Factors affecting effects of ultrasound guided high intensity focused ultrasound for single uterine fibroids: a retrospective analysis

Abstract

Objective: To investigate factors affecting effects of ultrasound guided high intensity focused ultrasound (USgHIFU) in the treatment of single uterine fibroids (UFs) with different magnetic resonance imaging (MRI) features. Methods: A total of 207 patients with single symptomatic UFs who were treated with HIFU were retrospectively analyzed. All UFs were grouped according to MRI features, and factors affecting HIFU ablation were set as independent variables. Non-perfusion volume ratio (NPVR) and energy efficiency factor (EEF) were set as dependent variables to establish multiple linear regression models with a stepwise method. Results: All patients had successful HIFU treatment, with the mean NPVR of 74.7 ± 15.1% and the mean EEF of 7.4 ± 5.2 j/mm 3. The NPVR was negatively correlated with transmural type of UFs, hyperintense on T2 weighted image (T2WI), enhancement type on T1 weighted image (T1WI), distance from UFs ventral side to skin and posterior location of UFs, but positively correlated with anterior location of UFs, hypointense on T2WI and anteverted uterus (uterine location). The EEF was negatively correlated with size, anterior location of UFs and hypointense on T2WI, but positively correlated with distance from UFs ventral side to skin, enhancement type on T1WI and transmural type of UFs. The UFs size and enhancement type on T1WI were the greatest factors affecting the ablation effect. Conclusions: The effect of HIFU treatment for single UFs is affected by multiple factors, and the UFs of hypointense on T2WI, large size, mild enhancement on T1WI and anteverted uterus can be easily ablated with high ablation efficiency.

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Long-term follow-up outcome and reintervention analysis of ultrasound-guided high intensity focused ultrasound treatment for uterine fibroids

“…The previous studies have demonstrated that the longterm symptomatic relief of patients with uterine fibroids is related to NPV ratio of the treated fibroids. Many factors included the size of uterine fibroids, distance from fibroid ventral side to the skin, location of the uterus, location of uterine fibroids, signal intensity on T2WI, and enhancement type may affect the treatment results [18][19][20][21][22]. Our results showed that the reintervention rate was negatively correlated with the NPV ratio, number of uterine fibroids, and enhancement degree on T1WI.…”

Magnetic resonance imaging parameters in predicting the ablative efficiency of high-intensity focused ultrasound for uterine fibroids

“…The main therapeutic effect of HIFU treatment for uterine fibroids is thermal effect [24,25]. Several studies have shown that the degree of perfusion on contrast-enhancement MRI has a negative relationship to the NPV ratio of fibroids [18,19,26,27]. The characteristics of blood perfusion in uterine fibroids were assessed subjectively by comparing the enhancement intensity of the fibroid and myometrium.…”