Die Echotherapie als nichtinvasives Therapieverfahren von Schilddrüsenveränderungen

Zusammenfassung

Fokussierter Ultraschall gewinnt durch die Echotherapiebehandlung auch im Einsatz bei Schilddrüsenveränderungen zunehmend an Bedeutung. Der vorliegende Beitrag gibt Einblicke in den Einsatz der Echotherapie und den Ablauf einer Behandlung sowie die klinischen Erfahrungen und Zukunftsperspektiven. Studien bei der Therapie von gutartigen symptomatischen Schilddrüsenknoten konnten bereits signifikante Volumenreduktionen des krankhaften Gewebes und eine damit verbundene Verbesserung der Symptomatik zeigen. Zudem konnten eine gute Verträglichkeit und ein geringes Risiken- und Nebenwirkungsprofil demonstriert werden.

Abstract

Focused ultrasound is becoming more and more important when it comes to its application in thyroid diseases due to the development of echotherapy. This article provides insights in the application of echotherapy and the treatment process as well as clinical experiences and future perspectives. Studies have already been able to show significant volume reductions and improvement of symptoms after the treatment of benign and symptomatic thyroid nodules. Moreover, a high tolerability and a low profile in risk and side effects has been demonstrated.

Schlüsselwörter

HIFU - Echotherapie - fokussierter Ultraschall - Thermoablation - Schilddrüsenknoten

Key words

HIFU - echotherapy - focused ultrasound - thermal ablation - thyroid nodules

Publikationsverlauf

Artikel online veröffentlicht:
23. Juni 2022

• Literatur

• 1 Lynn JG, Zwemer RL, Chick AJ. et al. A new method for the generation and use of focused ultrasound in experimental biology. The Journal of General Physiology 1942; 26: 179-193
• 2 Kassell NF. State of the Filed 2018 – Focused Ultrasound. Focused Ultrasound Foundation; 2018
• 3 Esnault O, Franc B, Monteil JP. et al. High-intensity focused ultrasound for localized thyroid-tissue ablation: preliminary experimental animal study (in eng). 2004 14. 1072-1076
• 4 Esnault O. et al. High-intensity focused ultrasound ablation of thyroid nodules: first human feasibility study (in eng). Thyroid 2011; 21: 965-973
• 5 Lang BHH, Wong CKH, Ma EPM. et al. A propensity-matched analysis of clinical outcomes between open thyroid lobectomy and high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules (in eng). Surgery 2019; 165: 85-91
• 6 Theraclion. Unser Produkt: Der Echopulse [Online] 2018. Available (3.1.2019): http://www.theraclion.de/der-echopulse/
• 7 Kovatcheva R, Zaletel K. High-intensity focused ultrasound for thyroid nodule ablation: the evidence to date. Reports in Medical Imaging 2017; 10: 9-16
• 8 Lang BHH, Wong CKH, Ma EPM. Single-session high intensity focussed ablation (HIFU) versus open cervical hemithyroidectomy for benign thyroid nodule: analysis on early efficacy, safety and voice quality (in eng). Int J Hyperthermia 2017; 33: 868-874
• 9 Trimboli P, Bini F, Marinozzi F. et al. High-intensity focused ultrasound (HIFU) therapy for benign thyroid nodules without anesthesia or sedation (in eng). Endocrine 2018; 61: 210-215
• 10 Lang BHH, Woo YC, Chiu KW. Two-year efficacy of single-session high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules (in eng). Eur Radiol 2018; 29: 93-101
• 11 Korkusuz H, Fehre N, Sennert M. et al. Volume reduction of benign thyroid nodules 3 months after a single treatment with high-intensity focused ultrasound (HIFU) (in eng). J Ther Ultrasound 2015; 3: 4
• 12 Lang BHH, Woo YC, Chiu KW. Evaluation of pain during high-intensity focused ultrasound ablation of benign thyroid nodules (in eng). Eur Radiol 2018; 28: 2620-2627
• 13 Lang BH, Woo YC, Wong CKH. High-Intensity Focused Ultrasound for Treatment of Symptomatic Benign Thyroid Nodules: A Prospective Study (in eng). Radiology 2017; 284: 897-906
• 14 Korkusuz H, Fehre N, Sennert M. et al. Early assessment of high-intensity focused ultrasound treatment of benign thyroid nodules by scintigraphic means (in eng). J Ther Ultrasound 2014; 2: 18
• 15 Peter B. Hypnose. In: Kröner-Herwig B, Frettlöh J, Klinger R. et al., Eds. Schmerzpsychotherapie: Grundlagen – Diagnostik – Krankheitsbilder – Behandlung. Berlin, Heidelberg: Springer; 2007: 581-601
• 16 Hoppe F. Schmerz. In: Revenstorf D. Ed. Klinische Hypnose. Berlin, Heidelberg: Springer; 1993: 297-312
• 17 HypnoVR. HypnoVR [Online] 2019. Available (14.02.2019): https://hypnovr.io/?lang=en
• 18 Lang BH, Wu ALH. High intensity focused ultrasound (HIFU) ablation of benign thyroid nodules – a systematic review (in eng). J Ther Ultrasound 2017; 5: 11
• 19 Lang BH, Woo YC, Chiu KW. Single-Session High-Intensity Focused Ultrasound Treatment in Large-Sized Benign Thyroid Nodules (in eng). Thyroid 2017; 27: 714-721
• 20 Korkusuz H, Sennert M, Fehre N. et al. Local thyroid tissue ablation by high-intensity focused ultrasound: effects on thyroid function and first human feasibility study with hot and cold thyroid nodules (in eng). Int J Hyperthermia 2014; 30: 480-485
• 21 Korkusuz H, Sennert M, Fehre N. et al. Localized Thyroid Tissue Ablation by High Intensity Focused Ultrasound: Volume Reduction, Effects on Thyroid Function and Immune Response (in eng). Röfo 2015; 187: 1011-1015
• 22 Lang BHH, Woo YC, Chiu KW. Sequential high intensity focused ultrasound (HIFU) ablation in the treatment of benign multinodular goitre: an observational retrospective study (in eng). Eur Radiol 2018; 28: 237-244
• 23 Lang BH, Woo YC, Wong IY. et al. Single-Session High-Intensity Focused Ultrasound Treatment for Persistent or Relapsed Graves Disease: Preliminary Experience in a Prospective Study (in eng). Radiology 2017; 285: 1011-1022
• 24 Lang B. A Trial Comparing USG-HIFU vs AS in Management of Low-risk PTMC [Online] 2018. Available (1.2.2019): https://www.clinicaltrials.gov/ct2/show/NCT03327636?term=HIFU&cond=Thyroid+Cancer&rank=1