Department of Nuclear Medicine and Thyroid Centre, Oncology Institute of Southern Switzerland, Bellinzona, 6500, Switzerland.
Department of Mechanical and Aerospace Engineering, "Sapienza" University of Rome, Rome, 00184, Italy.
Endocrine. 2018 Aug;61(2):210-215. doi: 10.1007/s12020-018-1560-1. Epub 2018 Feb 16.
Thermal ablation of thyroid nodules has gained momentum due to the possibility to avoid surgery. High-intensity focused ultrasound (HIFU) allows thermal treatment by energy ultrasound beam inside the targeted zone. Aim of our study was to evaluate the effects of HIFU treatment using Beamotion mode without anesthesia.
Since 2016, patients with normal thyroid function, benign thyroid nodules with diameter no larger than 4 cm, and presenting local discomfort and/or compressive symptoms were treated by HIFU. We performed Beamotion HIFU and did not use anesthesia. Nodule size and thyroid function were evaluated before HIFU and 6 and 12 months later. Complications to therapy and tolerability of patients were also recorded. According to local ethical committee, for this retrospective study formal consent was not required.
The final series included 26 nodules from 26 patients with estimated volume of 2.81 ± 2.04 mL, treated by a power of 33.3 ± 10.3 W/site and energy of 2.1 ± 1.1 kJ. Nodules volume was significantly (p < 0.0001) reduced at 6 months of follow-up (1.83 ± 1.63 mL), and further at 1 year (1.57 ± 1.47 mL). Mean percentage of reduction over time of nodules was 48%. A 73% of patients described good comfort during treatment, 100% experienced good comfort just after therapy, and tolerability was high. No complications were recorded. At one 1 year of follow-up, 85% of subjects reported a reduction of local symptoms.
HIFU therapy is effective in reducing size of thyroid nodules with major diameter below 4 cm and can be performed without anesthesia.
由于避免手术的可能性，甲状腺结节的热消融术得到了发展。高强度聚焦超声（HIFU）允许在目标区域内通过能量超声束进行热治疗。我们的研究目的是评估使用 Beamotion 模式进行 HIFU 治疗而无需麻醉的效果。
自 2016 年以来，具有正常甲状腺功能、最大直径不超过 4cm 的良性甲状腺结节、并出现局部不适和/或压迫症状的患者接受了 HIFU 治疗。我们进行了 Beamotion HIFU 治疗，并未使用麻醉。在 HIFU 治疗前、治疗后 6 个月和 12 个月评估结节大小和甲状腺功能。还记录了治疗并发症和患者的耐受性。根据当地伦理委员会的规定，对于这项回顾性研究，不需要正式同意。
最终系列包括 26 名患者的 26 个结节，估计体积为 2.81±2.04mL，每个部位的功率为 33.3±10.3W，能量为 2.1±1.1kJ。在 6 个月的随访时（1.83±1.63mL），结节体积明显（p<0.0001）减少，1 年后（1.57±1.47mL）进一步减少。随着时间的推移，结节的平均减少百分比为 48%。73%的患者在治疗过程中描述舒适度良好，100%的患者在治疗后立即感觉舒适，且耐受性良好。未记录到并发症。在 1 年的随访中，85%的患者报告局部症状减轻。
HIFU 治疗可有效缩小最大直径小于 4cm 的甲状腺结节大小，且无需麻醉即可进行。
