Korkusuz Huedayi, Fehre Niklas, Sennert Michael, Happel Christian, Grünwald Frank
Department of Nuclear Medicine, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
J Ther Ultrasound. 2014 Sep 30;2:18. doi: 10.1186/2050-5736-2-18. eCollection 2014.
High-intensity focused ultrasound (HIFU) allows to inflict intracorporal thermal lesions without penetrating the skin or damaging the surrounding tissue. This analysis intends to assess the magnitude of HIFU-induced ablations within benign thyroid nodules using scintigraphic imaging with (99m)Tc.
Ten cold, hot, or indifferent nodules were treated using multiple pulses of HIFU to induce temperatures of around 85°C within the ablation zone. Pre- and posttreatment, uptake values of (99m)Tc-pertechnetate or (99m)Tc-MIBI were recorded. The pre-post reduction of nodular uptake was evaluated to assess ablation magnitude.
Relative nodular uptake in relation to total thyroidal uptake decreased after one session of HIFU in all cases. Median (99m)Tc-MIBI uptake reduction was 35.5% (ranging from 11% to 57%; p < 0.1), while (99m)Tc-pertechnetate scintigraphy showed a median uptake reduction of 27% (range 10% to 44%; p < 0.1). No major complications were observed.
HIFU appears to be safe and is an easy to perform means of thermal ablation. This study shows that HIFU treatment in thyroidal nodules can be evaluated by scintigraphic means shortly after the intervention. Due to small sample size, the exact magnitude of HIFU ablation efficiency in thyroidal nodules remains a value to be assessed in a larger study.
高强度聚焦超声（HIFU）能够在不穿透皮肤或损伤周围组织的情况下造成体内热损伤。本分析旨在使用锝（99m）Tc闪烁成像评估高强度聚焦超声诱导的良性甲状腺结节内消融的程度。
使用高强度聚焦超声的多个脉冲治疗10个冷、热或等回声结节，以在消融区内诱导约85°C的温度。在治疗前和治疗后，记录高锝酸盐（99m）Tc或甲氧基异丁基异腈（99m）Tc-MIBI的摄取值。评估结节摄取的治疗前后减少情况以评估消融程度。
在所有病例中，经过一轮高强度聚焦超声治疗后，相对于甲状腺总摄取的相对结节摄取量均下降。（99m）Tc-MIBI摄取减少的中位数为35.5%（范围为11%至57%；p < 0.1），而高锝酸盐（99m）Tc闪烁显像显示摄取减少的中位数为27%（范围为10%至44%；p < 0.1）。未观察到重大并发症。
高强度聚焦超声似乎是安全的，并且是一种易于实施的热消融手段。本研究表明，甲状腺结节的高强度聚焦超声治疗可在干预后不久通过闪烁显像手段进行评估。由于样本量小，高强度聚焦超声在甲状腺结节中的消融效率的确切程度仍有待在更大规模的研究中评估。
