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Erschienen in:
08.01.2018 | Interventional
Significance of hyperechoic marks observed during high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules
Erschienen in: European Radiology | Ausgabe 6/2018
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Objective
To examine the association between the appearance of hyperechoic marks (HEMs) during high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules and nodule shrinkage at 6 months.
Methods
One hundred and thirty-six patients who underwent HIFU for benign thyroid nodule were analysed. An independent person carefully examined the B-mode ultrasonography screen for the appearance of HEMs after each pulse. The proportion of HEMs (%) was calculated by: [(Number of pulses that resulted in HEMs) / (Total number of pulses given per treatment) × 100] while the nodule shrinkage was measured by volume reduction ratio (VRR) = [Baseline volume–volume at 6 months]/[Baseline volume] * 100. Treatment success was defined as VRR ≥ 50 %.
Results
Patients with HEMs (n=91) had significantly greater 6-month VRR than those without HEMs (n=45) (65.76 % vs. 36.76 %, p<0.001). By regression analysis, after adjusting for age and energy per pulse, smaller nodule volume at baseline (OR 1.143, 95 % CI 1.038–1.256, p=0.006) and appearance of HEMs (OR 275.44, 95 % CI 26.63–2848.98, p<0.001) were independent predictors for treatment success.
Conclusions
The appearance of HEMs during treatment was an independent determinant of treatment success following single-session HIFU ablation of benign thyroid nodule.
Key Points
• HIFU is a safe and effective treatment for benign thyroid nodules.
• Lower BMI and greater applied power increase likelihood of hyperechoic marks.
• The appearance of hyperechoic marks during HIFU affects subsequent treatment outcome.