Effectiveness of High-intensity Focused Ultrasound (HIFU) Therapy of Solid and Complex Benign Thyroid Nodules – A Long-term Follow up Two-center Study

2022 ◽  
Author(s):  
Anne Fischer ◽  
Christian Vorländer ◽  
Hüdayi Korkusuz
Keyword(s):  
Thyroid Nodules ◽  
High Intensity Focused Ultrasound ◽  
Rank Test ◽  
Signed Rank ◽  
Wilcoxon Signed Rank Test ◽  
Signed Rank Test ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Abstract Purpose To investigate the effectiveness of high-intensity focused ultrasound (HIFU) of solid and complex benign thyroid nodules. Methods Fifty-eight patients with benign thyroid nodules were treated with HIFU at two centers from 2014–2019. The device, EchoPulse (Teraclion, Malakoff, France), heats the nodes to 80–90 °C. Nodal volumes were measured by ultrasound at regular intervals before and up to 12 months after therapy. In a retrospective long-term two-center study, average volume reductions in relation to baseline volume were statistically analyzed by the Wilcoxon signed-rank test. Side effects were documented. Results In solid nodules, the average percent volume reductions at the 3, 6, 9, and 12-months follow-up were 49.98%, 46.40%, 65.77%, and 63.88%, respectively. The results were significant with p<0.05 in the Wilcoxon signed-rank test at the 3, 6, and 9-months follow-up. In complex nodules, the average percent volume reduction was 35.2% at 3 months, 36.89% at 6 months, and 63.64% at twelve months follow up. The results were significant with p<0.05 in the Wilcoxon signed-rank test at the 3- and 6-months follow-up. The complication rate was 5.2%. All complications occurred in patients with solid nodules. Conclusion The study showed that HIFU is an effective treatment method for both solid and complex nodules. The complication rate is relatively high at 5.2%. No long-term complications occurred. The solid nodules responded better to HIFU than complex nodules.

scholarly journals Efficacy of Microneedling with Dermaroller Alternating with CROSS Peeling with 30% TCA in Management of Acne Induced Scarring

2019 ◽  
Vol 7 (4) ◽  
pp. 299-303
Author(s):  
Nadia Waqas ◽  
Muhammad Amer Saleem
Keyword(s):  
Rank Test ◽  
Acne Scar ◽  
Signed Rank ◽  
Wilcoxon Signed Rank Test ◽  
Signed Rank Test ◽  
Acne Scarring ◽  
Grade Ii ◽  
Skin Scar ◽  
Grade Iii

Objective: To study the effect of combination of two therapies i.e. Microneedling with Dermaroller alternating with Chemical Reconstruction Skin Scar (CROSS) peeling with 30% TCA in management of acne induced scarring.Patients and Methods: This experimental study was conducted in the department of Dermatology, Benazir Bhutto Hospital, Rawalpindi from March 2017 to December 2017. A total of 20 patients underwent microneedling with dermaroller at week=0 (baseline) and were subjected to CROSS peeling with 30% TCA on follow up after 2 weeks. Four sessions of each procedure were repeated at 2 weeks’ interval. Photographs were taken at baseline and 4 weeks after the end of therapy (week=18). The baseline and final photographs were assessed for acne scar grading as per Goodman and Baron qualitative scale by two dermatologists who were blinded to the whole study.Results: Out of 20 patients, 16 (80%) of the patients had grade IV acne scarring and 4 (20%) had grade III scarring at baseline (week=0). On assessment at 4 weeks after the end of therapy (week=18), 16 patients who were having grade IV acne 6 (37.5%) improved to grade III, and 10 (62.5%) improved to grade II. Out of 4 patients who were initially having grade III at week=0, all 4 (100%) improved to grade II by week=18. A Wilcoxon signed rank test showed highly significant improvement in the grading of scarring (z=-3.92, p=0.00008).Conclusion: The combination therapy of microneedling with dermaroller, alternating with CROSS peeling with 30% TCA was highly effective in treating all types of atrophic acne scarring.

scholarly journals Long-Term Results of Ultrasound-Guided Radiofrequency Ablation of Benign Thyroid Nodules: State of the Art and Future Perspectives—A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Hervé Monpeyssen ◽  
Ahmad Alamri ◽  
Adrien Ben Hamou
Keyword(s):  
Systematic Review ◽  
Radiofrequency Ablation ◽  
Thyroid Nodules ◽  
Long Term Results ◽  
Future Perspectives ◽  
Time Duration ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

BackgroundNearly 20 years after the first feasibility study, minimally invasive ultrasound (US)-guided therapeutic techniques are now considered as a safe and effective alternative to surgery for symptomatic benign thyroid nodules. Radiofrequency ablation (RFA) is one of the most widely used treatment in specialized thyroid centers but, due to the relatively recent introduction into clinical practice, there are limited long-term follow-up studies. Aim of our work was to review the outcomes of RFA on solid nonfunctioning and on autonomous thyroid nodules (AFTN) on a long-time period for assessing the results in term of efficacy, complications, and costs and to compare them to the current indications of RFA.MethodsA systematic review was performed using EMBASE and Medline library data between 2008 and 2021. Seventeen studies evaluated RFA for the treatment of benign solid (nonfunctioning or autonomous) thyroid nodules, with an at least 18 months of follow-up. Data extraction and quality assessment were performed by two endocrinologist according to PRISMA guidelines. Anthropometric data, safety and efficacy parameters were collected.ResultsThe majority of the studies was retrospective study and reported 933 nodules, mostly solid. Baseline volume ranged between 6.1 ± 9.6 and 36.3 ± 59.8 ml. Local analgesia was used and the time duration of the treatment was between 5 ± 2 and 22.1 ± 10.9 min. The volume reduction rate at 12 months ranged from 67% to 75% for the nodule treated with a single procedure and reached to 93.6 ± 9.7% for nodules treated with repeat ablations. The regrowth rate at 12 months ranged from 0% to 34%.ConclusionAll the studies under examination consistently validated the long-term clinical efficacy and the substantial safety of RFA for the treatment of benign thyroid nodules. Thermal ablation, however, is an operator-dependent technique and should be performed in centers with specific expertise. The selection of the patients should be rigorous because the nodule size and the structural and functional characteristics influence the appropriateness and the outcomes of the treatment. Future perspectives as the treatment of micro-papillary thyroid cancer or cervical recurrence need further investigations.

High-intensity focused ultrasound (HIFU) for benign thyroid nodules: 2-year follow-up results

Endocrine ◽  
2019 ◽  
Vol 65 (2) ◽  
pp. 312-317 ◽  
Author(s):  
Pierpaolo Trimboli ◽  
Federico Pelloni ◽  
Fabiano Bini ◽  
Franco Marinozzi ◽  
Luca Giovanella
Keyword(s):  
High Intensity ◽  
Focused Ultrasound ◽  
Thyroid Nodules ◽  
High Intensity Focused Ultrasound ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

scholarly journals Follow-up study on serum cholesterol profiles and potential sequelae in recovered COVID-19 patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guiling Li ◽  
Li Du ◽  
Xiaoling Cao ◽  
Xiuqi Wei ◽  
Yao Jiang ◽  
...  
Keyword(s):  
White Blood Cells ◽  
Recovery Process ◽  
Serum Levels ◽  
Rank Test ◽  
Follow Up Study ◽  
Laboratory Values ◽  
Signed Rank ◽  
Signed Rank Test

Abstract Background COVID-19 patients develop hypolipidemia. However, it is unknown whether lipid levels have improved and there are potential sequlae in recovered patients. Objective In this follow-up study, we evaluated serum lipidemia and various physiopathological laboratory values in recovered patients. Methods A 3–6 month follow-up study was performed between June 15 and September 3, 2020, to examine serum levels of laboratory values in 107 discharged COVID-19 patients (mild = 59; severe/critical = 48; diagnoses on admission). Sixty-one patients had a revisit chest CT scan. A Wilcoxon signed-rank test was used to analyze changes in laboratory values at admission and follow-up. Results LDL-c and HDL-c levels were significantly higher at follow-up than at admission in severe/critical cases (p <  0.05). LDL-c levels were significantly higher at follow-up than at admission in mild cases (p <  0.05). Coagulation and liver functional values were significantly improved at follow-up than at admission for patients (p <  0.05). Increases in HDL-c significantly correlated with increases in numbers of white blood cells (p <  0.001) during patients’ recovery. With exclusion of the subjects taking traditional Chinese medicines or cholesterol-lowering drugs, LDL-c and HDL-c levels were significantly increased at follow-up than at admission in severe/critical cases (p <  0.05). Residue lesions were observed in CT images in 72% (44 of 61) of follow-up patients. Conclusions Improvements of LDL-c, HDL-c, liver functions, and incomplete resolution of lung lesions were observed at 3–6 month follow-up for recovered patients, indicating that a long-term recovery process could be required and the development of sequelae such as pulmonary fibrosis could be expected in some patients.

scholarly journals Long-Term Outcome of Microwave Ablation for Benign Thyroid Nodules: A 48-Month Follow-up Study

2021 ◽  
Author(s):  
Jia-Rui Du ◽  
Wen-Hui Li ◽  
Cheng-Hai Quan ◽  
Deng-Ke Teng ◽  
Hui Wang
Keyword(s):  
Thyroid Function ◽  
Microwave Ablation ◽  
Thyroid Nodules ◽  
Reduction Rate ◽  
Long Term Results ◽  
Long Term Outcome ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Abstract Purpose The short-term effects of microwave ablation (MWA) in the treatment of benign thyroid nodules (BTNs) were satisfactory in previous studies. However, as a slowly progressing disease, the long-term efficacy of MWA for BTNs at present is not clear. Our study aim was to assess the long-term results of MWA for BTNs after a 48-month follow-up. Methods From June 2015 to September 2017, 148 patients had 148 BTNs lesions. All patients were from China-Japan Union Hospital of Jilin University. Careful ultrasound examinations were performed 1 day, 1 month, 3 months, 6 months, 12 months, and every 6 months after MWA. The volume, volume reduction rate (VRR) recurrence rate of the ablated area and thyroid function were recorded. Results The mean volume of the 148 nodules were 15.6±9.4 cm3 (range: 1.3-48.9 cm3) and 0.6±0.6 cm3 (range: 0-3.5 cm3) before and 48 months after MWA, respectively, for a nodule VRR of 96.9±2.5% (range: 90.4-100%). Two patients (1.35%) had recurrence after MWA. Compared with that before MWA, no significant variation in thyroid function was observed after MWA. Five patients experienced complications (3.38%): two patients (1.35%) had bleeding, two patients (1.35%) had ear pain and toothache during MWA, and one patient (0.68%) had hoarseness after MWA. No cases of oesophageal injury, tracheal injury, infection, skin burn, etc., were reported during or after MWA. Conclusions Over long-term follow-up, MWA is an effective method for treating BTNs and is expected to be a potential first-line treatment.

VP44 Rapid Health Technology Assessment – High-Intensity Focused Ultrasound For Breast Fibroadenomas And Benign Thyroid Nodules

2017 ◽  
Vol 33 (S1) ◽  
pp. 167-168 ◽  
Author(s):  
Keng Ho Pwee
Keyword(s):  
Focused Ultrasound ◽  
Thyroid Nodules ◽  
Case Series ◽  
Health Technology ◽  
High Intensity Focused Ultrasound ◽  
Short Term ◽  
Randomized Controlled ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

INTRODUCTION:High-intensity focused ultrasound (HIFU) is a non-invasive ablative technique to treat breast fibroadenomas and benign thyroid nodules. A rapid Health Technology Assessment (HTA) was commissioned to inform the Changi General Hospital's decision on procuring a HIFU system.METHODS:A systematic literature search was conducted for systematic reviews, HTA reports and clinical practice guidelines on the clinical effectiveness of HIFU systems with the following PICO elements:Patients = patients with benign breast fibroadenomas or thyroid nodulesIntervention = HIFUComparator = conventional treatmentOutcomes = clinical outcomesRetrieved studies were summarized in a narrative synthesis.RESULTS:A few small case series showed reduction in volume of fibroadenomas/nodules in the short term and side effects were minor. Additionally, in HIFU for benign thyroid nodules, conference abstracts described a small open-label, randomized controlled trial where patients receiving HIFU had nodule volume reduction of over 30 percent compared to no reduction in the observation group, at 6 months; and a small non-randomized controlled study where volume reduction was about 70 percent in patients receiving HIFU compared to active observation.Recent clinical guidelines do not mention HIFU as a therapeutic option for fibroadenomas/nodules.Major United States health insurers do not cover HIFU and consider it experimental, investigational or unproven. In Germany, HIFU for breast fibroadenomas and benign thyroid nodules are covered by some insurers under special integrated care contracts.CONCLUSIONS:HIFU for fibroadenomas/nodules is a technology still developing its evidence base. The peer-reviewed literature comprises a few small case series and two controlled trials showing fibroadenoma/nodule reduction in the short term (up to 12 months) but no long term outcomes. Professional opinion from current guidelines does not mention HIFU as an option.It may be prudent to await stronger evidence on long-term patient-important outcomes before offering the treatment as a hospital service. HIFU may be suitable for further clinical research.

Fate of untreated benign thyroid nodules: Results of long-term follow-up

1994 ◽  
Vol 18 (4) ◽  
pp. 495-498 ◽  
Author(s):  
Kanji Kuma ◽  
Fumio Matsuzuka ◽  
Tamotsu Yokozawa ◽  
Akira Miyauchi ◽  
Masahiro Sugawara
Keyword(s):  
Thyroid Nodules ◽  
Long Term Follow Up ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

scholarly journals Comparison of self-reported and public registered absenteeism among people on long-term sick leave due to musculoskeletal disorders: criterion validity of the iMTA Productivity Cost Questionnaire

2021 ◽  
Author(s):  
Rikke Munk Killingmo ◽  
Anne Therese Tveter ◽  
Milada C. Småstuen ◽  
Kjersti Storheim ◽  
Margreth Grotle
Keyword(s):  
Sick Leave ◽  
Musculoskeletal Disorders ◽  
Criterion Validity ◽  
Registry Data ◽  
Rank Test ◽  
Productivity Cost ◽  
Signed Rank ◽  
Wilcoxon Signed Rank Test ◽  
Signed Rank Test

Abstract Objective To evaluate criterion validity of the iMTA Productivity Cost Questionnaire (iPCQ) by comparing iPCQ-reported occurrence and duration of long-term absenteeism (> 4 weeks) with public registry data collected from the Norwegian Labour and Welfare Administration (NAV) among people on sick leave due to musculoskeletal disorders. Method Baseline data from a cohort study was used, in which people on sick leave for at least 4 weeks due to musculoskeletal disorders were recruited electronically through the NAV website. To compare the occurrence of long-term absenteeism overall agreement between the two methods was measured by percentages. To compare the duration (number of days with absenteeism) and adjusted duration (number of days with complete absenteeism) of long-term absenteeism we conducted intraclass correlation coefficient (ICC) two-way random average agreement, descriptive statistic and Wilcoxon signed-rank test. Results In total, 144 participants with a median age (range) of 49 (24–67) were included. The overall agreement on the occurrence of long-term absenteeism was 100%. The ICC value was 0.97 and 0.86 for duration and adjusted duration of long-term absenteeism, respectively. The median difference(iPCQ-registry) between the two methods was 0 and 17 days for long-term absenteeism duration and adjusted duration, respectively. A significant difference between the two methods was observed (Wilcoxon signed-rank test, p < 0.001) with regards to adjusted duration of long-term absenteeism. Conclusion The iPCQ showed good agreement with public registry data regarding the occurrence and duration of long-term absenteeism among people with musculoskeletal disorders on long-term sick-leave in Norway. However, the iPCQ does not cover part-time sick-leave and thereby potentially overestimate the total amount of long-term absenteeism. Trial registration ClinicalTrials.gov Identifier no. NCT04196634.

scholarly journals High-intensity focused ultrasound (HIFU) therapy for benign thyroid nodules: a 3-year retrospective multicenter follow-up study

2020 ◽  
Vol 37 (1) ◽  
pp. 1301-1309
Author(s):  
Hervé Monpeyssen ◽  
Adrien Ben Hamou ◽  
Laszlo Hegedüs ◽  
Édouard Ghanassia ◽  
Pauline Juttet ◽  
...  
Keyword(s):  
High Intensity ◽  
Focused Ultrasound ◽  
Thyroid Nodules ◽  
High Intensity Focused Ultrasound ◽  
Follow Up Study ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid
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