Effective ablation therapy of adenomyosis with ultrasound‐guided high‐intensity focused ultrasound

Zhang, Xin; Li, Kequan; Xie, Bin; He, Miao; He, Jia; Zhang, Lian

doi:10.1016/j.ijgo.2013.08.022

Cited by 81 publications

(112 citation statements)

References 17 publications

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“…Class A adverse effects have included abdominal pain, mild sciatic/ buttock pain, genital bleeding/increased discharge, and a prolonged next period. 37 Zhang et al 33 reported a slightly increased frequency of abdominal pain (64% vs 71%) and skin reaction (0.8/2.4%) in patients with diffuse adenomyosis compared with those with focal disease.…”

Section: Safety/complicationsmentioning

confidence: 97%

“…Objective treatment success is demonstrated by a significant reduction in the uterine volume in several studies, with values from 12.7% to 54%. 36,37,41 The NPVR, where reported, ranges from 62.5% to 80.7% 33,35,36,39,41 (Table 1).…”

Section: Reduction Of Tissuementioning

confidence: 99%

“…The typical selection criteria require a patient to be 18 years and above, in premenopausal status, and to have symptomatic adenomyosis with an endometrial-myometrial junctional zone thickness of more than 3 cm for diffuse adenomyosis or a lesion diameter of 3-10 cm for focal adenomyosis. 33 Consideration needs to be given to the position of the adenomyotic lesion to ensure that the procedure can be performed safely. It has been noted that adenomyosis in the posterior wall of the uterus can coexist with severe pelvic endometriosis, with obliteration of the posterior culde-sac and utero-rectal adhesions, characterized on MRI by a "teardrop" deformity of the rectum.…”

Section: Criteria For Hifumentioning

confidence: 99%

“…To avoid bowel injury during treatment and minimize interference with treatment images, bowel loops in the acoustic pathway are pushed away or compressed by placing a degassed water balloon over the abdominal wall of the patient, or a urinary catheter is inserted. 33,35,36 Skin preparation including degassing and degreasing are performed immediately before treatment to reduce the risk of skin burns. 35 Some centers use sedation with fentanyl, midazolam, and/or propofol for the procedure.…”

Section: Preparation For Hifumentioning

confidence: 99%

“…[36][37][38][39][40] More recently, the focus has moved to examine the level of reduction of symptoms in treated patients. 33,35,41 Treatment adjuncts have also been explored in an attempt to further enhance clinical effectiveness and improve efficiency. 42 As the therapeutic technique is the same for both MR-guided and US-guided HIFU, studies using both guidance methods have been included in this review.…”

Section: Studiesmentioning

confidence: 99%

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MR-guided focused ultrasound for the treatment of adenomyosis: current insights

Chin¹,

Walbridge²,

Quinn³

2015

RRFU

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Adenomyosis is a benign gynecological condition causing significant morbidity among women of reproductive age. The available treatments are currently limited in number and efficacy. While hysterectomy is curative, it is unacceptable to many women, particularly those wishing to conserve their fertility. Magnetic resonance-guided focused ultrasound surgery is a noninvasive treatment method that has been used to effectively treat uterine leiomyomata, but until recently has not been routinely used to treat adenomyosis. This review summarizes the current understanding of adenomyosis and high-intensity focused ultrasound, and the recent research into the safety and efficacy of this technique.

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Section: Safety/complicationsmentioning

confidence: 97%

Section: Reduction Of Tissuementioning

confidence: 99%

Section: Criteria For Hifumentioning

confidence: 99%

Section: Preparation For Hifumentioning

confidence: 99%

Section: Studiesmentioning

confidence: 99%

See 3 more Smart Citations

MR-guided focused ultrasound for the treatment of adenomyosis: current insights

Chin¹,

Walbridge²,

Quinn³

2015

RRFU

View full text Add to dashboard Cite

show abstract

Magnetic resonance imaging T2WI hyperintense foci number and the prognosis of adenomyosis after high‐intensity focused ultrasound treatment

Wang

et al. 2021

Intl J Gynecology & Obste

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Objective To investigate the relationship between the number of hyperintense foci of T2‐weighted imaging (T2WI) and the efficacy of high‐intensity focused ultrasound (HIFU) in the treatment of adenomyosis. Methods This prospective cohort study enrolled 102 patients with adenomyosis. Participants were classified into two groups: 50 patients in whom the number of hyperintense foci on magnetic resonance imaging (MRI) T2WI was more than five were placed in the >5 group and 52 patients in whom the number of hyperintense foci on MRI T2WI was five or fewer were placed in the ≤5 group. Uterine fibroid symptoms (UFS) and visual analog scale (VAS) scores were recorded as indicators for the course of adenomyosis treatment. Results Among the enrolled patients, 84 received HIFU treatment and were followed up. At 6, 12, 24, and 36 months after HIFU treatment, the UFS score of women in the >5 group was higher than that of the patients in the ≤5 group (P < 0.05). The ablation rate of MRI T2WI in the hyperintense foci ≤5 group was higher than the hyperintense foci >5 group (P < 0.05). Conclusion Number of MRI T2WI hyperintense foci is a factor affecting the ablation rate and the clinical efficacy of HIFU treatment in women with adenomyosis. It is likely to be a predictor of the efficacy of HIFU in adenomyosis treatment.

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High‐intensity focused ultrasound compared with uterine artery chemoembolization with methotrexate for the management of cesarean scar pregnancy

Wang

Chen

Yang

et al. 2021

Intl J Gynecology & Obste

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Objective To compare the effectiveness and safety of high‐intensity focused ultrasound (HIFU) versus uterine artery chemoembolization with methotrexate for the management of cesarean scar pregnancy (CSP). Methods A total of 170 women with CSP were enrolled in the retrospective cohort study from April 2016 to September 2020. One hundred women received HIFU followed by suction curettage, and 70 women were treated with uterine artery chemoembolization followed by suction curettage. Results The median blood loss during suction curettage was 20 ml (range 2–800 ml) in the HIFU group versus 20 ml (range 5–200 ml) in the chemoembolization group (P = 0.837). The mean time for β‐human chorionic gonadotropin normalization was 28.52 ± 10.82 days versus 26.69 ± 8.97 days (P = 0.246), respectively. The mean time of menstruation recovery was 34.36 ± 10.63 days versus 31.93 ± 8.53 days (P = 0.114), respectively. The incidence of adverse effects in the HIFU group was lower than that in the chemoembolization group (P = 0.028). The median hospitalization time in the HIFU group was longer than that in the chemoembolization group (P = 0.000). Conclusion HIFU was as effective and safe as uterine artery chemoembolization in the management of CSP, and the incidence of adverse effects was lower.

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Effective ablation therapy of adenomyosis with ultrasound‐guided high‐intensity focused ultrasound

Abstract: Ultrasound-guided HIFU was found to be an effective technique for treating both focal and diffuse adenomyotic lesions to alleviate the symptoms of menorrhagia or dysmenorrhea.

Cited by 81 publications

References 17 publications

MR-guided focused ultrasound for the treatment of adenomyosis: current insights

MR-guided focused ultrasound for the treatment of adenomyosis: current insights

Magnetic resonance imaging T2WI hyperintense foci number and the prognosis of adenomyosis after high‐intensity focused ultrasound treatment

High‐intensity focused ultrasound compared with uterine artery chemoembolization with methotrexate for the management of cesarean scar pregnancy

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