International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group最新文献

{"title":"Integrating temperature-dependent tissue properties into focused ultrasound computational models for enhanced treatment planning.","authors":"Christian Valencia Narva, Allison Payne, Christopher R Dillon","doi":"10.1080/02656736.2025.2606701","DOIUrl":"10.1080/02656736.2025.2606701","url":null,"abstract":"<p><strong>Objective: </strong>Focused ultrasound (FUS) is a noninvasive therapy that can ablate tissues with precision. Computational simulations using the Pennes Bioheat Transfer Equation (PBTE) can aid FUS treatments by predicting temperature distributions. However, traditional models assume constant thermal and acoustic properties, potentially oversimplifying tissue behavior during treatments.</p><p><strong>Methods: </strong>This study integrates temperature-dependent thermal properties (thermal conductivity, specific heat capacity, and perfusion) into finite-difference time-domain FUS simulations. Three scenarios were simulated: (1) homogeneous liver with both high- and low-power sonications, (2) rabbit thigh muscle validated against preclinical magnetic resonance temperature imaging (MRTI), and (3) an extended simulation of the rabbit thigh with temperature-dependent acoustic properties. Comparisons were made against models using constant-properties collected at 25 °C, 20 °C, and/or 37 °C.</p><p><strong>Results: </strong>For high-power liver sonications, temperature-dependent properties increased necrosis (tissue volume exceeding 240 CEM43) by 17.6% and 13% compared to constant-property models at 25 °C and 37 °C, respectively. Low-power sonications had 17-20% lower temperature rises with temperature-dependent properties. In rabbit muscle, temperature-dependent models showed up to 18% difference in necrosis volume, with temperature curves following the trends observed in MRTI. Incorporating temperature-dependent acoustic properties increased the predicted necrosis volume by up to 30%. Updating thermal properties every 2.5 s maintained accuracy (<1% difference in peak temperature) while reducing computational cost by 70%.</p><p><strong>Conclusion: </strong>For FUS simulations involving perfusion shutdown in highly perfused tissues (high-power ablations) or involving hyperemia (low-power hyperthermia), incorporating temperature-dependent properties substantially impacts temperature profiles and necrosis predictions. Properties need not be updated every time step to balance simulation accuracy and computational efficiency.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2606701"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction of a nomogram predictive model for thermal ablation efficacy in benign thyroid nodules based on multimodal ultrasound and serological markers.","authors":"Mengyao Zhao, Zeyang Dong, Jie Chen, Yuke Zhao, Xixi Sun, Bin Huang, Nan Cao","doi":"10.1080/02656736.2026.2658732","DOIUrl":"10.1080/02656736.2026.2658732","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop a nomogram for predicting the 1-year volume reduction ratio (VRR) of the ablated area after thermal ablation of benign thyroid nodules (BTN) based on preoperative clinical, ultrasound, and serological features, and to explore the role of the ablation volume ratio (AVR).</p><p><strong>Methods: </strong>This retrospective study included 243 BTN patients who underwent ultrasound-guided radiofrequency or microwave ablation between January 2020 and December 2024. Clinical, ultrasound, serological, and procedural data were collected. Contrast-enhanced ultrasound was performed immediately after ablation to assess the ablation zone and calculate AVR. Patients were followed at 1, 3, 6, and 12 months and classified as favorable (VRR ≥80%) or unfavorable. The cohort was randomly divided into training (70%) and validation (30%) sets. Logistic regression identified independent predictors, and a nomogram was constructed and evaluated using ROC, calibration, and decision curve analyses.</p><p><strong>Results: </strong>Among 243 patients, 142 (58.4%) achieved VRR ≥80%. Significant differences were observed in BMI, nodule size, vascularity, morphology, FT3 level, and location within the dangerous triangle (all <i>p</i> < 0.05). AVR was higher in the favorable group but was not an independent predictor. Multivariate analysis identified BMI, maximum diameter, FT3, morphology, vascularity, and dangerous triangle location as independent predictors. The model showed good performance (AUC 0.904 training, 0.815 validation).</p><p><strong>Conclusion: </strong>A nomogram based on preoperative factors provides a noninvasive tool for predicting 1-year outcomes after BTN ablation. AVR reflects procedural adequacy but has limited prognostic value. Further multicenter validation is needed.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2658732"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated subcutaneous fat segmentation with a convolutional neural network in magnetic resonance guided high-intensity focused ultrasound treatment for uterine fibroids.","authors":"Chenchen Bing, Anna Laaksonen, Kirsi Joronen, Gaber Komar, Teija Sainio, Roberto Blanco Sequeiros, Ari Partanen, Simon Köttgen","doi":"10.1080/02656736.2026.2634734","DOIUrl":"10.1080/02656736.2026.2634734","url":null,"abstract":"<p><strong>Introduction: </strong>In MR-guided high-intensity focused ultrasound (MR-HIFU) treatment for uterine fibroids, the subcutaneous abdominal fat layer is prone to unwanted heating, especially during consecutive sonications. Automating its delineation with a deep learning algorithm would enhance treatment safety, efficiency and simplify clinical workflow.</p><p><strong>Materials and methods: </strong>The subcutaneous fat layer was manually segmented on MR images from 62 patients treated with MR-HIFU. An attention gated U-Net convolutional neural network (CNN) was trained and validated using the Dice coefficient (DC). Model performance was tested using the DC and 95th percentile Hausdorff distance (HD95). The clinically relevant accuracy was assessed by the average fat layer thickness. The model's transferability was determined on data prepared by a second reader and compared to the interobserver variability.</p><p><strong>Results: </strong>The model achieved a DC of 0.972 (IQR: 0.951-0.983), and an HD95 of 1.1 (IQR: 0.8-3.2) mm on the held-out test dataset. The mean absolute thickness error between ground truth and the model's prediction was 0.8 ± 0.8 mm for the test dataset, and was 0.7-0.8 mm on the two patients prepared by the secondary reader. The automated segmentation algorithm successfully reduced the segmentation time from 3 min to 3 s.</p><p><strong>Conclusion: </strong>We established an automatic segmentation algorithm based on an attention-gated U-Net architecture to delineate the abdominal fat layer in MR images of uterine fibroids patients. The model achieved high accuracy, robustly handling both thin and thick fat layers, and performed reliable on data prepared by a second reader.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2634734"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147314494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal MRI radiomics for predicting HIFU ablation efficacy in uterine fibroids: a machine learning study.","authors":"Xue Zhou, Yaxuan Qiu, Ying Chen, Meijie Yang, Jinyun Chen","doi":"10.1080/02656736.2026.2642916","DOIUrl":"10.1080/02656736.2026.2642916","url":null,"abstract":"<p><strong>Objective: </strong>To explore the predictive value of machine learning-based multimodal MRI radiomics combined with clinical features in the efficacy of high-intensity focused ultrasound (HIFU) ablation of uterine fibroids.</p><p><strong>Methods: </strong>This study included 390 patients with uterine fibroids who underwent HIFU ablation. Patients were stratified into high and low ablation groups based on an 80% non-perfused volume ratio (NPVR) and randomly divided into training (70%) and test (30%) sets. Radiomics features were extracted from T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), and diffusion-weighted imaging (DWI). The most predictive features were selected via Recursive Feature Elimination (RFE) and the Least Absolute Shrinkage and Selection Operator (LASSO), and combined with clinical characteristics. Logistic Regression (LR), Random Forest (RF) and eXtreme Gradient Boosting (XGBoost), were constructed to predict ablation efficacy, with performance assessed using the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>The results indicated that age, uterine fibroid location, and T2WI signal intensity were independent predictive factors (<i>p</i> < 0.05). The multimodal-clinical fusion XGBoost model exhibited the optimal performance. In the test set, this model achieved an AUC of 0.894, with an accuracy of 82.1%, sensitivity of 88.9%, and specificity of 74.1%.The calibration curve and decision curve analysis (DCA) confirmed that the predicted probabilities of the model were highly consistent with the actual risks, and stable clinical net benefits were achieved.</p><p><strong>Conclusion: </strong>The XGBoost model based on multimodal MRI and clinical features may serve as a reference for predicting HIFU ablation efficacy and optimizing treatment strategies.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2642916"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological evaluation of papillary thyroid carcinoma following thermal ablation.","authors":"Hanxiao Zhao, Yun Niu, Meng Yang, Lili Peng, Yan Li, Ming-An Yu","doi":"10.1080/02656736.2026.2645762","DOIUrl":"10.1080/02656736.2026.2645762","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize histopathological changes in surgically resected papillary thyroid carcinoma (PTC) following thermal ablation (TA), including residual tumor patterns with cellular viability assessment, peritissue adhesion, and temporal evolution of ablation zones.</p><p><strong>Methods: </strong>This retrospective study included 15 patients with 19 cytologically confirmed PTC lesions who underwent surgical resection following TA between January 2016 and July 2025 due to confirmed or suspected lymph node metastasis, new PTC, failed TA, or patient anxiety. Specimens were processed for hematoxylin and eosin staining. For residual tumor areas exhibiting sublethal thermal injury, CD34 and Ki67 immunohistochemistry were performed to evaluate microvessel density and proliferative activity.</p><p><strong>Results: </strong>Complete ablation was achieved in 12/19 tumors (63.2%); 7 (36.8%) had residual disease with two patterns: central residuals (<i>n</i> = 5) exhibiting sublethal thermal injury with heterogeneous CD34/Ki67 expression (2 cases showed functional inactivation while 3 retained proliferative potential), and peripheral residuals (<i>n</i> = 2) from insufficient ablation margins. Among 13 capsule-adjacent tumors (≤2 mm), 6 (46.2%) developed adhesions, including 4 with thermal muscle injury and 2 with mild fibrous adhesion. Ablation zones evolved temporally: three-layer structure with inflammation (0-3 months), chronic inflammation with progressive fibrosis (4-12 months), and mature scar (>12 months).</p><p><strong>Conclusion: </strong>This study characterized histopathological changes following TA for PTC, revealing two residual tumor patterns with distinct biological viability, a predictable evolution of ablation zones, and a close association between peritissue adhesion and thermal field management. Rigorous operator training and standardized protocols are essential for optimizing treatment efficacy and advancing the application of TA in PTC management.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2645762"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Boiling-induced susceptibility artifact correction for clinical 3D PRFS thermometry in hepatic microwave ablation.","authors":"Dominik Horstmann, Othmar Belker, Daniel Düx, Moritz Gutt, Simon Schröer, Frank Wacker, Marcel Gutberlet, Bennet Hensen","doi":"10.1080/02656736.2026.2661103","DOIUrl":"10.1080/02656736.2026.2661103","url":null,"abstract":"<p><strong>Introduction: </strong>Boiling-induced susceptibility artifacts substantially degrade Proton Resonance Frequency Shift (PRFS) thermometry during hepatic microwave ablation (MWA), leading to systematic temperature errors and biased ablation-zone prediction. Existing volumetric correction approaches assume temporally static artifacts. To address this limitation, this study introduces a dynamic, frame-wise susceptibility correction for clinical 3D thermometry.</p><p><strong>Methods: </strong>In 10 patients (12 hepatic lesions) undergoing MRI-guided MWA at 1.5 T, fully reconstructed 3D PRFS temperature maps were retrospectively corrected. For each time frame, the expected thermal evolution was predicted by propagating the previously corrected temperature map using a calibrated Pennes' bioheat simulation; the residual between this prediction and the measured temperature was attributed to susceptibility artifacts. A dynamic bubble-support mask constrained Tikhonov inversion of the susceptibility distribution, followed by dipole-based synthesis and subtraction of the resulting temperature offset, was used to obtain a corrected temperature map. Thermometry-derived ablation zones (CEM43 ≥ 240min) were compared with post-contrast reference segmentations using Dice score (DS), sensitivity, precision, and mean surface distance (MSD) across complementary spatial evaluation regimes.</p><p><strong>Results: </strong>Susceptibility correction significantly improved volumetric ablation-zone agreement, with gains across all 3D metrics (ΔDS 6.2 ± 3.3%, Δsensitivity 3.3 ± 3.4%, Δprecision 8.0 ± 4.9%, ΔMSD -0.8 ± 0.6 mm). Effects were smaller in central ablation regions primarily affected by susceptibility-related temperature overestimation, whereas the largest improvements were observed in more peripheral regions dominated by temperature underestimation. Processing time per frame was 1.26 ± 0.12s.</p><p><strong>Conclusion: </strong>Dynamic, frame-wise susceptibility correction substantially improves the accuracy of clinical 3D PRFS thermometry during hepatic microwave ablation. Future work should focus on seamless integration into fully real-time clinical thermometry workflows.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2661103"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Device-specific spatio-temporal drifts in proton resonance frequency shift thermometry at 3 T.","authors":"Johannes Lindemeyer, Stefanie Berger, Mona Ayary, Rüdiger Stirnberg, Sascha Brunheim, Timm Wetzel, Holger Grüll","doi":"10.1080/02656736.2026.2718983","DOIUrl":"https://doi.org/10.1080/02656736.2026.2718983","url":null,"abstract":"<p><strong>Purpose: </strong>Magnetic resonance imaging is the modality of choice for noninvasive temperature mapping to monitor and also to control hyperthermia. Temperature rise is observed through the proton resonance frequency shift (PRFS) reflecting in the phase of gradient echo acquisitions. Temporal and spatial magnetic field drift, generated under intense gradient use affects the phase and induces strong temperature misinterpretations. This work investigates the impact of hardware and imaging sequence on long-term temperature monitoring accuracy.</p><p><strong>Methods: </strong>The behavior of field drift was recorded over time using image-based field mapping. Measurements were performed on a custom agar phantom with different imaging protocols and MRI scanners.</p><p><strong>Results: </strong>The spatio-temporal evolution of drift varies with MRI device, vendor, and site and can exceed 10² °C. Strongest changes of center frequency and spatial inhomogeneity arise over up to 70 min of high gradient intensity. Saturation is not reached even after almost 2 h. Observed field distortions could be associated with the employed gradient groups. Drift was even observed under minimal gradient use. Drift patterns were reproducible using the same device and sequence configuration and could successfully be modeled by multidimensional polynomials.</p><p><strong>Discussion: </strong>Spatio-temporal drift characterization is important for PRFS thermometry. It can be used to define 'warm up' phases for MRI scanners, after which further drift effects are reduced. A priori knowledge on the spatio-temporal drift evolution could also be applied to correct for background fields instead of blind fitting. These findings may pave new pathways to increase temperature mapping accuracy for various thermal intervention techniques.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2718983"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryoablation versus radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis.","authors":"Kui Mao, Youqing Wang, Weijun Yao, Junjun Ding, Zi Ye, Yangtian Ye, Rui Zhu","doi":"10.1080/02656736.2026.2713200","DOIUrl":"10.1080/02656736.2026.2713200","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review and meta-analysis was conducted to comprehensively examine the clinical effectiveness and safety of cryoablation (CA) versus radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>Relevant studies published up to September 2025 were identified in PubMed, Wanfang, Embase, Cochrane Library, and Web of Science. Eligible data were extracted and quantitatively synthesized.</p><p><strong>Results: </strong>A total of 7 studies were analyzed. In these, 544 individuals underwent CA, while 925 individuals received RFA. Compared with RFA, CA was associated with a significantly higher pooled initial complete ablation rate (<i>p</i> = 0.04) and a significantly lower incidence of intraoperative pain (<i>p</i> = 0.02). The CA and RFA groups were comparable in terms of progression-free survival (PFS) duration (<i>p</i> = 0.37), 1-year PFS (<i>p</i> = 0.11), 5-year PFS (<i>p</i> = 0.12), overall survival (OS) duration (<i>p</i> = 0.24), 1-year OS (<i>p</i> = 0.90), 5-year OS (<i>p</i> = 0.58), overall complications (<i>p</i> = 0.94), or major complications (<i>p</i> = 0.59). Substantial heterogeneity was detected for PFS duration (I² = 92%), 5-year PFS (I² = 59%), OS duration (I² = 89%), and intraoperative pain (I² = 58%). Funnel plot analyses indicated an absence of publication bias in terms of outcomes.</p><p><strong>Conclusions: </strong>Compared with RFA, CA may offer advantages in achieving higher initial complete tumor ablation and improved intraoperative patient comfort in HCC treatment. However, CA did not increase the PFS and OS when compared to RFA. The safety profiles appear comparable between the two techniques.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2713200"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of neoadjuvant androgen deprivation therapy on prostate and tumor morphology prior to MRI-guided transurethral ultrasound ablation of prostate cancer.","authors":"Ilari Virtanen, Pietari Mäkelä, Teija Sainio, Mikael Högerman, Pertti Nurminen, Otto Ettala, Mikael Anttinen","doi":"10.1080/02656736.2026.2716351","DOIUrl":"10.1080/02656736.2026.2716351","url":null,"abstract":"<p><strong>Background: </strong>Thermal ablation is a minimally invasive treatment for localized prostate cancer (PCa). MRI-guided transurethral ultrasound ablation (TULSA) enables precise, temperature-controlled therapy, but its 3 cm ablation radius may limit coverage in large prostates or capsule-adjacent tumors. Neoadjuvant androgen deprivation therapy (nADT) may improve treatment feasibility by reducing prostate and tumor size.</p><p><strong>Methods: </strong>In this prospective, single-arm pilot study (NCT05917860), 15 treatment-naïve patients with organ-confined, intermediate-risk ISUP 2-3 PCa and at least one biopsy-concordant PI-RADS ≥ 3 lesion received 3-month nADT with degarelix before whole-gland TULSA. Multiparametric MRI was performed at baseline and monthly thereafter to assess prostate and lesion volumes, tumor-capsule relationship, and urethra-capsule distance.</p><p><strong>Results: </strong>All patients completed nADT. Across 27 PI-RADS ≥ 3 lesions, four patients had unifocal disease, and 11 had multifocal disease (2-3 lesions). Twenty lesions were ISUP Grade Group 2 and three were Grade Group 3. PSA declined by 87% (-7.6 ng/mL; 95% CI. -9.7 to -5.7; <i>p</i> < 0.001), and all patients achieved castrate testosterone levels. Prostate volume decreased by 26% (-15 mL; 95% CI. -20 to -12; <i>p</i> < 0.001), index lesion volume by 69% (-0.8 mL; 95% CI. -1.2 to -0.5; <i>p</i> < 0.001), and index-lesion capsule contact length by 40% (-5 mm; 95% CI. -7 to -4; <i>p</i> < 0.001). Capsule bulging resolved in four of seven patients, and urethra-capsule distance decreased to ≤ 30 mm in all six patients with a baseline distance > 30 mm.</p><p><strong>Conclusion: </strong>Short-term nADT with degarelix was associated with significant changes in prostate and tumor morphology. Future studies should determine whether these changes improve TULSA outcomes.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2716351"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy and thyroid function effects of non-surgical treatments for benign thyroid nodules: a Bayesian network meta-analysis.","authors":"Heng Weng, Dejian Meng, Gang Liu","doi":"10.1080/02656736.2026.2713764","DOIUrl":"10.1080/02656736.2026.2713764","url":null,"abstract":"<p><strong>Objective: </strong>Non-surgical treatments for benign thyroid nodules (BTN) have shown variable effects across different outcome domains, but randomized comparative evidence remains fragmented, particularly regarding both structural efficacy and thyroid function effects. This study aimed to compare available non-surgical interventions for nodule volume and thyroid function parameters using a Bayesian network meta-analysis.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and Cochrane Library were searched through August 17, 2025. RCTs evaluating levothyroxine (L-T4), radiofrequency ablation (RFA), microwave ablation (MWA), percutaneous ethanol injection (PEI), or percutaneous laser ablation (PLA) in adults with BTN were included. Outcomes were nodule volume, TSH, FT3, and FT4. Bayesian random-effects network meta-analysis used R Studio (gemtc) and STATA; rankings employed SUCRA.</p><p><strong>Results: </strong>Fourteen RCTs (545 participants) were included. For nodule volume, PLA (WMD≈-5.23, 95% CI: -8.26 to -2.15) and RFA (WMD≈-4.11, 95% CI: -6.19 to -2.38) were superior to L-T4 and placebo. L-T4 showed strongest TSH suppression (vs. MWA: WMD≈-1.59, 95% CI: -2.42 to -0.79). No significant differences were observed for FT3 or FT4.</p><p><strong>Conclusions: </strong>Within the available randomized evidence base, non-surgical treatments for BTN showed outcome-specific differences. Thermal ablation techniques, particularly PLA and RFA, were associated with greater reductions in nodule volume, whereas levothyroxine showed the strongest effect on TSH suppression. However, because the network was largely built on historical comparators and did not include several key patient-centered clinical outcomes, the applicability of these findings to current practice remains limited. Further head-to-head trials comparing contemporary minimally invasive treatments are needed.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2713764"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}