Therapeutic dose and long-term efficacy of high-intensity focused ultrasound ablation for different types of uterine fibroids based on signal intensity on T2-weighted MR images

Yangyang Wang; Chunmei Gong; Min He; Zhenjiang Lin; Feng Xu; Song Peng; Lian Zhang

doi:10.1080/02656736.2023.2194594

International Journal of Hyperthermia (Dec 2023)

Therapeutic dose and long-term efficacy of high-intensity focused ultrasound ablation for different types of uterine fibroids based on signal intensity on T2-weighted MR images

Yangyang Wang,
Chunmei Gong,
Min He,
Zhenjiang Lin,
Feng Xu,
Song Peng,
Lian Zhang

Affiliations

Yangyang Wang: College of Biomedical Engineering, State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, China
Chunmei Gong: College of Biomedical Engineering, State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, China
Min He: College of Biomedical Engineering, State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, China
Zhenjiang Lin: College of Biomedical Engineering, State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, China
Feng Xu: College of Biomedical Engineering, State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, China
Song Peng: Department of Radiology, Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
Lian Zhang: College of Biomedical Engineering, State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, China

DOI: https://doi.org/10.1080/02656736.2023.2194594
Journal volume & issue: Vol. 40, no. 1

Abstract

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AbstractObjective To investigate the therapeutic dose and long-term efficacy of high-intensity focused ultrasound (HIFU) ablation for different types of uterine fibroids based on signal intensity on T2-weighted MR images (T2WI).Materials and methods Four hundred and one patients with a solitary uterine fibroid treated with HIFU were classified into four groups consisting of extremely hypointense, hypointense, isointense and hyperintense fibroids. Each group was further classified into two subtypes: homogeneous and heterogeneous, based on signal homogeneity of fibroids. The therapeutic dose and long-term follow-up results were compared.Results There were significant differences in treatment time, sonication time, treatment intensity, total treatment dosage, treatment efficiency, energy-efficiency factor (EEF) and non-perfused volume (NPV) ratio among the four groups (p<.05). The average NPV ratio achieved in patients with extremely hypointense, hypointense, isointense and hyperintense fibroids was 75.2 ± 14.6%, 71.1 ± 15.6%, 68.2 ± 17.3% and 67.8 ± 16.6%, respectively; the re-intervention rates at 36 months after HIFU were 8.4%, 10.3%, 12.5% and 6.1%, respectively. Sonication time, treatment intensity and total energy for heterogeneous fibroids were greater than that for homogeneous fibroids in patients with extremely hypointense fibroids (p<.05). The treatment time for heterogeneous fibroids was significantly longer than that for homogeneous fibroids in patients with isointense fibroids (p<.05). Multivariate ordered logistic regression analysis showed that the ablation volume of fibroids and treatment time were related to NPV ratio (p<.05).Conclusion Every group of patients obtained satisfactory long-term results. Hyperintense fibroids are difficult to treat by HIFU. Heterogeneous fibroids are more difficult to treat with HIFU than homogeneity fibroids.

Published in International Journal of Hyperthermia

ISSN: 0265-6736 (Print); 1464-5157 (Online)
Publisher: Taylor & Francis Group
Country of publisher: United Kingdom
LCC subjects: Medicine: Medicine (General): Medical technology
Website: https://www.tandfonline.com/journals/ihyt

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