From: High intensity focused ultrasound (HIFU) ablation of benign thyroid nodules – a systematic review
First author (year) | Inclusion criteria | Exclusion criteria |
---|---|---|
Esnault (2011) [15] | - At least two thyroid nodules, with at least one for surgery - Nodule targeted for HIFU located at least 3 mm from the trachea, esophagus, recurrent nerve, carotid artery, skin - Selected nodule for HIFU treatment was different from the one indicated for surgery | - Suspicion of malignancy nodule, neck irradiation, previous surgery, previous radioactive iodine treatment - Any cystic components ≥ 20% or any large calcifications - Patient unable to maintain a stable position with hyperextended neck |
Korkusuz (2014) [19] | At least one benign thyroid nodule with associated thyrotoxicosis, neck pain, throat hoarseness, swallowing disorders, discomfort and/or cost concern. | - Malignant nodule - Close to heat-sensitive structures like the recurrent laryngeal nerve, trachea, esophagus and carotid artery |
Korkusuz (2015) [21] | - Over 18 years old - At least one benign thyroid nodule with associated issues (neck pain, hoarseness, swallowing disorders, discomfort, cosmetic concerns and/or thyrotoxicosis - Refused surgery/RIT | - Malignant nodules - Target nodules close to sensible structures such as trachea, carotid arteries - Patients who showed any contraindication to HIFU (recurrent nerve anomalies, target volumes not) |
Korkusuz (2015) [22] | - Patient with symptomatic nodule - Cosmetic concerns - Refused surgery or contraindicated | - Patients with asymptomatic nodules - Nodule volume ≥ 10 mL - Histological evidence for malignancy |
Kovatcheva (2015) [23] | - Over 18 years old - Presence of one or more thyroid nodules without signs of malignancy - A nodule measured on US ≥10 mm in three orthogonal dimensions - ≤30% of the targeted nodule is cystic - HIFU accessibility of the targeted nodule - Normal thyrotropin concentrations - Absence of vocal cord immobility at laryngoscopy | - Head and/or neck disease which prevents hyperextension of neck - Past medical history of thyroid cancer or other malignant tumors in the neck region - History of neck irradiation - Intra-nodular macro-calcifications which precludes treatment with HIFU - Nodules next to posterior margin of the thyroid lobe with anteroposterior diameter less than 15 mm - Pregnancy/lactation - Any contraindications related to intravenous moderate sedation |
Lang (2017) [24] | - Benign cytology and low to very low suspicion sonographic pattern - Nodule believed to be causing pressure symptoms - All 3 dimensions between 10 and 40 mm - Nodule ≥ 70% solidity - Nodule within 5–30 mm from skin - Normal thyroid function and calcitonin levels | - Age ≤ 18 years old - Pregnant or lactating women - Indeterminate or malignant nodules - Intra-nodular macro-calcifications - History of head and neck irradiation - History of non-medullary thyroid carcinoma - Pre-existing vocal cord palsy |