title: Feasibility, Safety, and Efficacy of Accurate Uterine Fibroid Ablation Using Magnetic Resonance Imaging-Guided High-Intensity Focused Ultrasound With Shot Sonication.
abstract: The aim of this study was to investigate the feasibility, safety, and efficacy of uterine fibroid treatment using magnetic resonance imaging (MRI)-guided high-intensity focused ultrasound (US) with shot sonication for accurate ablation. Forty-three patients with 51 symptomatic uterine fibroids were treated with MRI-guided high-intensity focused US with shot sonication, which was a small acoustic focus of higher intensity with a shorter time (2 seconds) of US exposure and a shorter cooling time (2-3 seconds). The treatment efficacy and adverse events were analyzed, and the changes in the severity of symptoms and the reduction in fibroid volume were assessed 3 and 6 months after the procedure. All patients were successfully treated in a single session, without major complications, and the mean nonperfused volume ratio ± SD was 84.3% ± 15.7% (range, 33.8%-100%).Complete ablation was achieved in 13 T2-hypointense fibroids from 10 patients, and partial ablation was achieved in 38 fibroids from 33 patients. The overall mean treatment time was 135.0 ± 50.9 minutes (2.2 ± 0.8 hours). The transformed symptom severity scores and mean fibroid volumes decreased significantly after treatment (P < .05). In conclusion, MRI-guided high-intensity focused US with shot sonication is a feasible, safe, and effective technique for ablation of uterine fibroids and complete ablation of T2-hypointense fibroids.
authors.affiliation: College of Biomedical Engineering and First Affiliated Hospital of Chongqing Medical University, Chongqing, China (Y.X., W.-Z.C., Z.W.); and Xuhui Central Hospital of Shanghai and Shanghai Clinical Center, China Academy of Sciences, Shanghai, China (Y.X., Z.F., L.Y., Z.H.). yhxu@scrc.ac.cn.
authors.forename: Yonghua
authors.initials: Y
authors.lastname: Xu
authors.affiliation: College of Biomedical Engineering and First Affiliated Hospital of Chongqing Medical University, Chongqing, China (Y.X., W.-Z.C., Z.W.); and Xuhui Central Hospital of Shanghai and Shanghai Clinical Center, China Academy of Sciences, Shanghai, China (Y.X., Z.F., L.Y., Z.H.).
authors.forename: Zhongxiang
authors.initials: Z
authors.lastname: Fu
authors.affiliation: College of Biomedical Engineering and First Affiliated Hospital of Chongqing Medical University, Chongqing, China (Y.X., W.-Z.C., Z.W.); and Xuhui Central Hospital of Shanghai and Shanghai Clinical Center, China Academy of Sciences, Shanghai, China (Y.X., Z.F., L.Y., Z.H.).
authors.forename: Lixia
authors.initials: L
authors.lastname: Yang
authors.affiliation: College of Biomedical Engineering and First Affiliated Hospital of Chongqing Medical University, Chongqing, China (Y.X., W.-Z.C., Z.W.); and Xuhui Central Hospital of Shanghai and Shanghai Clinical Center, China Academy of Sciences, Shanghai, China (Y.X., Z.F., L.Y., Z.H.).
authors.forename: Zili
authors.initials: Z
authors.lastname: Huang
authors.affiliation: College of Biomedical Engineering and First Affiliated Hospital of Chongqing Medical University, Chongqing, China (Y.X., W.-Z.C., Z.W.); and Xuhui Central Hospital of Shanghai and Shanghai Clinical Center, China Academy of Sciences, Shanghai, China (Y.X., Z.F., L.Y., Z.H.).
authors.forename: Wen-Zhi
authors.initials: WZ
authors.lastname: Chen
authors.affiliation: College of Biomedical Engineering and First Affiliated Hospital of Chongqing Medical University, Chongqing, China (Y.X., W.-Z.C., Z.W.); and Xuhui Central Hospital of Shanghai and Shanghai Clinical Center, China Academy of Sciences, Shanghai, China (Y.X., Z.F., L.Y., Z.H.).
authors.forename: Zhibiao
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007889:Leiomyoma / Q000473:pathology* / Q000601:surgery*; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D061214:Patient Safety; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult
keywords: ablation; magnetic resonance imaging; magnetic resonance imaging–guided high-intensity focused ultrasound; nonperfused volume; uterine fibroid