Role of second high-intensity focused ultrasound (HIFU) treatment for unsatisfactory benign thyroid nodules after first treatment
Background We aimed to assess the efficacy and safety of second high-intensity focused ultrasound (HIFU) ablation treatment in benign thyroid nodules that had failed to shrink by > 50% 6 months after the first treatment. Methods Twenty-eight patients who did not achieve 50% volume reduction at 6...
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| Veröffentlicht in: | European radiology 2019-03, Vol.29 (3), p.1469-1478 |
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| creator | Lang, Brian Hung-Hin Woo, Yu-Cho Chiu, Keith Wan-Hang |
| description | Background
We aimed to assess the efficacy and safety of second high-intensity focused ultrasound (HIFU) ablation treatment in benign thyroid nodules that had failed to shrink by > 50% 6 months after the first treatment.
Methods
Twenty-eight patients who did not achieve 50% volume reduction at 6 months after the first HIFU treatment underwent a second HIFU treatment. Nodule volume was measured on ultrasound at baseline, 3 months and 6 months. Extent of nodule shrinkage (by volume reduction ratio) (VRR) = [Baseline volume – volume at 6 months]/[Baseline volume] * 100. Treatment success was defined as VRR > 50%. Obstructive symptom score (by 0–10 visual analogue scale, VAS) was evaluated for 6 months after treatment.
Results
No complications occurred after the second treatment. The mean 6-month VRR was 21.78 ± 16.87% with a median (range) of 16.16 (1.63–54.07)%. At 6 months, only two (7.1%) patients achieved treatment success, while nine (32.1%) patients had VRR < 10%. However, relative to baseline (3.96 ± 1.04), the mean VAS significantly improved at 3 and 6 months (2.96 ± 1.43,
p |
| doi_str_mv | 10.1007/s00330-018-5671-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2085662117</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2085662117</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-eb1eaa7275d64b70c3c855e3636330297d11b3815c192c45193fe7cc6bbb4a9d3</originalsourceid><addsrcrecordid>eNp1kUFrFDEUx4Modq1-AC8S8FIP0ZdkZjJzlGJtoSCIPYdM5s1uymxS8zKHPfrNzbLVgmDeIYf3-_8T-DH2VsJHCWA-EYDWIED2ou2MFPCMbWSjlZDQN8_ZBgbdCzMMzRl7RXQPAINszEt2pgH6HjqzYb--pwV5mjmhT3Hiu7DdiRALRgrlwOfkV8KJr0vJjtJaiYvrm6u7D7xkdGWPsVQm8zWSK4Fm50vKBz5iDNvIy-6QU5h4TNO6IHE3F8x8DpnKU_41ezG7hfDN433O7q6-_Li8Frffvt5cfr4VXhtVBI4SnTPKtFPXjAa89n3bou7qaFCDmaQcdS9bLwflm1YOekbjfTeOY-OGSZ-zi1PvQ04_V6Ri94E8LouLmFayCvq265SUpqLv_0Hv05pj_d2Rarp6FFRKniifE1HG2T7ksHf5YCXYox978mOrH3v0Y4-Zd4_N67jH6W_ij5AKqBNAdRW3mJ-e_n_rb3VtnDo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2084666620</pqid></control><display><type>article</type><title>Role of second high-intensity focused ultrasound (HIFU) treatment for unsatisfactory benign thyroid nodules after first treatment</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Lang, Brian Hung-Hin ; Woo, Yu-Cho ; Chiu, Keith Wan-Hang</creator><creatorcontrib>Lang, Brian Hung-Hin ; Woo, Yu-Cho ; Chiu, Keith Wan-Hang</creatorcontrib><description>Background
We aimed to assess the efficacy and safety of second high-intensity focused ultrasound (HIFU) ablation treatment in benign thyroid nodules that had failed to shrink by > 50% 6 months after the first treatment.
Methods
Twenty-eight patients who did not achieve 50% volume reduction at 6 months after the first HIFU treatment underwent a second HIFU treatment. Nodule volume was measured on ultrasound at baseline, 3 months and 6 months. Extent of nodule shrinkage (by volume reduction ratio) (VRR) = [Baseline volume – volume at 6 months]/[Baseline volume] * 100. Treatment success was defined as VRR > 50%. Obstructive symptom score (by 0–10 visual analogue scale, VAS) was evaluated for 6 months after treatment.
Results
No complications occurred after the second treatment. The mean 6-month VRR was 21.78 ± 16.87% with a median (range) of 16.16 (1.63–54.07)%. At 6 months, only two (7.1%) patients achieved treatment success, while nine (32.1%) patients had VRR < 10%. However, relative to baseline (3.96 ± 1.04), the mean VAS significantly improved at 3 and 6 months (2.96 ± 1.43,
p
<0.001 and 2.58 ± 1.39,
p
<0.001, respectively). There was a significant correlation between VRR and improvement in VAS score at 6 months (
ρ
=0.438,
p
=0.025). Greater nodule volume before the second treatment (OR=1.169, 95% CI=1.004–1.361,
p
=0.045) was a significant factor for greater VRR after the second treatment.
Conclusions
Although subjective obstructive symptoms continued to improve after the second treatment, the actual extent of nodule shrinkage was small. Larger-volume nodules tended to shrink more significantly than smaller-volume nodules in the second treatment.
Key Points
•
Second treatment resulted in small shrinkage in unsatisfactory nodules after first treatment.
• Obstructive symptoms tended to continue to improve after second treatment.
• Larger-size nodules tended to respond better in the second treatment.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-018-5671-0</identifier><identifier>PMID: 30088067</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Benign ; Complications ; Diagnostic Radiology ; Female ; High-Intensity Focused Ultrasound Ablation - adverse effects ; Humans ; Imaging ; Internal Medicine ; Interventional Radiology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neuroradiology ; Nodules ; Patients ; Radiology ; Reduction ; Reoperation ; Shrinkage ; Thyroid ; Thyroid gland ; Thyroid Nodule - pathology ; Thyroid Nodule - surgery ; Treatment Outcome ; Ultrasonic imaging ; Ultrasound ; Visual Analog Scale</subject><ispartof>European radiology, 2019-03, Vol.29 (3), p.1469-1478</ispartof><rights>European Society of Radiology 2018</rights><rights>European Radiology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-eb1eaa7275d64b70c3c855e3636330297d11b3815c192c45193fe7cc6bbb4a9d3</citedby><cites>FETCH-LOGICAL-c372t-eb1eaa7275d64b70c3c855e3636330297d11b3815c192c45193fe7cc6bbb4a9d3</cites><orcidid>0000-0002-9362-0086</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-018-5671-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-018-5671-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30088067$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lang, Brian Hung-Hin</creatorcontrib><creatorcontrib>Woo, Yu-Cho</creatorcontrib><creatorcontrib>Chiu, Keith Wan-Hang</creatorcontrib><title>Role of second high-intensity focused ultrasound (HIFU) treatment for unsatisfactory benign thyroid nodules after first treatment</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Background
We aimed to assess the efficacy and safety of second high-intensity focused ultrasound (HIFU) ablation treatment in benign thyroid nodules that had failed to shrink by > 50% 6 months after the first treatment.
Methods
Twenty-eight patients who did not achieve 50% volume reduction at 6 months after the first HIFU treatment underwent a second HIFU treatment. Nodule volume was measured on ultrasound at baseline, 3 months and 6 months. Extent of nodule shrinkage (by volume reduction ratio) (VRR) = [Baseline volume – volume at 6 months]/[Baseline volume] * 100. Treatment success was defined as VRR > 50%. Obstructive symptom score (by 0–10 visual analogue scale, VAS) was evaluated for 6 months after treatment.
Results
No complications occurred after the second treatment. The mean 6-month VRR was 21.78 ± 16.87% with a median (range) of 16.16 (1.63–54.07)%. At 6 months, only two (7.1%) patients achieved treatment success, while nine (32.1%) patients had VRR < 10%. However, relative to baseline (3.96 ± 1.04), the mean VAS significantly improved at 3 and 6 months (2.96 ± 1.43,
p
<0.001 and 2.58 ± 1.39,
p
<0.001, respectively). There was a significant correlation between VRR and improvement in VAS score at 6 months (
ρ
=0.438,
p
=0.025). Greater nodule volume before the second treatment (OR=1.169, 95% CI=1.004–1.361,
p
=0.045) was a significant factor for greater VRR after the second treatment.
Conclusions
Although subjective obstructive symptoms continued to improve after the second treatment, the actual extent of nodule shrinkage was small. Larger-volume nodules tended to shrink more significantly than smaller-volume nodules in the second treatment.
Key Points
•
Second treatment resulted in small shrinkage in unsatisfactory nodules after first treatment.
• Obstructive symptoms tended to continue to improve after second treatment.
• Larger-size nodules tended to respond better in the second treatment.</description><subject>Adult</subject><subject>Benign</subject><subject>Complications</subject><subject>Diagnostic Radiology</subject><subject>Female</subject><subject>High-Intensity Focused Ultrasound Ablation - adverse effects</subject><subject>Humans</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neuroradiology</subject><subject>Nodules</subject><subject>Patients</subject><subject>Radiology</subject><subject>Reduction</subject><subject>Reoperation</subject><subject>Shrinkage</subject><subject>Thyroid</subject><subject>Thyroid gland</subject><subject>Thyroid Nodule - pathology</subject><subject>Thyroid Nodule - surgery</subject><subject>Treatment Outcome</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><subject>Visual Analog Scale</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kUFrFDEUx4Modq1-AC8S8FIP0ZdkZjJzlGJtoSCIPYdM5s1uymxS8zKHPfrNzbLVgmDeIYf3-_8T-DH2VsJHCWA-EYDWIED2ou2MFPCMbWSjlZDQN8_ZBgbdCzMMzRl7RXQPAINszEt2pgH6HjqzYb--pwV5mjmhT3Hiu7DdiRALRgrlwOfkV8KJr0vJjtJaiYvrm6u7D7xkdGWPsVQm8zWSK4Fm50vKBz5iDNvIy-6QU5h4TNO6IHE3F8x8DpnKU_41ezG7hfDN433O7q6-_Li8Frffvt5cfr4VXhtVBI4SnTPKtFPXjAa89n3bou7qaFCDmaQcdS9bLwflm1YOekbjfTeOY-OGSZ-zi1PvQ04_V6Ri94E8LouLmFayCvq265SUpqLv_0Hv05pj_d2Rarp6FFRKniifE1HG2T7ksHf5YCXYox978mOrH3v0Y4-Zd4_N67jH6W_ij5AKqBNAdRW3mJ-e_n_rb3VtnDo</recordid><startdate>20190301</startdate><enddate>20190301</enddate><creator>Lang, Brian Hung-Hin</creator><creator>Woo, Yu-Cho</creator><creator>Chiu, Keith Wan-Hang</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9362-0086</orcidid></search><sort><creationdate>20190301</creationdate><title>Role of second high-intensity focused ultrasound (HIFU) treatment for unsatisfactory benign thyroid nodules after first treatment</title><author>Lang, Brian Hung-Hin ; Woo, Yu-Cho ; Chiu, Keith Wan-Hang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-eb1eaa7275d64b70c3c855e3636330297d11b3815c192c45193fe7cc6bbb4a9d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Benign</topic><topic>Complications</topic><topic>Diagnostic Radiology</topic><topic>Female</topic><topic>High-Intensity Focused Ultrasound Ablation - adverse effects</topic><topic>Humans</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neuroradiology</topic><topic>Nodules</topic><topic>Patients</topic><topic>Radiology</topic><topic>Reduction</topic><topic>Reoperation</topic><topic>Shrinkage</topic><topic>Thyroid</topic><topic>Thyroid gland</topic><topic>Thyroid Nodule - pathology</topic><topic>Thyroid Nodule - surgery</topic><topic>Treatment Outcome</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><topic>Visual Analog Scale</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lang, Brian Hung-Hin</creatorcontrib><creatorcontrib>Woo, Yu-Cho</creatorcontrib><creatorcontrib>Chiu, Keith Wan-Hang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lang, Brian Hung-Hin</au><au>Woo, Yu-Cho</au><au>Chiu, Keith Wan-Hang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of second high-intensity focused ultrasound (HIFU) treatment for unsatisfactory benign thyroid nodules after first treatment</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2019-03-01</date><risdate>2019</risdate><volume>29</volume><issue>3</issue><spage>1469</spage><epage>1478</epage><pages>1469-1478</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Background
We aimed to assess the efficacy and safety of second high-intensity focused ultrasound (HIFU) ablation treatment in benign thyroid nodules that had failed to shrink by > 50% 6 months after the first treatment.
Methods
Twenty-eight patients who did not achieve 50% volume reduction at 6 months after the first HIFU treatment underwent a second HIFU treatment. Nodule volume was measured on ultrasound at baseline, 3 months and 6 months. Extent of nodule shrinkage (by volume reduction ratio) (VRR) = [Baseline volume – volume at 6 months]/[Baseline volume] * 100. Treatment success was defined as VRR > 50%. Obstructive symptom score (by 0–10 visual analogue scale, VAS) was evaluated for 6 months after treatment.
Results
No complications occurred after the second treatment. The mean 6-month VRR was 21.78 ± 16.87% with a median (range) of 16.16 (1.63–54.07)%. At 6 months, only two (7.1%) patients achieved treatment success, while nine (32.1%) patients had VRR < 10%. However, relative to baseline (3.96 ± 1.04), the mean VAS significantly improved at 3 and 6 months (2.96 ± 1.43,
p
<0.001 and 2.58 ± 1.39,
p
<0.001, respectively). There was a significant correlation between VRR and improvement in VAS score at 6 months (
ρ
=0.438,
p
=0.025). Greater nodule volume before the second treatment (OR=1.169, 95% CI=1.004–1.361,
p
=0.045) was a significant factor for greater VRR after the second treatment.
Conclusions
Although subjective obstructive symptoms continued to improve after the second treatment, the actual extent of nodule shrinkage was small. Larger-volume nodules tended to shrink more significantly than smaller-volume nodules in the second treatment.
Key Points
•
Second treatment resulted in small shrinkage in unsatisfactory nodules after first treatment.
• Obstructive symptoms tended to continue to improve after second treatment.
• Larger-size nodules tended to respond better in the second treatment.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>30088067</pmid><doi>10.1007/s00330-018-5671-0</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-9362-0086</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0938-7994 |
| ispartof | European radiology, 2019-03, Vol.29 (3), p.1469-1478 |
| issn | 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2085662117 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Adult Benign Complications Diagnostic Radiology Female High-Intensity Focused Ultrasound Ablation - adverse effects Humans Imaging Internal Medicine Interventional Radiology Male Medicine Medicine & Public Health Middle Aged Neuroradiology Nodules Patients Radiology Reduction Reoperation Shrinkage Thyroid Thyroid gland Thyroid Nodule - pathology Thyroid Nodule - surgery Treatment Outcome Ultrasonic imaging Ultrasound Visual Analog Scale |
| title | Role of second high-intensity focused ultrasound (HIFU) treatment for unsatisfactory benign thyroid nodules after first treatment |
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