title: Volumetric MR-guided high-intensity focused ultrasound ablation to treat uterine fibroids through the abdominal scars using scar patch: a case report.
abstract: BACKGROUND
  Abdominal scars pose a challenge in magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) therapies, limiting patient selection and increasing the risk of skin burns. Especially, scars arising from longitudinal incisions are problematic as they usually lie medially at the lower abdomen where the ultrasound beam has to go through. Volumetric sonication has been shown to efficiently enlarge the ablated volume per sonication, but they nevertheless require more thermal energy to be deposited per sonication which increases the temperature in the near-field area located between the transducer and the target region.
  
  
  METHODS
  The scar patch was used in three patients undergoing MR-HIFU ablation of fibroids using volumetric technique, one with transverse incision and the other two with longitudinal incision. No severe adverse effects were observed. The relative shrinkage of the fibroid of these patients at 6-month follow-up were 67, 78, and 59 %, respectively.
  
  
  CONCLUSIONS
  Our preliminary experience suggests that the use of scar patch on MR-HIFU ablation of fibroids using volumetric technique provides an effective treatment option for patients who were previously excluded from MR-HIFU treatment due to the abdominal scars.
authors.affiliation: Radiology Department, Peking University First Hospital, 8 Xishiku Street, Beijing, 100034 China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Philips Healthcare, Seoul, South Korea.
authors.forename: Bilgin
authors.initials: B
authors.lastname: Keserci
authors.affiliation: Philips Healthcare, Vantaa, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Viitala
authors.affiliation: Philips Research China, Shanghai, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Wei
authors.affiliation: Radiology Department, Peking University First Hospital, 8 Xishiku Street, Beijing, 100034 China.
authors.forename: Xuedong
authors.initials: X
authors.lastname: Yang
authors.affiliation: Radiology Department, Peking University First Hospital, 8 Xishiku Street, Beijing, 100034 China.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Wang
keywords: Scar patch; Uterine fibroid; Volumetric MR-guided high-intensity focused ultrasound