Safety and Efficacy of Ultrasound-Guided High-Intensity Focused Ultrasound Treatment for Uterine Fibroids and Adenomyosis

Lee, Jae Seong; Hong, Gi Youn; Lee, Kye Hwa; Song, Jung Hwa; Kim, Tae Eung

doi:10.1016/j.ultrasmedbio.2019.08.022

Cited by 50 publications

(45 citation statements)

References 12 publications

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“…Currently, most HIFU treatments are performed by scanning the whole fibroid. It usually takes a long period for large fibroids (Fan et al 2012;Lee et al 2019;ºozi nski et al 2019). The result of Adler grade demonstrates that fibroid vascularity is independent of fibroid volume (Fig.…”

Section: Feasibility Of Devascularization and Treatment Outcomementioning

confidence: 95%

Ultrasound-Guided High-Intensity Focused Ultrasound for Devascularization of Uterine Fibroid: A Feasibility Study

Zhou

Niu

et al. 2021

Ultrasound in Medicine & Biology

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This study aimed to establish the feasibility of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for devascularization of uterine fibroids. Ultrasound color Doppler flow imaging (CDFI) and B-mode imaging were used to target fibroid vascularity. The vessels were covered and ablated by high-intensity focused ultrasound spots. In this study, 42 fibroids with a volume of 66.98 § 4.00 cm 3 were treated. No blood flow was detected by post-treatment CDFI in 40 fibroids. The 6-mo non-perfusion volume rate was 75.23% § 34.77% (n = 40). The mean shrinkage in fibroid volume was 38.20% and 43.89%, respectively, at 1 and 6 mo after treatment (p < 0.001). The uterine fibroid symptom and quality of life scores were reduced by 9.43% at 1 mo and 26.66% at 6-mo after treatment (p < 0.001). No serious adverse event was observed. This study demonstrates the feasibility of USgHIFU-induced fibroid devascularization, and more studies are required for the evaluation of safety and efficacy.

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Section: Feasibility Of Devascularization and Treatment Outcomementioning

confidence: 95%

Ultrasound-Guided High-Intensity Focused Ultrasound for Devascularization of Uterine Fibroid: A Feasibility Study

Zhou

Niu

et al. 2021

Ultrasound in Medicine & Biology

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“…We further compared the treatment efficacy and found that the mean reduction in the maximum fibroid diameter in the HIFU group was significantly larger than that in the GnRH-a group. This phenomenon can be explained by that HIFU could ablate the fibroids precisely, thus leading to notable shrinkage of fibroids [11,19]. However, the main effect of GnRH-a on fibroids is the inhibition of hormone secretion, we should consider the fact that some fibroids may be not sensitive to estrogen.…”

Section: Discussionmentioning

confidence: 99%

“…High-intensity focused ultrasound (HIFU) is a novel noninvasive treatment for uterine fibroids. The previous studies have shown that HIFU is safe and effective in the treatment of uterine fibroids [11,12]. This technique is based on the characteristics of ultrasound beams, which can be focused at a distance from the surface of transducer.…”

Section: Introductionmentioning

confidence: 99%

Comparison of outcomes of hysteroscopic myomectomy of type 2 submucous fibroids greater than 4 cm in diameter via pretreatment with HIFU or GnRH-a

Liao

Jiang

Zeng

et al. 2021

International Journal of Hyperthermia

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“…The incidence of minor adverse events was 39.0%, 51.3% and 3.6% after HIFU, PMWA and RFA, respectively. The main minor adverse events were transient sciatic nerve pain, transient unilateral leg weakness, transient hematuria, skin burn, vaginal bleeding and lower abdominal pain in the HIFU group [19][20][21]24,26,28,[35][36][37], and transient macroscopic hematuria, vaginal discharge and lower abdominal pain in the PMWA and RFA groups [46][47][48]51,52,54]. Although all cases were minor and recovered without any permanent adverse effects, these events revealed thermal injury to the surrounding tissues, such as the sciatic nerve, bladder, endometrium, bowel and abdominal skin.…”

Section: Main Findings and Comparison With Existing Literaturementioning

confidence: 99%

Image-guided thermal ablation in the management of symptomatic adenomyosis: a systematic review and meta-analysis

Liu

Wang

Lei

2021

International Journal of Hyperthermia

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Objective: To evaluate the clinical effects of image-guided thermal ablation for the treatment of symptomatic adenomyosis (AD). Data sources: We searched PubMed, Web of Science, Cochrane Library, EMBASE, ClinicalTrials.gov and Google Scholar for literature from January 2000 to September 2020. Methods of study selection: We included all studies reporting clinical outcomes of image-guided thermal ablation for AD, involving high-intensity focused ultrasound (HIFU), percutaneous microwave ablation (PMWA) and radiofrequency ablation (RFA). Two independent researchers performed study selection according to the screening criteria. Results: A total of 38 studies representing 15,908 women were included. Compared with those at baseline, the visual analog scale scores, the symptom severity scores and the menorrhagia severity scores decreased significantly after these thermal ablation therapies. The mean ablation time was 92.18 min, 24.15 min and 31.93 min during HIFU, PMWA and RFA, respectively. The non-perfused volume ratio of AD was 68.3% for HIFU, 82.5% for PMWA and 79.2% for RFA. The reduction rates of uterine volume were 33.6% (HIFU), 46.8% (PMWA) and 44.0% (RFA). The reduction rates of AD volume were 45.1% (HIFU), 74.9% (PMWA) and 61.3% (RFA). The relief rates of dysmenorrhea were 84.2% (HIFU), 89.7% (PMWA) and 89.2% (RFA). The incidence of minor adverse events was 39.0% (HIFU), 51.3% (PMWA) and 3.6% (RFA). The re-intervention rates were 4.0% (HIFU) and 28.7% (RFA). The recurrence rate was 10.2% after HIFU. The pregnancy rates were 16.7% (HIFU), 4.93% (PMWA) and 35.8% (RFA). Conclusion: Image-guided HIFU, PMWA and RFA may be effective and safe minimally invasive therapies for symptomatic AD.

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Safety and Efficacy of Ultrasound-Guided High-Intensity Focused Ultrasound Treatment for Uterine Fibroids and Adenomyosis

Cited by 50 publications

References 12 publications

Ultrasound-Guided High-Intensity Focused Ultrasound for Devascularization of Uterine Fibroid: A Feasibility Study

Ultrasound-Guided High-Intensity Focused Ultrasound for Devascularization of Uterine Fibroid: A Feasibility Study

Comparison of outcomes of hysteroscopic myomectomy of type 2 submucous fibroids greater than 4 cm in diameter via pretreatment with HIFU or GnRH-a

Image-guided thermal ablation in the management of symptomatic adenomyosis: a systematic review and meta-analysis

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