High-intensity focused ultrasound for the targeted destruction of uterine tissues: experiences from a pilot study using a mobile HIFU unit.
BACKGROUND
High intensity focused ultrasound (HIFU) is a novel method which offers the non-invasive ablation of tissues without harming overlying organs or skin. It has been introduced successfully in urology for the ablation of prostatic hyperplasia and seems to be promising in the treatment of uterine fibroids. In this study we aimed to examine the feasibility and possible side effects of HIFU treatment of uterine tissues using an experimental mobile HIFU unit with ultrasound guidance.


METHODS
For these experiments, a 1.07 MHz ultrasound source was used which allows treatment depths between 0 and 10 cm. In 12 patients scheduled to have abdominal hysterectomy, 5-60 impulses of HIFU were applied through the intact skin upon uterine tissues directly prior to the surgical procedure. Tissue intensities lay between 3,200 and 6,300 W/cm(2) and a fixed pulse length of 4 s was used.


RESULTS
No side effects were encountered other than one first-degree skin burn and the treatment was well tolerated. Histology showed clearly demarcated coagulative necrosis in the targeted tissues. Treatment was concluded in less than 45 min for each patient.


CONCLUSIONS
Focused ultrasound is an effective method to selectively destroy tissue within the uterus and the transabdominal access route is very feasible. This study shows that a mobile ultrasound source can be used safely and effectively to destroy uterine tissues, such as fibroids, without major side effects.
Fruehauf
Johannes H
JH
Department of Obstetrics and Gynaecology, University Hospital Mannheim, Mannheim, Germany. jfruehau@bidmc.harvard.edu
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Walter
W
Eiermann
Alexa
A
Lang
Michael-Christian
MC
Pessel
Martin
M
Marlinghaus
Ernst
E
Melchert
Frank
F
Volz-Köster
Stefanie
S
Volz
Joachim
J
D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000628:therapy*; D008875:Middle Aged; D010865:Pilot Projects; D014464:Ultrasonic Therapy; D014549:Urinary Incontinence / Q000628:therapy; D014594:Uterine Neoplasms / Q000628:therapy*; D014599:Uterus / Q000473:pathology