Safety and efficacy of US-guided high-intensity focused ultrasound for treatment of submucosal fibroids.
OBJECTIVE
To evaluate the safety and efficacy of US-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of submucosal fibroids


METHODS
A total of 76 women with 78 submucosal uterine fibroids (68 type II fibroids, 10 type I fibroids) underwent US-guided HIFU ablation. The pretreatment fibroid diameter ranged from 2.4 to 13.5 cm (mean 5.7 ± 2.3 cm). The fibroids were ablated using a power output of 420-520 W. During follow-up, the volume shrinkage of the ablated fibroids was continuously observed on contrast-enhanced MR and/or contrast-enhanced ultrasound (CEUS). The change of symptoms was evaluated by using the symptom severity score questionnaire.


RESULTS
HIFU ablation was well tolerated in all patients. No major complications occurred. The mean nonperfused ablation ratio was 80 ± 12 % on CEUS. During follow-up, the ablated fibroids shrank significantly over time. The symptoms were alleviated significantly. No patients had amenorrhoea after treatment. Vaginal expulsion of necrotic tissue was seen in 58 % (44/76) of patients after HIFU ablation which disappeared after 2-4 menstrual cycles. Four patients received repeated HIFU ablation for enlarged residual fibroids.


CONCLUSIONS
US-guided HIFU ablation may be a safe and effective treatment for submucosal fibroids. Further studies are warranted to observe its influence on fertility.


CONCLUSIONS
• High-intensity focused ultrasound (HIFU) is a new minimally invasive therapeutic technique.                                  • HIFU ablation may be safe and effective for treatment of submucosal fibroids                                  • Treatment is minimally invasive and repeatable.                                  • Vaginal expulsion of necrotic tissue is common after treatment.
Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. wangw1016@yahoo.com.cn
Wei
W
Wang
Yang
Y
Wang
Ting
T
Wang
Junyan
J
Wang
Longxia
L
Wang
Jie
J
Tang
D000328:Adult; D003287:Contrast Media / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D057086:High-Intensity Focused Ultrasound Ablation / Q000379:methods*; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging* / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D061214:Patient Safety; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods; D014463:Ultrasonography
D003287:Contrast Media