Zastosowanie echolasera w leczeniu guzków tarczycy – innowacyjna metoda terapeutyczna w endokrynologii
Keywords:
tarczyca, echolaser, guzy tarczycy, nieinwazyjna metoda, leczenieSynopsis
Tarczyca to gruczoł wydzielania wewnętrznego zlokalizowany w przedniej części szyi, odpowiedzialny za produkcję hormonów regulujących metabolizm, rozwój i homeostazę. Guzki tarczycy stanowią powszechny problem kliniczny – dotyczą około 25% populacji, z czego ponad 90% to zmiany łagodne. Echolaser jest innowacyjną technologią termoablacji laserowej (LITT), stanowiącą minimalnie inwazyjną alternatywę dla leczenia łagodnych guzków tarczycy. Procedura oparta na przezskórnym wprowadzeniu światłowodów do wnętrza zmiany umożliwia precyzyjne zniszczenie tkanki poprzez kontrolowaną martwicę koagulacyjną. Zabieg wykonywany jest ambulatoryjnie, pod kontrolą USG, bez potrzeby znieczulenia ogólnego, co przekłada się na wysoki komfort pacjenta i krótki czas rekonwalescencji. Efektywność metody potwierdzono w licznych badaniach klinicznych – osiągając redukcję objętości guzków o 63,4% po 3 i 81% po 12 miesiącach. W porównaniu do chirurgii, Echolaser pozwala uniknąć powikłań, blizn, zachować funkcję gruczołu i zminimalizować ryzyko uszkodzenia nerwu krtaniowego. Technologia ta znajduje także zastosowanie w leczeniu zmian prostaty, przytarczyc oraz guzów wątroby. Dalsze kierunki badań obejmują wieloośrodkowe, randomizowane analizy z długoterminową obserwacją oraz rozwój automatyzacji procedur ablacyjnych.
The thyroid is an endocrine gland located in the anterior part of the neck, responsible for producing hormones that regulate metabolism, development, and homeostasis. Thyroid nodules are a common clinical problem – they affect approximately 25% of the population, of which over 90% are benign lesions. Echolaser is an innovative laser-induced thermal therapy (LITT) technology, representing a minimally invasive alternative for the treatment of benign thyroid nodules. The procedure, based on percutaneous insertion of optical fibers into the lesion, enables precise tissue destruction through controlled coagulative necrosis. The treatment is performed on an outpatient basis, under ultrasound guidance, without the need for general anesthesia, which translates into high patient comfort and a short recovery time. The effectiveness of the method has been confirmed in numerous clinical studies – achieving a nodule volume reduction of 63.4% after 3 months and 81% after 12 months. Compared to surgery, Echolaser avoids complications, scarring, preserves gland function, and minimizes the risk of recurrent laryngeal nerve injury. This technology is also used in the treatment of prostate lesions, parathyroid glands, and liver tumors. Future research directions include multicenter randomized studies with long-term follow-up and the development of automated ablation procedures.
References
Allen E, Fingeret A. Anatomy, Head and Neck, Thyroid. 2023 Jul 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 29262169.
Shahid MA, Ashraf MA, Sharma S. Physiology, Thyroid Hormone. 2023 Jun 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 29763182.
Boucai L, Zafereo M, Cabanillas ME. Thyroid Cancer: A Review. JAMA. 2024 Feb 6;331(5):425-435. doi: 10.1001/jama.2023.26348. PMID: 38319329.
Grani G, Sponziello M, Filetti S, Durante C. Thyroid nodules: diagnosis and management. Nat Rev Endocrinol. 2024 Dec;20(12):715-728. doi: 10.1038/s41574-024-01025-4. Epub 2024 Aug 16. PMID: 39152228.
Laios K, Lagiou E, Konofaou V, Piagkou M, Karamanou M. From thyroid cartilage to thyroid gland. Folia Morphol (Warsz). 2019;78(1):171-173. doi: 10.5603/FM.a2018.0059. Epub 2018 Jul 16. PMID: 30009365.
https://archive.org/details/bub_gb_5Xby3nxU3XMC/page/n458/mode/1up?q=Glándula+
Loevner LA. Imaging of the thyroid gland. Semin Ultrasound CT MR. 1996 Dec;17(6):539-62. doi: 10.1016/s0887-2171(96)90003-7. PMID: 9023867.
Branca JJV, Lascialfari Bruschi A, Pilia AM, Carrino D, Guarnieri G, Gulisano M, Pacini A, Paternostro F. The Thyroid Gland: A Revision Study on Its Vascularization and Surgical Implications. Medicina (Kaunas). 2022 Jan 17;58(1):137. doi: 10.3390/medicina58010137. PMID: 35056445; PMCID: PMC8779193.
Khan YS, Farhana A. Histology, Thyroid Gland. 2022 Dec 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 31869123.
Geraci G, Pisello F, Li Volsi F, Modica G, Sciumè C. The importance of pyramidal lobe in thyroid surgery. G Chir. 2008 Nov-Dec;29(11-12):479-82. PMID: 19068184.
Zivic R, Radovanovic D, Vekic B, Markovic I, Dzodic R, Zivaljevic V. Surgical anatomy of the pyramidal lobe and its significance in thyroid surgery. S Afr J Surg. 2011 Aug 31;49(3):110, 112, 114 passim. PMID: 21933507.
Freilinger A, Kaserer K, Zettinig G, Pruidze P, Reissig LF, Rossmann T, Weninger WJ, Meng S. Ultrasound for the detection of the pyramidal lobe of the thyroid gland. J Endocrinol Invest. 2022 Jun;45(6):1201-1208. doi: 10.1007/s40618-022-01748-z. Epub 2022 Feb 14. PMID: 35157251; PMCID: PMC9098552.
Brent GA. Mechanisms of thyroid hormone action. J Clin Invest 122: 3035–3043, 2012 [DOI] [PMC free article] [PubMed] [Google Scholar]
Chiang JY. Bile acids: regulation of synthesis. J Lipid Res 50: 1955–1966, 2009 [DOI] [PMC free article] [PubMed] [Google Scholar]
Oetting A, Yen PM. New insights into thyroid hormone action. Best Pract Res Clin Endocrinol Metab 21: 193–208, 2007 [DOI] [PubMed] [Google Scholar]
Fox CS, Pencina MJ, D'Agostino RB, Murabito JM, Seely EW, Pearce EN, Vasan RS. Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample. Arch Intern Med 168: 587–592, 2008 [DOI] [PubMed] [Google Scholar][Ref list]
Iwen KA, Schroder E, Brabant G. Thyroid hormone and the metabolic syndrome. Eur Thyroid J 2: 83–92, 2013 [DOI] [PMC free article] [PubMed] [Google Scholar][Ref list]
Knudsen N, Laurberg P, Rasmussen LB, Bulow I, Perrild H, Ovesen L, Jorgensen T. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab 90: 4019–4024, 2005 [DOI] [PubMed] [Google Scholar][Ref list]
Brent GA. Clinical practice. Graves' disease. N Engl J Med 358: 2594–2605, 2008 [DOI] [PubMed] [Google Scholar][Ref list]
Brent GA. Hypothyroidism and thyroiditis. In: Williams Textbook of Endocrinology, edited by Melmed SP, Larsen PR, Kronenberg HM. Philadelphia, PA: Elsevier, 2012 [Google Scholar][Ref list]
Mullur R, Liu YY, Brent GA. Thyroid hormone regulation of metabolism. Physiol Rev. 2014 Apr;94(2):355-82. doi: 10.1152/physrev.00030.2013. PMID: 24692351; PMCID: PMC4044302.
Everett LJ, Lazar MA. Cell-specific integration of nuclear receptor function at the genome. Wiley Interdiscip Rev Syst Biol Med 5: 615–629, 2013 [DOI] [PMC free article] [PubMed] [Google Scholar][Ref list]
Shulman AI, Mangelsdorf DJ. Retinoid X receptor heterodimers in the metabolic syndrome. N Engl J Med 353: 604–615, 2005 [DOI] [PubMed] [Google Scholar][Ref list]
Mottis A, Mouchiroud L, Auwerx J. Emerging roles of the corepressors NCoR1 and SMRT in homeostasis. Genes Dev 27: 819–835, 2013 [DOI] [PMC free article] [PubMed] [Google Scholar][Ref list]
You SH, Liao X, Weiss RE, Lazar MA. The interaction between nuclear receptor corepressor and histone deacetylase 3 regulates both positive and negative thyroid hormone action in vivo. Mol Endocrinol 24: 1359–1367, 2010 [DOI] [PMC free article] [PubMed] [Google Scholar][Ref list]
Dasgupta S, Lonard DM, O'Malley BW. Nuclear receptor coactivators: master regulators of human health and disease. Annu Rev Med. In press [DOI] [PMC free article] [PubMed] [Google Scholar][Ref list]
Klein I. Thyroid hormone and the cardiovascular system. Am J Med. 1990 Jun;88(6):631-7. doi: 10.1016/0002-9343(90)90531-h. PMID: 2189307.
Nauman P. Thyroid hormones in the central nervous system (CNS) and their effect on neoplasm formation, particularly on the development and course of glioblastoma multiforme - research hypothesis. Endokrynol Pol. 2015;66(5):444-59. doi: 10.5603/EP.2015.0055. PMID: 26457500.
Rousset B, Dupuy C, Miot F, Dumont J. Chapter 2 Thyroid Hormone Synthesis And Secretion. 2015 Sep 2. In: Feingold KR, Ahmed SF, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, de Herder WW, Dhatariya K, Dungan K, Hofland J, Kalra S, Kaltsas G, Kapoor N, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, Levy M, McGee EA, McLachlan R, Muzumdar R, Purnell J, Rey R, Sahay R, Shah AS, Singer F, Sperling MA, Stratakis CA, Trence DL, Wilson DP, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000–. PMID: 25905405.
Mariotti S, Beck-Peccoz P. Physiology of the Hypothalamic-Pituitary-Thyroid Axis. [Updated 2021 Apr 20]. In: Feingold KR, Ahmed SF, Anawalt B, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278958/
Miśkiewicz-Orczyk KA, Lisowska G, Kajdaniuk D, Wojtulek M. Can Hashimoto's thyroiditis cause vertigo? [Czy choroba Hashimoto może być przyczyną zawrotów głowy?]. Endokrynol Pol. 2020;70(1):76-86. doi: 10.5603/EP.a2019.0069. PMID: 32129465.
Nowak M, Marek B, Kos-Kudła B, Siemińska L, Londzin-Olesik M, Głogowska-Szeląg J, Nowak W, Kajdaniuk D. Optimization of the treatment of moderate to severe and active thyroid orbitopathy considering the recommendations of the European Group on Graves' Orbitopathy (EUGOGO) [Optymalizacja leczenia umiarkowanej do ciężkiej i aktywnej orbitopatii tarczycowej z uwzględnieniem zaleceń European Group on Graves' Orbitopathy (EUGOGO)]. Endokrynol Pol. 2022;73(4):756-777. English. doi: 10.5603/EP.a2022.0040. PMID: 36059167.
Patil N, Rehman A, Anastasopoulou C, Jialal I. Hypothyroidism. 2024 Feb 18. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 30137821.
Molewijk E, Fliers E, Dreijerink K, van Dooren A, Heerdink R. Quality of life, daily functioning, and symptoms in hypothyroid patients on thyroid replacement therapy: A Dutch survey. J Clin Transl Endocrinol. 2024 Feb 2;35:100330. doi: 10.1016/j.jcte.2024.100330. PMID: 38357535; PMCID: PMC10864335.
Lee SY, Pearce EN. Hyperthyroidism: A Review. JAMA. 2023 Oct 17;330(15):1472-1483. doi: 10.1001/jama.2023.19052. PMID: 37847271; PMCID: PMC10873132.
Bartalena L, Smith TJ. Treatment of Hyperthyroidism in Graves' Disease Complicated by Thyroid Eye Disease. J Clin Endocrinol Metab. 2025 Mar 17;110(4):922-930. doi: 10.1210/clinem/dgaf009. PMID: 39787151.
Mao G, Zhou C, Huang L, Mo Z, Su D, Gu S, Guo F, Wang Y, Chen Z, Zhang R, Lou X, Wang X, Hu J, Gu F, Dong B. Role of Iodine Status and Lifestyle Behaviors on Goiter among Children and Adolescents: A Cross-Sectional Study in Zhejiang Province, China. Nutrients. 2024 Aug 31;16(17):2910. doi: 10.3390/nu16172910. PMID: 39275226; PMCID: PMC11397286.
Tazaki R, Kobashi Y, Nakahata N, Asano M, Abe N, Ejiri H, Sato A, Nagamine N, Takahashi C, Yamaya Y, Iwadate M, Matsuzuka T, Suzuki S, Ohira T, Suzuki S, Furuya F, Shimura H, Suzuki S, Yokoya S, Yamashita S, Ohto H, Yasumura S. Potential implications of thyroid autoantibodies in children, adolescents, and young adults with thyroid nodules in Japan: The Fukushima Health Management Survey. Endocr J. 2024 Dec 2;71(12):1145-1155. doi: 10.1507/endocrj.EJ24-0293. Epub 2024 Sep 20. PMID: 39313370; PMCID: PMC11778349.
Baloch ZW, Asa SL, Barletta JA, Ghossein RA, Juhlin CC, Jung CK, LiVolsi VA, Papotti MG, Sobrinho-Simões M, Tallini G, Mete O. Overview of the 2022 WHO Classification of Thyroid Neoplasms. Endocr Pathol. 2022 Mar;33(1):27-63. doi: 10.1007/s12022-022-09707-3. Epub 2022 Mar 14. PMID: 35288841.
Jung CK, Bychkov A, Kakudo K. Update from the 2022 World Health Organization Classification of Thyroid Tumors: A Standardized Diagnostic Approach. Endocrinol Metab (Seoul). 2022 Oct;37(5):703-718. doi: 10.3803/EnM.2022.1553. Epub 2022 Oct 4. PMID: 36193717; PMCID: PMC9633223.
Todsen T, Bennedbaek FN, Kiss K, Hegedüs L. Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules. Head Neck. 2021 Mar;43(3):1009-1013. doi: 10.1002/hed.26598. Epub 2020 Dec 28. PMID: 33368812.
Grani, G., Sponziello, M., Filetti, S. et al. Thyroid nodules: diagnosis and management. Nat Rev Endocrinol 20, 715–728 (2024). https://doi.org/10.1038/s41574-024-01025-4
Kant R, Davis A, Verma V. Thyroid Nodules: Advances in Evaluation and Management. Am Fam Physician. 2020 Sep 1;102(5):298-304. PMID: 32866364.
Thomas J, Ledger GA, Haertling T. Effects of Ultrasound-Guided Laser Ablation Therapy on Symptomatic Benign Thyroid Nodules, Using EchoLaser - Results of a Pilot Study in the United States. Endocr Pract. 2023 Dec;29(12):942-947. doi: 10.1016/j.eprac.2023.08.015. Epub 2023 Sep 11. PMID: 37704167.
Ridouani F, Tuttle RM, Ghosn M, Li D, Wong RJ, Fagin JA, Monette S, Solomon SB, Camacho JC. Ultrasound-Guided Percutaneous Laser Ablation of the Thyroid Gland in a Swine Model: Comparison of Ablation Parameters and Ablation Zone Dimensions. Cardiovasc Intervent Radiol. 2021 Nov;44(11):1798-1806. doi: 10.1007/s00270-021-02915-0. Epub 2021 Jul 12. PMID: 34254175; PMCID: PMC9578502.
Malik I, Mitchell J, Thomas J. Efficacy of echolaser smart interface-guided laser ablation in volume reduction of symptomatic benign thyroid nodules. Front Endocrinol (Lausanne). 2024 Oct 9;15:1402522. doi: 10.3389/fendo.2024.1402522. PMID: 39444453; PMCID: PMC11496115.
Gambelunghe, G., Ristagno, S., Stefanetti, E., Avenia, N., & De Feo, P. (2022). Ultrasound-guided laser ablation of very large benign thyroid nodules: 4-year, retrospective follow-up in 24 patients. International Journal of Hyperthermia, 39(1), 217–221. https://doi.org/10.1080/02656736.2022.2025923
Min Y, Wang X, Chen H, Chen J, Xiang K, Yin G. Thermal Ablation for Papillary Thyroid Microcarcinoma: How Far We Have Come? Cancer Manag Res. 2020 Dec 24;12:13369-13379. doi: 10.2147/CMAR.S287473. PMID: 33380841; PMCID: PMC7769090.
Meneghetti I, Giardino D, Morganti R, Marino V, Menchini Fabris F, Bartoletti R, Pinzi N. A single-operator experience using EchoLaser SoracteLiteTM for focal laser ablation of prostate cancer: One more arrow in the quiver for the conservative management of the disease. Arch Ital Urol Androl. 2022 Dec 27;94(4):406-412. doi: 10.4081/aiua.2022.4.406. PMID: 36576471.
Appelbaum L, Goldberg SN, Ierace T, Mauri G, Solbiati L. US-guided laser treatment of parathyroid adenomas. Int J Hyperthermia. 2020;37(1):366-372. doi: 10.1080/02656736.2020.1750712. PMID: 32308070.
Deng M, Li SH, Guo RP. Recent Advances in Local Thermal Ablation Therapy for Hepatocellular Carcinoma. Am Surg. 2023 May;89(5):1966-1973. doi: 10.1177/00031348211054532. Epub 2021 Nov 8. PMID: 34743609.
Cocci A, Pezzoli M, Bianco F, Blefari F, Bove P, Cornud F, De Rienzo G, Destefanis P, Di Trapani D, Giacobbe A, Giovanessi L, Laganà A, Lughezzani G, Manenti G, Muto G, Patelli G, Pinzi N, Regusci S, Russo GI, Salamanca JIM, Salvi M, Silvestri L, Verweij F, Walser E, Bertolo RG, Iacovelli V, Bertaccini A, Marchiori D, Davila H, Ditonno P, Gontero P, Iapicca G, M De Reijke T, Ricapito V, Pellegrini P, Minervini A, Serni S, Sessa F. Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project. Asian J Urol. 2024 Apr;11(2):271-279. doi: 10.1016/j.ajur.2023.07.001. Epub 2023 Jul 11. PMID: 38680587; PMCID: PMC11053328.
Laganà A, Di Lascio G, Di Blasi A, Licari LC, Tufano A, Flammia RS, De Carolis A. Ultrasound-guided SoracteLite™ transperineal laser ablation (TPLA) of the prostate for the treatment of symptomatic benign prostatic hyperplasia (BPH): a prospective single-center experience. World J Urol. 2023 Apr;41(4):1157-1162. doi: 10.1007/s00345-023-04322-1. Epub 2023 Feb 28. PMID: 36853444; PMCID: PMC10160153.
van Kollenburg RAA, van Riel LAMJG, Oddens JR, de Reijke TM, van Leeuwen TG, de Bruin DM. Contrast-enhanced Ultrasound Imaging Following Transperineal Laser Ablation for Lower Urinary Tract Symptoms. Urology. 2024 Nov 26:S0090-4295(24)01089-6. doi: 10.1016/j.urology.2024.11.043. Epub ahead of print. PMID: 39603354.
Zhang YR, Fang LY, Yu C, Sun ZX, Huang Y, Chen J, Guo T, Xiang FX, Wang J, Lu CF, Yan TW, Lv Q, Xie MX. Laser-induced interstitial thermotherapy via a single-needle delivery system: Optimal conditions of ablation, pathological and ultrasonic changes. J Huazhong Univ Sci Technolog Med Sci. 2015 Aug;35(4):579-584. doi: 10.1007/s11596-015-1474-6. Epub 2015 Jul 31. PMID: 26223931.
Farmer W, Hannon G, Ghosh S, Prina-Mello A. Thermal ablation in pancreatic cancer: A scoping review of clinical studies. Front Oncol. 2022 Nov 29;12:1066990. doi: 10.3389/fonc.2022.1066990. PMID: 36524000; PMCID: PMC9745020.
Published
September 8, 2025
Copyright (c) 2025 Julia Strzelczyk, Natalia Cabak, Maja Butrym, Maciej Białek, Tomasz Głowniak
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
