title: High-intensity focused ultrasound for the targeted destruction of uterine tissues: experiences from a pilot study using a mobile HIFU unit.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital Mannheim, Mannheim, Germany. jfruehau@bidmc.harvard.edu
authors.forename: Johannes H
authors.initials: JH
authors.lastname: Fruehauf
authors.forename: Walter
authors.initials: W
authors.lastname: Back
authors.forename: Alexa
authors.initials: A
authors.lastname: Eiermann
authors.forename: Michael-Christian
authors.initials: MC
authors.lastname: Lang
authors.forename: Martin
authors.initials: M
authors.lastname: Pessel
authors.forename: Ernst
authors.initials: E
authors.lastname: Marlinghaus
authors.forename: Frank
authors.initials: F
authors.lastname: Melchert
authors.forename: Stefanie
authors.initials: S
authors.lastname: Volz-Köster
authors.forename: Joachim
authors.initials: J
authors.lastname: Volz
mesh_terms: 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