title: Using microbubble sonographic contrast agent to enhance the effect of high intensity focused ultrasound for the treatment of uterine fibroids.
abstract: OBJECTIVE
  To evaluate the effects of the ultrasound contrast agent SonoVue in enhancing the ablative effects of Ultrasound-Guided high-intensity focused ultrasound (HIFU) on different sub-types of uterine fibroids.
  
  
  METHODS
  In this study, 390 fibroids from 319 patients were retrospectively evaluated, among which 155 were treated with SonoVue and 235 were without SonoVue during HIFU ablation. The efficacy of HIFU was evaluated using magnetic resonance scanning (MRI) in all patients.
  
  
  RESULTS
  The total ablation time to achieve the same non-perfused volume was significantly shortened with SonoVue. The average energy used and the acoustic energy for treating 1 mm(3) (EEF) was less when SonoVue is used as enhancing agent. The non-perfused volume (NPV) was measured by post-HIFU MRI and the mean fractional ablation was calculated. Mean NPV was 74% (range: 15%-100%) in the HIFU-only group and 75% (range: 17%-100%) in the HIFU+ SonoVue group. However, for T2 MRI low intensity signal fibroids, NPV in the SonoVue group reached 83% (range: 20%-100%) that was significantly higher than in the HIFU-only group, which was 76% (range: 15%-100%). No differences in adverse events were observed between the two groups.
  
  
  CONCLUSIONS
  Our observations demonstrate that the use of therapeutic SonoVue during the HIFU procedure can significantly decrease the ablation time and the energy requirement for the treatment of the same fibroid volume in all types of fibroids.
authors.affiliation: HIFU Unit, University Hospital Mutua de Terrassa, Spain; Department of Obstetrics and Gynecology, University Hospital Mutua de Terrassa, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Isern
authors.affiliation: HIFU Unit, University Hospital Mutua de Terrassa, Spain; Department of Obstetrics and Gynecology, University Hospital Mutua de Terrassa, Spain. Electronic address: apessarrodona@mutuaterrassa.es.
authors.forename: A
authors.initials: A
authors.lastname: Pessarrodona
authors.affiliation: HIFU Unit, University Hospital Mutua de Terrassa, Spain; Department of Obstetrics and Gynecology, University Hospital Mutua de Terrassa, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Rodriguez
authors.affiliation: HIFU Unit, University Hospital Mutua de Terrassa, Spain; Department of Obstetrics and Gynecology, University Hospital Mutua de Terrassa, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Vallejo
authors.affiliation: Department of Radiology, University Hospital Mutua de Terrassa, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Gimenez
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Mutua de Terrassa, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Cassadó
authors.affiliation: Department of Radiology, University Hospital Mutua de Terrassa, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: De Marco
authors.affiliation: Department of Radiology, University Hospital Mutua de Terrassa, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Pedrerol
mesh_terms: D000328:Adult; D003287:Contrast Media / Q000627:therapeutic use*; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D045423:Microbubbles; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: HIFU; SonoVue; T2MRI signal; Uterine fibroid