Factors influencing thermal injury to skin and abdominal wall structures in HIFU ablation of uterine fibroids

Yin, Ningbei; Hu, Liang; Xiao, Zhibo; Liu, Chang; Chen, Wenzhi; Roberts, Neil; Chen, Jin-Yun; Wang, Zhibiao

doi:10.1080/02656736.2018.1433880

Cited by 27 publications

(24 citation statements)

References 19 publications

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“…Scar tissue was particularly problematic in 1 of our patients where a large inguinal scar and an overlying skinfold compromised acoustic contact. Factors significantly associated with thermal injury to skin, in a univariate logistic regression analysis of 892 cases, were related to sonication time, sonication time per hour, total energy deposited, distance from uterine fibroid ventral side to skin, volume of uterine fibroids, abdominal wall scar, abdominal wall thickness, and body mass index; in a multivariate analysis, however, total energy, abdominal wall scar and abdominal wall thickness only were significant [35]. To overcome the problem of abdominal scars, acoustic patches on the skin, which reflect the ultrasound energy from scars, have been introduced [36] and increase eligibility for MRgHIFU [37] without compromising the efficacy of the treatment [38].…”

Section: Discussionmentioning

confidence: 94%

Feasibility of palliating recurrent gynecological tumors with MRGHIFU: comparison of symptom, quality-of-life, and imaging response in intra and extra-pelvic disease

Imseeh

Giles

Taylor

et al. 2021

International Journal of Hyperthermia

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Objective: To document longitudinal symptom, quality-of-life and imaging response in patients with recurrent gynecological tumors treated with magnetic resonance guided high intensity focused ultrasound (MRgHIFU), and compare changes in patients with intra-versus extra-pelvic lesions. Methods: Eleven symptomatic patients with painful recurrent gynecological tumors were treated with MRgHIFU (Profound Sonalleve) in a prospective single center study (NCT02714621). Pain scores, analgesic intake and quality-of-life metrics, whole tumor volume, and perfused tumor volume from Gadolinium-enhanced T1W imaging documented before and up to 90 days after treatment were compared between patients with intra-and extra-pelvic tumors. Results: Two of five patients with intra-pelvic and three of six patients with extra-pelvic tumors were classified as responders (>2 point reduction in NRS pain score without analgesia increase or a > 25% reduction in analgesic use). Cohort reductions in worst pain scores were not significant for either group. Emotional functioning for the whole cohort improved, although physical functioning did not. Ablative thermal temperatures were achieved in three patients with extra-pelvic tumors, but in none whose tumors were intra-pelvic. Pain response did not correlate with thermal dose. Tumor volume increased by 18% immediately post-treatment in the extra-pelvic but not in the intra-pelvic group. Ratio of perfused to whole lesion volume decreased by >20% by day 30 in extra-pelvic, but not intrapelvic tumors although at day 30 both extra-pelvic and intra-pelvic tumors increased in volume. Conclusion: MRgHIFU treatments can be delivered safely to patients with recurrent gynecological tumors. Extra-pelvic tumors responded better than intra-pelvic tumors and showed immediate swelling and reduction in perfused volume by day 30.

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Section: Discussionmentioning

confidence: 94%

Feasibility of palliating recurrent gynecological tumors with MRGHIFU: comparison of symptom, quality-of-life, and imaging response in intra and extra-pelvic disease

Imseeh

Giles

Taylor

et al. 2021

International Journal of Hyperthermia

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“…High‐intensity focused US has increasingly been used for treatment of uterine fibroids worldwide because of its excellent therapeutic efficacy in producing symptomatic relief . It has been revealed that HIFU has a therapeutic effect on uterine fibroids mainly by causing coagulation necrosis of targeted tissue, which was presented as a nonenhancement characteristic on enhanced MRI . Enhanced MRI was considered an important evaluation measure for the early therapeutic response of uterine fibroids to HIFU .…”

Section: Discussionmentioning

confidence: 99%

“…26,27 It has been revealed that HIFU has a therapeutic effect on uterine fibroids mainly by causing coagulation necrosis of targeted tissue, which was presented as a nonenhancement characteristic on enhanced MRI. 28,29 Enhanced MRI was considered an important evaluation measure for the early therapeutic response of uterine fibroids to HIFU. 18,30,31 The extent of the nonperfused volume or nonperfused volume ratio obtained from posttreatment enhanced MRI was significantly correlated with the treatment outcome for uterine fibroids.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Quantitative Uterine Fibroid Perfusion Parameters From Contrast‐Enhanced Ultrasound for the Therapeutic Effect of High‐Intensity Focused Ultrasound Ablation

Wang

Zhang

et al. 2018

J of Ultrasound Medicine

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Objectives To assess the predictive significance of quantitative perfusion parameters from contrast‐enhanced ultrasound (CEUS) for the therapeutic response to high‐intensity focused ultrasound (HIFU) ablation in patients with uterine fibroids. Methods A total of 263 patients with single uterine fibroids were treated with HIFU ablation under ultrasound guidance. The arrival time, peak time, enhancement time, enhancement intensity, and enhancement rate were evaluated with pretreatment CEUS. According to a nonperfused volume ratio evaluation by posttreatment magnetic resonance imaging, all patients were assigned to groups with volume ratios of 70% or higher and lower than 70%. Then the predictive performances of different parameters for ablation efficacy were studied. Results The arrival time, peak time, and enhancement time in the group with a nonperfused volume ratio of 70% or higher were longer than those in the group with a volume ratio lower than 70% (mean ± SD, 16.7 ± 3.5, 26.5 ± 4.9, and 10.2 ± 2.6 seconds, respectively, versus 13.3 ± 4.2, 20.8 ± 5.4, and 7.6 ± 2.3 seconds), whereas patients with a volume ratio of 70% or higher had a lower mean enhancement intensity and enhancement rate than those with a volume ratio lower than 70% (29.7 ± 16.7 dB and 3.2 ± 1.5 dB/s versus 63.2 ± 26.3 dB and 8.6 ± 4.3 dB/s; P < .05). The nonperfused volume ratio was negatively correlated with the enhancement intensity and enhancement rate (r = –0.631 and –0.712) but positively correlated with the arrival time, peak time, and enhancement time (r = 0.322, 0.456, and 0.477; P < .05). The areas under the receiver operating characteristic curve for the enhancement time, enhancement intensity, and enhancement rate were 0.73, 0.79, and 0.81 (P < .05). Conclusions Quantitative parameters from CEUS are potentially useful for evaluating the therapeutic effect of HIFU ablation for uterine fibroids.

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“…In modern medicine, HIFU is often used to treat diseases such as cancer and tumors [ 2 , 3 , 4 ]. Overtreatment will cause normal tissue to be damaged, so it is important to monitor whether the biological tissues have been denatured in the HIFU treatment region [ 5 ]. HIFU treatment monitoring has three kinds of monitoring methods, including computed tomography (CT) [ 6 , 7 ], magnetic resonance imaging (MRI) [ 8 , 9 ], and ultrasound [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Identification of Denatured Biological Tissues Based on Compressed Sensing and Improved Multiscale Dispersion Entropy during HIFU Treatment

Liu

Wang

Peng

et al. 2020

Entropy

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Identification of denatured biological tissue is crucial to high-intensity focused ultrasound (HIFU) treatment, which can monitor HIFU treatment and improve treatment efficiency. In this paper, a novel method based on compressed sensing (CS) and improved multiscale dispersion entropy (IMDE) is proposed to evaluate the complexity of ultrasonic scattered echo signals during HIFU treatment. In the analysis of CS, the method of orthogonal matching pursuit (OMP) is employed to reconstruct the denoised signal. CS-OMP can denoise the ultrasonic scattered echo signal effectively. Comparing with traditional multiscale dispersion entropy (MDE), IMDE improves the coarse-grained process in the multiscale analysis, which improves the stability of MDE. In the analysis of simulated signals, the entropy value of the IMDE method has less fluctuation compared with MDE, indicating that the IMDE method has better stability. In addition, MDE and IMDE are applied to the 300 cases of ultrasonic scattered echo signals after denoising (including 150 cases of normal tissues and 150 cases of denatured tissues). The experimental results show that the MDE and IMDE values of denatured tissues are higher than normal tissues. Both the MDE and IMDE method can be used to identify whether biological tissue is denatured. However, the multiscale entropy curve of IMDE is smoother and more stable than MDE. The interclass distance of IMDE is greater than MDE, and the intraclass distance of IMDE is less than MDE at different scale factors. This indicates that IMDE can better distinguish normal tissues and denatured tissues to obtain more accurate clinical diagnosis during HIFU treatment.

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Factors influencing thermal injury to skin and abdominal wall structures in HIFU ablation of uterine fibroids

Abstract: Multiple logistic regression analysis revealed that abdominal wall thickness, total energy and abdominal wall scar were the most significant influencing factors that influenced minimal thermal injury of abdominal wall structures in USgHIFU ablation of uterine fibroids.

Cited by 27 publications

References 19 publications

Feasibility of palliating recurrent gynecological tumors with MRGHIFU: comparison of symptom, quality-of-life, and imaging response in intra and extra-pelvic disease

Feasibility of palliating recurrent gynecological tumors with MRGHIFU: comparison of symptom, quality-of-life, and imaging response in intra and extra-pelvic disease

Predictive Value of Quantitative Uterine Fibroid Perfusion Parameters From Contrast‐Enhanced Ultrasound for the Therapeutic Effect of High‐Intensity Focused Ultrasound Ablation

Identification of Denatured Biological Tissues Based on Compressed Sensing and Improved Multiscale Dispersion Entropy during HIFU Treatment

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