Efficacy and safety of transvaginal high-intensity focused ultrasound therapy in women with symptomatic uterine leiomyomas: A clinical trial

Lee, Jae Young; Kim, Kidong; Hwang, Sung Il; Lee, Maria; Son, Keonho; Kim, Daeseung; Kim, Sun; Kim, Yong Beom

doi:10.1016/j.ejogrb.2020.11.049

Cited by 8 publications

(5 citation statements)

References 10 publications

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“…Currently, there are two modalities to guide HIFU treatment: MRI and ultrasound which may be integrated with HIFU. Ultrasound imaging is currently the most prominent in this application because of its ease of use, cost-effectiveness, and easy accessibility to the uterine lesions like the adenomyosis or adenomyoma 1 – 5 , 7 , 26 – 28 . Ultrasound-guided HIFU has also been used in other benign and malignant cancers like symptomatic benign thyroid nodules, colorectal cancer liver metastasis, prostate cancer, advanced cervical cancer, advanced pancreatic cancer, desmoid tumors, and breast cancer 29 – 37 .…”

Section: Discussionmentioning

confidence: 99%

“…In comparison with other minimally-invasive approaches of treatment like UAE and radiofrequency ablation, HIFU treatment has decreased rates of vascular adverse events and relevant complications 4 , 5 , 7 , 10 , 18 , 26 – 28 . UAE may have impaired ovarian blood flow causing subsequently ovarian failure and infection leading to subsequent fallopian tube damage and fertility besides other complications like vaginal discharge, fever, and post-embolization syndrome 49 .…”

Section: Discussionmentioning

confidence: 99%

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Effects of high-intensity focused ultrasound combined with levonorgestrel-releasing intrauterine system on patients with adenomyosis

Cai

Sun

et al. 2023

Sci Rep

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It is very important to treat adenomyosis which may cause infertility, menorrhagia, and dysmenorrhea for women at the reproductive age. High-intensity focused ultrasound (HIFU) is effective in destroying target tumor tissues without damaging the path of the ultrasound beam and surrounding normal tissues. The levonorgestrel-releasing intrauterine system (LN-IUS) is a medical system which is inserted into the uterine to provide medicinal treatment for temporary control of the symptoms caused by adenomyosis. This study was to investigate the effect of HIFU combined with the LN-IUS on adenomyosis. In the HIFU treatment, the parameters of the ultrasound were transmission frequency 0.8 MHz and input power 50–400 W (350 ± 30), and the temperature in the target tissue under these conditions would reach 60–100 °C (85 °C ± 6.3 °C). Size reduction and blood flow signal decrease were used to assess the effect of combined treatment. In this study, 131 patients with adenomyosis treated with HIFU combined with LN-IUS were retrospectively enrolled. The clinical and follow-up data were analyzed. After treatment, the volume of the uterine lesion was significantly decreased with an effective rate of 72.1%, and the adenomyosis blood flow signals were significantly reduced, with an effective rate of 71.3%. At six months, the menstrual cycle was significantly (P < 0.05) decreased from 31.4 ± 3.5 days before treatment to 28.6 ± 1.9 days, the menstrual period was significantly shortened from 7.9 ± 1.2 days before HIFU to 6.5 ± 1.3 days, and the menstrual volume was significantly (P < 0.05) decreased from 100 to 49% ± 13%. The serum hemoglobin significantly (P < 0.05) increased from 90.8 ± 6.2 g/L before treatment to 121.6 ± 10.8 g/L at six months for patients with anemia. Among seventy-two (92.3%) patients who finished the six-month follow-up, sixty-five (90.3%) patients had the dysmenorrhea completely relieved, and the other seven (9.7%) patients had only slight dysmenorrhea which did not affect their daily life. Adverse events occurred in 24 (18.3%) patients without causing severe consequences, including skin burns in two (1.5%) patients, skin swelling in four (3.1%), mild lower abdominal pain and low fever in 15 (11.5%), and subcutaneous induration in three (2.3%). Six months after treatment, no other serious side effects occurred in any patients with follow-up. In conclusions, the use of high-intensity focused ultrasound combined with the levonorgestrel-releasing intrauterine system for the treatment of adenomyosis is safe and effective even though the long-term effect remains to be confirmed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of high-intensity focused ultrasound combined with levonorgestrel-releasing intrauterine system on patients with adenomyosis

Cai

Sun

et al. 2023

Sci Rep

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“…In recent years, as a type of minimally invasive treatment, ultrasound-guided percutaneous anhydrous ethanol injection has been used to treat uterine leiomyomas (19,20). Its mechanism of action involves the anhydrous ethanol embolization of leiomyoma blood vessels, and it directly causes tissue protein coagulation in the tumor, thus resulting in leiomyoma coagulative necrosis.…”

Section: Effects Of Ultrasound-guided Percutaneous Anhydrous Ethanol ...mentioning

confidence: 99%

The safety and efficacy of add-on use of oxytocin in uterine leiomyoma patients undergoing high-intensity focused ultrasound and ultrasound-guided intratumoral ethanol injection: a randomized controlled trial

Zhang¹,

Zhang²,

Zhou³

et al. 2022

Ann Palliat Med

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Background: Uterine leiomyoma is one of the most common benign tumors in females. High-intensity focused ultrasound (HIFU) has been widely used in the therapy of uterine leiomyomas. However, HIFU method has a prolonged duration of operation and poor patient tolerance, which need improvement. This study sought to explore the efficacy and safety of add-on use of oxytocin in uterine leiomyomas patients who received HIFU and ultrasound-guided percutaneous anhydrous ethanol injection.Methods: This is a randomized controlled trial. A total of 60 patients with uterine leiomyomas were included and randomly divided into study group and control group. The patients in the control group were treated with HIFU and ultrasound-guided percutaneous anhydrous ethanol injection, while the study group received oxytocin injection in addition to the treatment measures of the control group. The efficacy and safety of the treatments were assessed by using the volume ablation rate of the tumor and the Society of Interventional Radiology (SIR) Practice Guidelines, respectively.Results: Finally, all of the 60 patients (30 in the study group and 30 in the control group) completed the treatments. There were no statistically significant differences between the 2 groups in terms of leiomyoma volume ablation rate (94.48%±2.07% vs. 94.91%±2.53%, P=0.36), crumb gray time (150.70±57.51 vs.

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“…The coagulated necrotic tissue can be metabolized by the body and gradually absorbed or scarred. This new technique for the local treatment of tumors, also known as thermal "excision", is mainly applicable to the treatment of malignant and benign solid tumors of tissues and organs [2].…”

Section: Introductionmentioning

confidence: 99%

Study on the application value of high intensity focused ultrasound in the treatment of gynecological diseases

Li¹

2023

J Clin Images Med Case Rep

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Efficacy and safety of transvaginal high-intensity focused ultrasound therapy in women with symptomatic uterine leiomyomas: A clinical trial

Cited by 8 publications

References 10 publications

Effects of high-intensity focused ultrasound combined with levonorgestrel-releasing intrauterine system on patients with adenomyosis

Effects of high-intensity focused ultrasound combined with levonorgestrel-releasing intrauterine system on patients with adenomyosis

The safety and efficacy of add-on use of oxytocin in uterine leiomyoma patients undergoing high-intensity focused ultrasound and ultrasound-guided intratumoral ethanol injection: a randomized controlled trial

Study on the application value of high intensity focused ultrasound in the treatment of gynecological diseases

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