Questions and Answers

What exactly is echotherapy? What occurs during treatment and will my health insurance cover it? Here you will find all the answers about a gentle alternative to surgery.

What is echotherapy?

Echotherapy is treatment with therapeutic ultrasound. Imagine rays of sunshine shining through a magnifying glass. The rays are concentrated and hit the target with greater intensity. Echotherapy uses exactly the same principle:

The tissue in the nodule rapidly heats up to about 85 °C. In this way, a type of “melting process” occurs during echotherapy. The effects of echotherapy continue after treatment and the nodule continues to shrink. The reason for this is that the body gradually degrades the tissue that has been “melted down”.   

What results are seen after echotherapy used on benign thyroid nodules?

 Within six months after the treatment, the size of a thyroid nodule decreases by an average of 50%.[1] The effects of echotherapy continue for a certain period of time after treatment and the nodule continues to shrink. The symptoms also improve as the nodule shrinks.

[1]US-guided High-Intensity Focused Ultrasound Ablation of Benign Solid Thyroid Nodules: Initial Clinical Outcomes; R. D. Kovatcheva, J. D. Vlahov, J. I. Stoinov, K. Zaletel; In: Radiology, 2015

When is it useful to undergo echotherapy treatment?

Treatment of a nodule with echotherapy is always an option when a surgical procedure would be appropriate. Thus, when the nodule grows very fast, when it causes symptoms or when the medications or radioiodine therapy no longer demonstrated therapeutic success. Echotherapy can, however, also be useful when you want to prevent further growth of a nodule. Discuss this with your doctor directly.   

What happens during echotherapy treatment?

Treatment occurs on an outpatient basis. Usually, you attend your appointment at the clinic and can go home directly after treatment. During the treatment, you lie comfortably on your back. In addition to the usual treatment, an ultrasound will be used for monitoring, as the therapeutic rays can be precisely controlled in this way. 

Is the treatment painful?

 During echotherapy, some patients feel a more or less noticeable pricking or stabbing sensation, this is normal. The doctor will take care of each individual situation, and the procedure might be performed under local anesthesia or conscious sedation. If unpleasant sensations appear, by simply telling the treating physician, the intensity of the treatment could be adapted accordingly.     

How long does the treatment take?

Usually, only a single session is required. Depending on the size of the nodule, this lasts between 20 minutes and 1.5 hours. 

What should I look out for at home after the treatment?

Actually, you can immediately carry on with your everyday life as usual. Since echotherapy is performed without cuts, there are no wounds or other impairments.

Is the treatment safe?

Therapeutic ultrasound has already been used successfully for treating tumours for several years. In this process, injured tissues are broken down without affecting the healthy tissue (see also: What is echotherapy?) Echotherapy uses this technique for the treatment of benign nodules in the thyroid and fibroadenomas in the breast. There are studies regarding the use of echotherapy in the region of the thyroid, especially for benign thyroid nodules.[2][3]

[2]Local thyroid tissue ablation by high-intensity focused ultrasound: Effects on thyroid function and first human feasibility study with hot and cold thyroid nodules; H. Korkusuz, M. Sennert, N. Fehre, C. Happel, F. Grünwald; In: International Journal of Hyperthermia, 2014; previously online: 1-6

[3]Minimally Invasive Ablation of a Toxic Thyroid Nodule by High-Intensity Focused Ultrasound. Esnault et al. Am J Neuroradiol Nov-Dec 2010; 31:1967– 68

What are the advantages of echotherapy?

Echotherapy can be performed completely without surgery, cuts or scars. Treatment occurs on an outpatient basis. Only the thyroid nodule is destroyed; the normal thyroid tissue is protected and retains its normal function. This is important, since patients who have either large parts or all of their thyroid gland removed must take hormones for the rest of their lives.