Comparison of high intensity focused ultrasound and radioiodine for treating toxic thyroid nodules

Summary Purpose We compared the effectiveness of high intensity focused ultrasound (HIFU) and radioiodine (RAI) to treat patients carrying toxic thyroid nodule (TTN). Normalization of serum thyrotropin (TSH) 1 year after treatment was the primary end‐point; concurrent changes in nodules' volume...

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Published in:Clinical endocrinology (Oxford) 2018-08, Vol.89 (2), p.219-225
Main Authors: Giovanella, Luca, Piccardo, Arnoldo, Pezzoli, Cinzia, Bini, Fabiano, Ricci, Riccardo, Ruberto, Teresa, Trimboli, Pierpaolo
Format: Article
Language:English
Subjects:
high intensity focused ultrasound
Nodules
Patients
Scintigraphy
thermal ablation
Thyroid
Thyroid gland
Thyroid-stimulating hormone
Ultrasonic imaging
Ultrasound
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container_end_page 225
container_issue 2
container_start_page 219
container_title Clinical endocrinology (Oxford)
container_volume 89
creator Giovanella, Luca
Piccardo, Arnoldo
Pezzoli, Cinzia
Bini, Fabiano
Ricci, Riccardo
Ruberto, Teresa
Trimboli, Pierpaolo
description Summary Purpose We compared the effectiveness of high intensity focused ultrasound (HIFU) and radioiodine (RAI) to treat patients carrying toxic thyroid nodule (TTN). Normalization of serum thyrotropin (TSH) 1 year after treatment was the primary end‐point; concurrent changes in nodules' volume and scintigraphic pattern were also evaluated as secondary end‐points. Materials and Methods Among patients ≥18 years old with TTN observed at our centre between January 1st, 2016 and December 31th, 2016 we prospectively enrolled 17 and 15 age and sex‐matched patients treated with RAI and HIFU, respectively. Biochemical thyroid tests and nodules' volume were assessed before and 3, 6 and 12 months after treatments. A thyroid scintigraphy was performed before and 1 year after treatment, respectively. Results The final series included 17 patients treated with RAI and 15 patients treated with HIFU, respectively. Neither demographic nor clinical differences were found at baseline. One year after treatment 14 of 17 RAI‐treated and 4 of 15 HIFU‐treated patients fulfilled criteria for response to treatment (P = .0008). Indeed, the median TSH value was 1.5 IU/mL and 0.2 IU/mL in HIFU and RAI groups, respectively (P 
doi_str_mv 10.1111/cen.13738
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Normalization of serum thyrotropin (TSH) 1 year after treatment was the primary end‐point; concurrent changes in nodules' volume and scintigraphic pattern were also evaluated as secondary end‐points. Materials and Methods Among patients ≥18 years old with TTN observed at our centre between January 1st, 2016 and December 31th, 2016 we prospectively enrolled 17 and 15 age and sex‐matched patients treated with RAI and HIFU, respectively. Biochemical thyroid tests and nodules' volume were assessed before and 3, 6 and 12 months after treatments. A thyroid scintigraphy was performed before and 1 year after treatment, respectively. Results The final series included 17 patients treated with RAI and 15 patients treated with HIFU, respectively. Neither demographic nor clinical differences were found at baseline. One year after treatment 14 of 17 RAI‐treated and 4 of 15 HIFU‐treated patients fulfilled criteria for response to treatment (P = .0008). Indeed, the median TSH value was 1.5 IU/mL and 0.2 IU/mL in HIFU and RAI groups, respectively (P &lt; .0001). Finally, despite a similar decrease in nodules' volume in both groups, a scintigraphic response was achieved in 16 of 17 (94%) RAI‐treated compared to 8 of 15 (53%) HIFU‐treated patients (P = .024), respectively. Conclusions In our series, RAI clearly outperforms HIFU in treating patients carrying TTN and remains the first‐line noninvasive treatment in such cases.</description><identifier>ISSN: 0300-0664</identifier><identifier>EISSN: 1365-2265</identifier><identifier>DOI: 10.1111/cen.13738</identifier><identifier>PMID: 29741290</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>high intensity focused ultrasound ; Nodules ; Patients ; Scintigraphy ; thermal ablation ; Thyroid ; Thyroid gland ; Thyroid-stimulating hormone ; Ultrasonic imaging ; Ultrasound</subject><ispartof>Clinical endocrinology (Oxford), 2018-08, Vol.89 (2), p.219-225</ispartof><rights>2018 John Wiley &amp; Sons Ltd</rights><rights>2018 John Wiley &amp; Sons Ltd.</rights><rights>Copyright © 2018 John Wiley &amp; Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-bb09aa044fbdf5a58ce138351139f3641003ca08e55bbdd10ee075296f3969443</citedby><cites>FETCH-LOGICAL-c3538-bb09aa044fbdf5a58ce138351139f3641003ca08e55bbdd10ee075296f3969443</cites><orcidid>0000-0003-0230-0974</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29741290$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giovanella, Luca</creatorcontrib><creatorcontrib>Piccardo, Arnoldo</creatorcontrib><creatorcontrib>Pezzoli, Cinzia</creatorcontrib><creatorcontrib>Bini, Fabiano</creatorcontrib><creatorcontrib>Ricci, Riccardo</creatorcontrib><creatorcontrib>Ruberto, Teresa</creatorcontrib><creatorcontrib>Trimboli, Pierpaolo</creatorcontrib><title>Comparison of high intensity focused ultrasound and radioiodine for treating toxic thyroid nodules</title><title>Clinical endocrinology (Oxford)</title><addtitle>Clin Endocrinol (Oxf)</addtitle><description>Summary Purpose We compared the effectiveness of high intensity focused ultrasound (HIFU) and radioiodine (RAI) to treat patients carrying toxic thyroid nodule (TTN). Normalization of serum thyrotropin (TSH) 1 year after treatment was the primary end‐point; concurrent changes in nodules' volume and scintigraphic pattern were also evaluated as secondary end‐points. Materials and Methods Among patients ≥18 years old with TTN observed at our centre between January 1st, 2016 and December 31th, 2016 we prospectively enrolled 17 and 15 age and sex‐matched patients treated with RAI and HIFU, respectively. Biochemical thyroid tests and nodules' volume were assessed before and 3, 6 and 12 months after treatments. A thyroid scintigraphy was performed before and 1 year after treatment, respectively. Results The final series included 17 patients treated with RAI and 15 patients treated with HIFU, respectively. Neither demographic nor clinical differences were found at baseline. One year after treatment 14 of 17 RAI‐treated and 4 of 15 HIFU‐treated patients fulfilled criteria for response to treatment (P = .0008). Indeed, the median TSH value was 1.5 IU/mL and 0.2 IU/mL in HIFU and RAI groups, respectively (P &lt; .0001). Finally, despite a similar decrease in nodules' volume in both groups, a scintigraphic response was achieved in 16 of 17 (94%) RAI‐treated compared to 8 of 15 (53%) HIFU‐treated patients (P = .024), respectively. Conclusions In our series, RAI clearly outperforms HIFU in treating patients carrying TTN and remains the first‐line noninvasive treatment in such cases.</description><subject>high intensity focused ultrasound</subject><subject>Nodules</subject><subject>Patients</subject><subject>Scintigraphy</subject><subject>thermal ablation</subject><subject>Thyroid</subject><subject>Thyroid gland</subject><subject>Thyroid-stimulating hormone</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><issn>0300-0664</issn><issn>1365-2265</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kM9LwzAUgIMobk4P_gMS8OSh20vTtM1RyvwBohc9l7RJt4wtmUmK9r832unNwCOX730PPoQuCcxJfItWmTmhBS2P0JTQnCVpmrNjNAUKkECeZxN05v0GAFgJxSmapLzISMphiprK7vbCaW8Nth1e69UaaxOU8ToMuLNt75XE_TY44W1vJBZxnJDaaiu1URFxODglgjYrHOynbnFYD85qiY2V_Vb5c3TSia1XF4d_ht7ulq_VQ_L0cv9Y3T4lLWW0TJoGuBCQZV0jOyZY2SpCS8oIobyjeUYAaCugVIw1jZQElIKCpTzvKM95ltEZuh69e2ffe-VDvbG9M_FknUIBcb8kPFI3I9U6671TXb13eifcUBOov2vWsWb9UzOyVwdj3-yU_CN_80VgMQIfequG_011tXwelV_lAX7_</recordid><startdate>201808</startdate><enddate>201808</enddate><creator>Giovanella, Luca</creator><creator>Piccardo, Arnoldo</creator><creator>Pezzoli, Cinzia</creator><creator>Bini, Fabiano</creator><creator>Ricci, Riccardo</creator><creator>Ruberto, Teresa</creator><creator>Trimboli, Pierpaolo</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope><orcidid>https://orcid.org/0000-0003-0230-0974</orcidid></search><sort><creationdate>201808</creationdate><title>Comparison of high intensity focused ultrasound and radioiodine for treating toxic thyroid nodules</title><author>Giovanella, Luca ; Piccardo, Arnoldo ; Pezzoli, Cinzia ; Bini, Fabiano ; Ricci, Riccardo ; Ruberto, Teresa ; Trimboli, Pierpaolo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-bb09aa044fbdf5a58ce138351139f3641003ca08e55bbdd10ee075296f3969443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>high intensity focused ultrasound</topic><topic>Nodules</topic><topic>Patients</topic><topic>Scintigraphy</topic><topic>thermal ablation</topic><topic>Thyroid</topic><topic>Thyroid gland</topic><topic>Thyroid-stimulating hormone</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Giovanella, Luca</creatorcontrib><creatorcontrib>Piccardo, Arnoldo</creatorcontrib><creatorcontrib>Pezzoli, Cinzia</creatorcontrib><creatorcontrib>Bini, Fabiano</creatorcontrib><creatorcontrib>Ricci, Riccardo</creatorcontrib><creatorcontrib>Ruberto, Teresa</creatorcontrib><creatorcontrib>Trimboli, Pierpaolo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><jtitle>Clinical endocrinology (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giovanella, Luca</au><au>Piccardo, Arnoldo</au><au>Pezzoli, Cinzia</au><au>Bini, Fabiano</au><au>Ricci, Riccardo</au><au>Ruberto, Teresa</au><au>Trimboli, Pierpaolo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of high intensity focused ultrasound and radioiodine for treating toxic thyroid nodules</atitle><jtitle>Clinical endocrinology (Oxford)</jtitle><addtitle>Clin Endocrinol (Oxf)</addtitle><date>2018-08</date><risdate>2018</risdate><volume>89</volume><issue>2</issue><spage>219</spage><epage>225</epage><pages>219-225</pages><issn>0300-0664</issn><eissn>1365-2265</eissn><abstract>Summary Purpose We compared the effectiveness of high intensity focused ultrasound (HIFU) and radioiodine (RAI) to treat patients carrying toxic thyroid nodule (TTN). Normalization of serum thyrotropin (TSH) 1 year after treatment was the primary end‐point; concurrent changes in nodules' volume and scintigraphic pattern were also evaluated as secondary end‐points. Materials and Methods Among patients ≥18 years old with TTN observed at our centre between January 1st, 2016 and December 31th, 2016 we prospectively enrolled 17 and 15 age and sex‐matched patients treated with RAI and HIFU, respectively. Biochemical thyroid tests and nodules' volume were assessed before and 3, 6 and 12 months after treatments. A thyroid scintigraphy was performed before and 1 year after treatment, respectively. Results The final series included 17 patients treated with RAI and 15 patients treated with HIFU, respectively. Neither demographic nor clinical differences were found at baseline. One year after treatment 14 of 17 RAI‐treated and 4 of 15 HIFU‐treated patients fulfilled criteria for response to treatment (P = .0008). Indeed, the median TSH value was 1.5 IU/mL and 0.2 IU/mL in HIFU and RAI groups, respectively (P &lt; .0001). Finally, despite a similar decrease in nodules' volume in both groups, a scintigraphic response was achieved in 16 of 17 (94%) RAI‐treated compared to 8 of 15 (53%) HIFU‐treated patients (P = .024), respectively. Conclusions In our series, RAI clearly outperforms HIFU in treating patients carrying TTN and remains the first‐line noninvasive treatment in such cases.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29741290</pmid><doi>10.1111/cen.13738</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-0230-0974</orcidid></addata></record>
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subjects high intensity focused ultrasound
Nodules
Patients
Scintigraphy
thermal ablation
Thyroid
Thyroid gland
Thyroid-stimulating hormone
Ultrasonic imaging
Ultrasound
title Comparison of high intensity focused ultrasound and radioiodine for treating toxic thyroid nodules
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