High intensity focused ultrasound treatment of adenomyosis: The relationship between the features of magnetic resonance imaging on T2 weighted images and the therapeutic efficacy

Gong, Chang; Setzen, Raymond; Liu, Zhongqiong; Liu, Yunchang; Xie, Bin; Aili, Aixingzi; Zhou, Lian

doi:10.1016/j.ejrad.2017.02.001

Cited by 28 publications

(49 citation statements)

References 18 publications

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“…In addition, lesions on the anterior wall or fundus of the uterus can take advantage of the gradual heataccumulation phenomenon, which is the cumulative energy deposition of overlapped sonication beam during ablation procedure. 7,8,[13][14][15] Due to the absorption and distortion of sonication energy by adipose tissue, abdominal subcutaneous fat thickness is one of the significant parameters negatively correlated with the NPV ratio. 14,15 Thus, patients with abdominal subcutaneous fat thickness ≥5 cm are not recommended for HIFU ablation, as there is a higher risk of subcutaneous fat burn and a lower chance of achieving high NPV ratio.…”

Section: Location Of Adenomyosis and Abdominal Subcutaneous Fat Thickmentioning

confidence: 99%

“…7,8,[13][14][15] Due to the absorption and distortion of sonication energy by adipose tissue, abdominal subcutaneous fat thickness is one of the significant parameters negatively correlated with the NPV ratio. 14,15 Thus, patients with abdominal subcutaneous fat thickness ≥5 cm are not recommended for HIFU ablation, as there is a higher risk of subcutaneous fat burn and a lower chance of achieving high NPV ratio. [17][18][19]…”

Section: Location Of Adenomyosis and Abdominal Subcutaneous Fat Thickmentioning

confidence: 99%

“…[4][5][6][7][8][9] Different biological elements of high SI foci inside adenomyosis lesions produce a heterogeneous surface at the target point and lead to arduous sonication deposit as well as swift sonication dispersion during the ablation procedure. 7,8,[13][14][15] Gong et al reported that an adenomyosis lesion with multiple hyperintense foci is more difficult to ablate than adenomyosis with fewer hyperintense foci ( Figure 5). The NPV ratio obtained in the group with fewer hyperintense foci was significantly higher than in the group with multiple hyperintense foci, with similar sonication power and treatment time.…”

Section: Focimentioning

confidence: 99%

“…The results suggested that the quantity of hyperintense foci is considered as a predictor of the response of the adenomyosis to HIFU treatment. 15…”

Section: Focimentioning

confidence: 99%

“…20 Some studies conclude that the volume of adenomyosis is positively correlated with the NPV ratio. 8,14,15 In a study by Xiao-Ying et al, diffuse adenomyosis patients with the volume of the uterus ≥300 cm 3 received 3 consecutive months of GnRHa prior to HIFU ablation were considered as HIFU plus GnRHa group. The results revealed that even adenomyosis volume in the HIFU plus GnRHa group was higher than the HIFU-only group, the NPV ratio, sonication power, and treatment time were significantly better than those in the HIFU-only group.…”

Section: Sizementioning

confidence: 99%

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Influences of screening magnetic resonance imaging parameters on high-intensity focused ultrasound outcome for adenomyosis

Duc¹,

Huy²

2018

RMI

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Uterine adenomyosis is one of the most common benign pelvic diseases that adversely affects the quality of a woman's life. High-intensity focused ultrasound is an effective noninvasive treatment option for symptomatic adenomyosis. Clinical studies showed that the prediction of immediate treatment outcome, defined as nonperfused volume ratio for adenomyosis, is one of the key parameters for determining the therapeutic efficacy. MRI parameters of adenomyosis in the screening phase, such as type, location, abdominal subcutaneous fat thickness, signal intensity of adenomyosis, size, number of foci inside the lesion, and perfusion, manifest the impact on nonperfused volume ratio. Therefore, in this article, we performed a literature review of the influential screening MRI parameters on the immediate high-intensity focused ultrasound outcome.

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Section: Location Of Adenomyosis and Abdominal Subcutaneous Fat Thickmentioning

confidence: 99%

Section: Location Of Adenomyosis and Abdominal Subcutaneous Fat Thickmentioning

confidence: 99%

Section: Focimentioning

confidence: 99%

“…The results suggested that the quantity of hyperintense foci is considered as a predictor of the response of the adenomyosis to HIFU treatment. 15…”

Section: Focimentioning

confidence: 99%

Section: Sizementioning

confidence: 99%

See 3 more Smart Citations

Influences of screening magnetic resonance imaging parameters on high-intensity focused ultrasound outcome for adenomyosis

Duc¹,

Huy²

2018

RMI

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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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Phase‐shift Perfluoropentane Nanoemulsions Enhance Pulsed High‐intensity Focused Ultrasound Ablation in an Isolated Perfused Liver System and Their Potential Value for Cancer Therapy

Zhao

Chen

Yang

et al. 2021

J of Ultrasound Medicine

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Purpose To investigate whether phase‐shift perfluoropetane (PFP) nanoemulsions can enhance pulsed high‐intensity focused ultrasound (HIFU) ablation. Methods PFP was encapsulated by poly(lactic‐co‐glycolic acid) (PLGA) to form a nanometer‐sized droplet (PLGA‐PFP), which was added to an isolated perfused liver system. Meanwhile, phosphate‐buffered saline (PBS) was used as a control. The perfused liver was exposed to HIFU (150 W, t = 3/5/10 s) at various duty cycles (DCs). The ultrasound images, cavitation emissions, and temperature were recorded. Rabbits with subcutaneous VX2 tumors were exposed to HIFU (150 W) at various DCs with or without PLGA‐PFP. After ablation, necrosis volume and energy efficiency factor were calculated. Pathologic characteristics were observed. Results Compared to the PBS control, PLGA‐PFP nanoemulsions markedly enhanced HIFU‐induced necrosis volume in both perfused livers and subcutaneous VX2 tumor‐bearing rabbits (P <.05). Inertial cavitation was much stronger in the pulsed‐HIFU exposure at 10% than that in the continuous‐wave HIFU exposure (P <.01). Peak temperature at 100% DC was significantly higher than that at 10% (P <.05). Compared to 100% DC HIFU exposure, the mean necrosis volume induced by 10 s exposure at 50% DC was significantly larger (P <.005) but lower at 10% DC in the isolated perfused livers (P <.05). In addition, the mean necrosis volume in subcutaneous VX2 tumor‐bearing rabbits was significantly increased after HIFU exposure at 10% DC when compared to those at 100% DC (P <.05). Histopathologic analysis showed liquefaction necrosis in pulsed HIFU. Conclusion PLGA‐PFP nanoemulsions can enhance HIFU ablation in the isolated perfused livers and promote tumor ablation in the subcutaneous xenograft rabbit model. Appropriate pulsed HIFU exposure may increase the necrosis volume and reduce total ultrasound energy required for HIFU ablation.

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High intensity focused ultrasound treatment of adenomyosis: The relationship between the features of magnetic resonance imaging on T2 weighted images and the therapeutic efficacy

Cited by 28 publications

References 18 publications

Influences of screening magnetic resonance imaging parameters on high-intensity focused ultrasound outcome for adenomyosis

Influences of screening magnetic resonance imaging parameters on high-intensity focused ultrasound outcome for adenomyosis

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

Phase‐shift Perfluoropentane Nanoemulsions Enhance Pulsed High‐intensity Focused Ultrasound Ablation in an Isolated Perfused Liver System and Their Potential Value for Cancer Therapy

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