High-Intensity Focused Ultrasound to Treat Primary Hyperparathyroidism: A Feasibility Study in Four Patients

Кovatcheva, Roussanka; Vlahov, Jordan; Shinkov, Alexander; Borissova, A M; Hwang, Joo Ha; Arnaud, Françoise; Hegedűs, László

doi:10.2214/ajr.09.3932

Cited by 51 publications

(30 citation statements)

References 23 publications

(31 reference statements)

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“…Good results have also been obtained in patients with primary or secondary hyperparathyroidism [94]. Two preliminary studies were conducted on ewe thyroids, confirming the safety and reproducibility of this technique for localized thyroid disease [95,96].…”

Section: Clinical Resultsmentioning

confidence: 68%

Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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Benign thyroid nodules are a common disease in the general population. Most often, they are completely asymptomatic and discovered occasionally during routine ultrasound examinations, and do not require any treatment. When thyroid nodules become symptomatic, surgical excision is still considered standard treatment. In the last few years, several experiences in the treatment of benign thyroid nodules through image-guided percutaneous thermal ablation have been reported with encouraging results, so that currently, these treatments are often proposed as first-choice options for patients with symptomatic benign thyroid nodules. In this paper, we discuss the present literature on the topic, focusing on different techniques available for image-guided percutaneous ablation, particularly radiofrequency (RFA), laser (LA), microwave (MWA), and high-intensity-focus ultrasound (HIFU). Little evidence about the efficacy of MWA and HIFU is now available. According to the literature, good results have been obtained with RFA and LA. Regarding RFA, volume reduction after ablative treatment has been found to range from 47 to 84 % at 3-6 months, and from 62 to 93 % at 1 year; LA also seems to be effective in achieving shrinkage of thyroid nodules, with volume reduction from 37 to 81 % at 3-6 months, and from 13 to 82 % at 1-year follow-up. Moreover, applications of advanced image-guidance modality, such as contrast-enhanced ultrasound and virtual navigation with fusion imaging, are discussed.Keywords Laser Á Radiofrequency Á Microwave Á Highintensity focused ultrasound Á Thyroid nodule SOMMARIO I noduli benigni della tiroide sono una evenienza comune nella popolazione generale. Più spesso vengono scoperti occasionalmente durante un esame ecografico fatto per altri motivi, sono asintomatici e non richiedono alcun trattamento. Qualora i noduli diventino sintomatici, l'escissione chirurgica è ancora considerato il trattamento standard. Tuttavia, negli ultimi anni, è cresciuta l'esperienza circa il trattamento di tali noduli tramite ablazione percutanea sotto guida ecografica tanto che, attualmente, questo viene spesso proposto come trattamento di scelta. Lo scopo del nostro lavoro è fare una revisione della letteratura riguardante l'argomento, con un particolare focus sulle differenti tecniche attualmente a disposizione, in particolare radiofrequenza (RFA), laser (LA), microonde (MWA) e high-intensity-focus ultrasound (HIFU). Al momento ci sono ancora poche evidenze sull'efficacia di MWA e HIFU. Secondo quanto riportato in letteratura, buoni risultati sono stati ottenuti con RFA e LA. Riguardo la radiofrequenza, la riduzione volumetrica dopo la procedura ablativa va da 47 a 84 % a 3-6 mesi e da 62 a 93 % a 1 anno; anche il laser sembra essere efficace nel causare la riduzione del nodulo, con percentuali che vanno da 37 a 81 % a 3-6-mesi a da 13 a 82 % a 1 anno di follow-up Abbiamo poi discusso brevemente le

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Section: Clinical Resultsmentioning

confidence: 68%

Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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“…9,[24][25][26][27] The device is designed to provide HIFU treatment for superficial structures, notably thyroid nodules, parathyroid glands, or breast fibroadenomas. 28 As described previously, the VTU incorporates both the imaging transducer (7.5 MHz, 128 elements, linear array) and the HIFU transducer (3 MHz, single element, 60 mm/ diameter) for delivering energy to the target.…”

Section: Hifu Equipmentmentioning

confidence: 99%

“…23 A favorable outcome has been observed also in patients with primary or secondary hyperparathyroidism. [24][25][26] In this article, we describe the procedure of HIFU for thyroid nodules ablation, as well as the available clinical results, efficacy, complications, and perspectives, based on the current evidence and our own experience.…”

Section: Introductionmentioning

confidence: 99%

High-intensity focused ultrasound for thyroid nodule ablation: the evidence to date

Кovatcheva¹,

Zaletel²

2017

RMI

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Thyroid nodules are common in occurrence and most of them are benign in nature. Some of these nodules are to be treated as they continue to grow or cause undesirable symptoms. Recently, several minimally invasive thermal ablation techniques have been introduced to overcome the complications of traditional methods such as surgery. High-intensity focused ultrasound (HIFU) is the latest advance in treatment modalities, which is a noninvasive procedure that permits localized target destruction without affecting the surrounding tissues. HIFU is currently used in the treatment of various solid malignant and benign tumors. The purpose of this review is to provide an introduction to the literature, principles, and advances of HIFU therapy of benign thyroid nodules, as well as to provide a discussion on its efficacy, complications, and future.

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“…The only reported experience is limited to studies from two teams using this procedure to treat thyroid nodules [ 8 ] or HPT [ 9 ].…”

mentioning

confidence: 99%

“…An additional study was performed on ewes to evaluate the reproducibility of a HIFU prototype designed specifi cally for human use [ 10 ]. First human feasibility studies are very recent since HIFU ablation of thyroid nodules was published only in 2011 for 25 patients included from 2003 to 2006 [ 11 ], and HIFU ablation of parathyroid adenoma was only reported in 2010 (4 patients, date of inclusion unknown) [ 9 ].…”

mentioning

confidence: 99%

High-Intensity Focused Ultrasound Ablation (HI-FU) in Endocrine Neck Diseases

Ménégaux

Leenhardt

Esnault

2016

Minimally Invasive Therapies for Endocrine Neck Diseases

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Thyroid nodules and primary hyperparathyroidism (HPT) are highly prevalent endocrine disorders. Fortunately, almost 100 % of parathyroid tumors and more than 95 % of thyroid nodules are benign. Some patients with thyroid nodules will need surgery for diagnostic purpose despite the improved accuracy of noninvasive procedures, and others for HPT. Complications of thyroid and parathyroid surgery such as recurrent laryngeal nerve (RLN) injury, superior laryngeal nerve injury, hypocalcaemia after total thyroid resection, and hemorrhage are not so rare and permanent complications can occur, respectively, at 2.1 % and 2.7 % RLN palsy, and hypoparathyroidism rates have been reported in a prospective multicenter study including departments specialized in endocrine surgery [ 1 ].Moreover, some patients in poor medical condition are contraindicated for a surgical neck exploration for a local recurrence of thyroid carcinoma or for a parathyroid adenoma because of a high risk of surgery and/or general anesthesia. This is why minimally invasive or noninvasive methods have been developed to ablate thyroid nodules and parathyroid glands without surgery: percutaneous ethanol injection therapy, percutaneous thermal procedures (radiofrequency ablation, laser coagulation), microwave ablation, and high-intensity focused ultrasound (HIFU) [ 2 ].

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High-Intensity Focused Ultrasound to Treat Primary Hyperparathyroidism: A Feasibility Study in Four Patients

Cited by 51 publications

References 23 publications

Image-guided thermal ablation of benign thyroid nodules

Image-guided thermal ablation of benign thyroid nodules

High-intensity focused ultrasound for thyroid nodule ablation: the evidence to date

High-Intensity Focused Ultrasound Ablation (HI-FU) in Endocrine Neck Diseases

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