Magnetic resonance-guided high-intensity ultrasound (MR-HIFU) in the treatment of symptomatic uterine fibroids — five-year experience

Abstract

Objectives: Uterine fibroids (UF) are the most common benign tumors of the female reproductive organ. It is crucial to recognize that the appropriate treatment of UFs requires an individualized approach. The present paper aimed at the presentation of the five-year experience of our center in the treatment of UFs with the use of magnetic resonance-guided high-intensity ultrasound (MR-HIFU) therapy. Material and methods:The study enrolled a total of 1284 patients with symptomatic UFs.The Sonalleve MR-HIFU system (Philips Ingenia 3.0T System) was used for magnetic resonance imaging (MRI) qualification and treatment. Results:The group of patients qualified for thermal ablation included 356 (28%) women. No significant differences were observed between the group undergoing thermal ablation and patients who were disqualified. A complete procedure was performed in 22.6% of patients who presented at the center. Non-perfused volume (NPV) is one of the most important parameters assessed during MR-HIFU procedures. The mean NPV value in the present study was 71%. The average UF volumes decreased by 27% at three-month follow-up ultrasound, by 34% after six months and by 39% as shown by MRI measurements performed 6 months post-treatment.Conclusions: According to our data, MR-HIFU therapy is associated with good clinical outcomes in patients with symptomatic UFs. The method facilitates a marked symptom reduction and, in many cases, diminishing tumor volume. The presented five-year outcomes as regards our experience in the MR-HIFU therapy of patients with symptomatic UFs indicate that the method offers an attractive alternative to the traditional methods of UF treatment in selected cases.

The role of microbiota in the pathophysiology of uterine fibroids – a systematic review

“…It is known that total hysterectomy is one of more commonly proposed procedures in women with uterine fibroids who do not have fertility requirements. A group of doctors obviously struggle with such an approach and try to convince their colleagues to switch to more conservative surgical methods, use non-operative methods such as thermoablation (Lozinski et al, 2021) or switch to pharmacological treatment (Niaz et al, 2022). Complete hysterectomy affects the level of sex hormones.…”

High-intensity focused ultrasound for the treatment of fibroids: A single-center experience in Singapore

“…Most studies demonstrate overall fibroid volume shrinkage ranging from 18% at 3 months to 84% at 36 months. [ 11 12 13 14 15 16 17 18 19 ] Systematic reviews and meta-analysis report promising data on fertility and pregnancy rates after HIFU, making it an attractive option for fertility-desiring women. [ 20 21 ]…”

Optical Property Measurement and Temperature Monitoring in High-Intensity Focused Ultrasound Therapy by Diffuse Optical Tomography: A Correlation Study

“…High-intensity focused ultrasound (HIFU), as a mature medical technology for conducting non-or minimally invasive tumor ablation therapy, is capable of inducing biological effects deep in the body by delivering acoustic energy with a millimeter-sized focal region [1]. In the past few decades, HIFU has been applied in high temperature thermal therapy to ablate solid malignant tumors in various organs, such as the prostate [2,3], breast [4], liver [5], pancreas [6] and uterine fibroids [7]. While the research interest in HIFU for hyperthermia has declined, the application of HIFU for the treatment of tremors [8,9], opening the BBB [10,11] and helping immunotherapy [12,13] has gained a lot of research interest lately and has been rapidly developing.…”