Introduction: To date, there have only been 2 systematic reviews, and 1 systematic review and
meta-analysis on high-intensity focused ultrasound (HIFU) for benign thyroid nodules. The present
systematic review and meta-analysis seeks to evaluate the efficacy and safety of HIFU in the
treatment of benign thyroid nodules.
Methods: PubMed, Embase and Cochrane databases were searched for relevant studies from 1990 to 2021.
Nine studies were included in the systematic review and 6 in the meta-analysis. Pooled volume reduction
rates (VRRs) at 3, 6 and 24 months after HIFU were assessed.
Results: This systematic review and meta-analysis showed that pooled VRRs at 3, 6, and 24 months after
HIFU were 42.14 (95% confidence interval [CI] 28.66–55.62, I2=91%), 53.51 (95% CI 36.78–70.25,
I2=97%) and 46.89 (95% CI 18.87–74.92, I2=99%), respectively. There was significant heterogeneity in
the pooled VRRs at 3, 6 and 24 months after HIFU. No studies recorded complete disappearance of the
nodules. Common side effects included pain, skin changes and oedema. There were no major
complications except for transient vocal cord paralysis and voice hoarseness (0.014%) and transient
Horner syndrome (0.5%).
Conclusion: HIFU may be an effective and safe alternative treatment modality for benign thyroid
nodules. Larger clinical trials with longer follow-up are needed to evaluate the effectiveness of HIFU
in treating benign thyroid nodules.
Keywords: Benign thyroid nodule, HIFU, high-intensity focused ultrasound, meta-analysis, minimally
invasive technique, MITT, systematic review