Feasibility of MRI-guided high intensity focused ultrasound treatment for adenomyosis

Fan, Tien Ying; Zhou, Lian; Chen, Wenzhi; Liu, Yinjiang; He, Miao; Huang, Xiaojun; Orsi, Franco; Wang, Zhibiao

doi:10.1016/j.ejrad.2011.05.036

Cited by 71 publications

(70 citation statements)

References 20 publications

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“…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%

“…Early studies examined the safety and efficacy of this technique. [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.…”

Section: Studiesmentioning

confidence: 99%

“…Treatment and follow-up protocols generally therefore include imaging to assess the overall uterine volume and volume of adenomyosis pre-and posttreatment, and the nonperfused volume of adenomyosis posttreatment. 36,41,42 It is clinically important to correlate this with actual symptom resolution. In order to quantify changes in symptoms, study groups have used recognized scoring systems such as Symptom Severity Score, Uterine Fibroid Symptom and Quality of Life, and Visual Analog Scale for pain.…”

Section: Efficacymentioning

confidence: 99%

“…41 Reported symptom reduction ranges from 25% to 83%. [36][37][38]41 Overall clinical effectiveness (defined as any degree of improvement in symptoms) ranges from 79% to 89%, with a significant proportion experiencing complete symptom relief (39%-46%). 33,35,[38][39][40]42 These effects appear to be sustained for at least 1-2 years 35,41 (Table 1).…”

Section: Reduction Of Symptomsmentioning

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%

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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: Reduction Of Tissuementioning

confidence: 99%

Section: Studiesmentioning

confidence: 99%

Section: Efficacymentioning

confidence: 99%

Section: Reduction Of Symptomsmentioning

confidence: 99%

Section: Preparation For Hifumentioning

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

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High‐intensity focused ultrasound in management of placenta accreta spectrum: A systematic review

Elazeem

Saad

Ahmed

et al. 2020

Intl J Gynecology & Obste

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Background: High-intensity focused ultrasound (HIFU) is a non-invasive procedure that has been studied in the management of placenta accreta spectrum (PAS). Objective: To appraise HIFU in the management of PAS and highlight the restrictions on converting uterus-preserving studies into evidence-based practice. Search strategy: A search on Scopus, Cochrane, PubMed and Web of Science was conducted from date of inception to January 2020. Selection criteria: Studies on using HIFU in the management of PAS were eligible. Review articles, conference papers, and case reports were excluded. Data collection: A standardized sheet was used to abstract data from eligible studies. CON-PAS registry was used to include studies on other conservative modalities. Results: Four studies were eligible (399 patients). Average residual placental volume was 61.74 cm 3 (6.01-339 cm 3). Treatment was successful in all patients. Normal menstruation recovered after 48.8 days (15-150 days). No major complications were encountered. Sixty-one studies were retrieved from the CON-PAS registry; uterine artery embolization (23 studies), balloon placement (15 studies), compression sutures (10 studies), placenta in situ (7 studies), and uterine resection (6 studies) were successful in 83.7%, 92.9%, 87.9%, 85.2%, and 79.3% of cases, respectively. Conclusions: HIFU may fit certain clinical situations in the management of PAS. A global research strategy is recommended to incorporate conservative approaches within a comprehensive management protocol.

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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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Feasibility of MRI-guided high intensity focused ultrasound treatment for adenomyosis

Cited by 71 publications

References 20 publications

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

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

High‐intensity focused ultrasound in management of placenta accreta spectrum: A systematic review

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

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