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. 2019 Apr;38(2):135-142.
doi: 10.14366/usg.18040. Epub 2018 Nov 9.

High-intensity focused ultrasound ablation as a treatment for benign thyroid diseases: the present and future

Nicholas Kotewall  1 , Brian H H Lang  1
Affiliations

High-intensity focused ultrasound ablation as a treatment for benign thyroid diseases: the present and future

Nicholas Kotewall et al. Ultrasonography. 2019 Apr.

Abstract

High-intensity focused ultrasound (HIFU) is a promising ablation technique for benign thyroid nodules. Current evidence has found good short- to medium-term outcomes, similar to those of better-established ablation techniques such as radiofrequency and laser ablation. The fact that it does not require insertion of a needle into the target makes HIFU a truly non-invasive treatment. Although it is not without risks, its low risk profile makes it an attractive alternative to surgery. There is much room for future development, starting from expanding the current indications to enhancing energy delivery. Relapsed Graves disease and papillary microcarcinoma are diseases that can benefit from HIFU treatment. Its role in the mediation of immune responses and synergistic effects with immunotherapy are promising in the fight against metastatic cancers.

Keywords: Ablation techniques; Goiter, nodular; High-intensity focused ultrasound ablation; Hyperthermia, induced; Ultrasonography, interventional.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.. The ultrasound-guided high-intensity focused ultrasound device that is commercially available.
The device comprises a generator, treatment head, computer, and screen.
Fig. 2.
Fig. 2.. The treatment screen captured immediately after an 8-second treatment pulse.
The presence of hyperechoic marks at the focal point indicates effective ablation at the ablated area.
Fig. 3.
Fig. 3.. Moderate shrinkage of a benign, isoechoic nodule taken from a 43-year-old woman before ablation and at 3-month and 6-month intervals after ablation.
The treated nodule appears more hypoechoic over time.
See this image and copyright information in PMC

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