Evaluation of high‐intensity focused ultrasound ablation for uterine fibroids: an <scp>IDEAL</scp> prospective exploration study

Chen, J; Li, Y; Wang, Z; McCulloch, Peter; Hu, Liang; Chen, W; Liu, G; Li, J; Lang, Jinghe

doi:10.1111/1471-0528.14689

Cited by 116 publications

(139 citation statements)

References 23 publications

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“…During myomectomy, the continuity of the normal myometrium was interrupted, and the formation of myometrial scars, which were strained and thinner than the normal myometrium, may exert a negative effect on uterine contractions and increase the risk of uterine rupture during pregnancy and labor [26,27]. HIFU ablation treatment for uterine fibroids is a noninvasive tissue ablation technique with similar efficacy, faster recovery, and fewer complications compared to myomectomy [14,28]. During treatment, an ultrasound probe is used to provide real-time imaging of the patient's anatomy surrounding the uterus and to monitor the thermal effect of the ablation on the targeted fibroids.…”

Section: Pregnancymentioning

confidence: 99%

“…High-intensity focused ultrasound (HIFU) ablation is a noninvasive technique for the treatment of solid tumors and has been shown in previous studies to be safe and effective for symptomatic uterine fibroids [8][9][10][11][12][13][14]. Because of its unknown effect on future fertility, initial trials of HIFU ablation treatment for uterine fibroids were restricted to patients with no desire for future fertility.…”

Section: Introductionmentioning

confidence: 99%

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Vaginal delivery outcomes of pregnancies following ultrasound-guided high-intensity focused ultrasound ablation treatment for uterine fibroids

Liu

Xue

Wang

et al. 2018

International Journal of Hyperthermia

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Objective: To evaluate the feasibility and safety of vaginal delivery after ultrasound-guided high-intensity focused ultrasound (HIFU) ablation treatment for women with uterine fibroids of childbearing ages. Methods: A prospective study was conducted on women who underwent ultrasound-guided HIFU therapy for uterine fibroids at the Chinese PLA General Hospital from January 2008 to December 2014. Patients were interviewed yearly to assess their fertility outcomes, including conception method, delivery mode, neonatal outcomes and complications during pregnancy, labor, and delivery. Results: A total of 174 patients with plans for future pregnancy were included, and 88 pregnancies in 81 women occurred. The pregnancy rate was 46.6% (81/174), and the median follow-up time was 76 months. The rate of pregnancies that ended in miscarriages was 10% (9/88), the rate of elective pregnancy termination was 6% (5/88), and 84% (74/88) of the pregnancies resulted in deliveries, with 3 of the 71 women having two deliveries. A cesarean section was requested by 50% (37/74) of the women, and 50% (37/74) opted for a vaginal delivery. Eleven of the 37 pregnancies were scheduled for elective cesarean sections, owing to pregnancy complications; the remaining 26 pregnancies were scheduled for vaginal delivery, and 21 (80.8%) were successful. None of the patients with a vaginal delivery experienced any complications during pregnancy and labor. Conclusions: Ultrasound-guided HIFU ablation could be considered a promising clinical treatment for women with uterine fibroids and plans for future pregnancy, and vaginal delivery after ultrasoundguided HIFU ablation treatment appear to be feasible and safe.

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Section: Pregnancymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vaginal delivery outcomes of pregnancies following ultrasound-guided high-intensity focused ultrasound ablation treatment for uterine fibroids

Liu

Xue

Wang

et al. 2018

International Journal of Hyperthermia

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“…As reported by the authors, major adverse events occurred in 0.2% of patients undergoing MR-HIFU and in almost 12.6% of all surgical cases. The authors concluded that MR-HIFU caused lower morbidity than surgery, with similar longerterm QoL effect [73]. However, while the experts agree that lower pregnancy rates, higher miscarriage rates and more adverse pregnancy outcomes are associated with UAE in comparison with myomectomies [60], data concerning the comparison between MRgFUS/MR-HIFU and LM are practically unavailable in the same context.…”

Section: Discussionmentioning

confidence: 99%

The effect of high-intensity focused ultrasound guided by magnetic resonance therapy on obstetrical outcomes in patients with uterine fibroids – experiences from the main Polish center and a review of current data

Łoziński¹,

Filipowska

Gurynowicz

et al. 2019

International Journal of Hyperthermia

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“…A trial at China studying pregnancy outcomes in nulliparous women after ultrasound ablation of uterine fibroids including Dimitrov/Zhou/Karamanliev/Joncheva/Yang/Ran/Gorchev/Jin/Tomov/Georgiev/Zhang/Ma/Zhu/Stanislavova 189 patients showed a pregnancy rate of 69.3% and a successful delivery rate of 76.3% [19]. Another study at China comparing HIFU, myomectomy and hysterectomy for treating symptomatic uterine fibroids showed that HIFU caused substantially less morbidity than surgery, with similar longterm QoL [20]. HIFU treatment seems to show equal quality in ablating uterine fibroids in patients with an anteverted uterus and the more difficult to treat retroverted uterus [21].…”

Section: Discussionmentioning

confidence: 99%

Introducing clinical protocol for ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroids in patients in Europe, provided from experienced Chinese center-prospective comparative

Dimitrov¹,

Zhou²,

Karamanliev³

et al. 2018

biomedicalresearch

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Introduction: This study aims to determine whether the Chinese clinical protocol, ultrasound guided high-intensity focused ultrasound (USgHIFU) combined with real-time monitoring using a contrast enhanced ultrasound (CEUS), also applies well in European patients with uterine fibroids. Methods: Seventy-five patients with 87 nodules of uterine fibroids from China and Bulgaria were treated with USgHIFU from April 2015 to July 2016, in the study. In Group A (Bulgarian) 26 (33 nodules) patients and in group B (Chinese) 49 (54 nodules) patients were included in the study. The same clinical procedure of USgHIFU treatment as well as a follow-up was performed on patients from China and Bulgaria. The general characteristics of the patients, the USgHIFU treatment and evaluation parameters, including; complications, fibroid size, tumor volume, subcutaneous fat size, non-perfused volume (NPV) and shrinkage process, were comparatively studied in Chinese and Bulgarian patients. Results: There were no significant differences in clinical parameters of Chinese and Bulgarian patients with uterine fibroids, such as vertical, left-right and аnterior-posterior size, treatment time, USgHIFU time.After USgHIFU treatment, no complications were recorded in both groups. On the 6 th and 12 th month after USgHIFU, fibroid nodules shrunk and the NPV was statistically significant compared to NPV before USgHIFU, but there were no statistically significant differences. Conclusions: The initial results of our study showed that CEUS clinical protocol for real time monitoring of efficacy and quality of the USgHIFU for uterine fibroid treatment that had been used in Chinese centers may also be applicable for European patients.

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Evaluation of high‐intensity focused ultrasound ablation for uterine fibroids: an IDEAL prospective exploration study

Abstract: HIFU had much better short-term outcomes than surgery for fibroids in 2411-patient Chinese IDEAL format study.

Cited by 116 publications

References 23 publications

Vaginal delivery outcomes of pregnancies following ultrasound-guided high-intensity focused ultrasound ablation treatment for uterine fibroids

Vaginal delivery outcomes of pregnancies following ultrasound-guided high-intensity focused ultrasound ablation treatment for uterine fibroids

The effect of high-intensity focused ultrasound guided by magnetic resonance therapy on obstetrical outcomes in patients with uterine fibroids – experiences from the main Polish center and a review of current data

Introducing clinical protocol for ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroids in patients in Europe, provided from experienced Chinese center-prospective comparative

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