid nodules - a systematic review. ed ultrasound (HIFU) ablation of benign thyroid nodules - a systematic review. J Ther Ultrasound. 2017 May 17;5:11. doi: 10.1186/s40349-017-0091-1. eCollection 2017. 

Lang BHH, Woo YC, Chiu KW. High-intensity focused ablation (HIFU) of single benign thyroid nodule rarely alters underlying thyroid function. Int J Hyperthermia. 2017 Apr 24:1-7. doi: 10.1080/02656736.2017.1318456. 

Lang BHH, Wong CKH, Ma EPM. Single-session high intensity focussed ablation (HIFU) versus open cervical hemithyroidectomy for benign thyroid nodule: analysis on early efficacy, safety and voice quality. Int J Hyperthermia. 2017 Mar 24:1-7. doi: 10.1080/02656736.2017.1305127.

Lang BH, Woo YC, Chiu KW. Single-Session High-Intensity Focused Ultrasound Treatment in Large-Sized Benign Thyroid Nodules. Thyroid. 2017 Mar 22. doi: 10.1089/thy.2016.0664.

Mainini AP, Monaco C, Pescatori LC, De Angelis C, Sardanelli F, Sconfienza LM, Mauri G. Image-guided thermal ablation of benign thyroid nodules. J Ultrasound. 2016 Oct 21;20(1):11-22. doi: 10.1007/s40477-016-0221-6. eCollection 2016 Oct 21.

Korkusuz H, Sennert M, Fehre N, Happel C, Grünwald F. Localized Thyroid Tissue Ablation by High Intensity Focused Ultrasound: Volume Reduction, Effects on Thyroid Function and Immune Response. Rofo. 2015 Nov;187(11):1011-5. doi: 10.1055/s-0035-1553348.

Kovatcheva RD, Vlahov JD, Stoinov JI, Zaletel K. Benign Solid Thyroid Nodules: US-guided High-Intensity Focused Ultrasound Ablation-Initial Clinical Outcomes. Radiology. 2015 Aug;276(2):597-605. doi: 10.1148/radiol.15141492.

Korkusuz H, Fehre N, Sennert M, Happel C, Grünwald F. Volume reduction of benign thyroid nodules 3 months after a single treatment with high-intensity focused ultrasound (HIFU). J Ther Ultrasound. 2015 Mar 4;3:4. doi: 10.1186/s40349-015-0024-9.

Click here for additional references from PubMed.

     

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