title: Safety of ultrasound-guided high-intensity focused ultrasound ablation for diffuse adenomyosis: A retrospective cohort study.
abstract: OBJECTIVE
  To evaluate the safety of ultrasound-guided high-intensity focused ultrasound (HIFU) ablation for patients with diffuse adenomyosis.
  
  
  METHODS
  This was a retrospective cohort study. The data was collected from 417 symptomatic adenomyosis patients who underwent ultrasound-guided HIFU between January 2012 and December 2015 at 1st Affiliated Hospital of Chongqing Medical University, Chongqing, China. Among them were 260 patients with diffuse adenomyosis (Group D) and 157 patients with focal adenomyosis (Group F). All patients underwent contrast-enhanced magnetic resonance imaging (MRI) one week before and the day after HIFU treatment. Successful treatment with HIFU was measured by the non-perfused volume ratio (NPVR). Intraprocedural and postprocedural adverse effects and complications were recorded to assess the safety of the procedure. Patients were followed-up for three months post-treatment. Complications were given a grade A through F according to the SIR Standards.
  
  
  RESULTS
  All patients successfully completed the procedure, non-perfused regions appeared in 415 (99.5%) patients. The non-perfused volume ratio (NPVR) of Group D was significantly lower than that of Group F (P<0.05). During the procedure, the odds ratio of skin-burning pain was 1.7 (OR=1.617, 95% CI: 1.103-2.532), when comparing Group D with Group F, while the odds ratio of inguinal pain was equal to 2.0 (OR=2.038, 95% CI: 1.161-3.580), when Group F was compared to Group D. 97 patients (23.3%) received nominal therapy due to complications ([Society of interventional radiology, SIR]-B grade), among them, there were 62 cases (23.8%) in Group D and 35 cases (22.3%) in Group F. No significant difference was found between the two groups (P>0.05) and neither of the reported complications of SIR-C-SIR-F occurred within the two groups.
  
  
  CONCLUSIONS
  Based on our results, ultrasound-guided HIFU is safe for the treatment of diffuse adenomyosis, and controlling the ablation zone is crucial to ensure patients' safety.
authors.affiliation: The State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing 400016, China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Feng
authors.affiliation: The State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing 400016, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Hu
authors.affiliation: The State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing 400016, China; Clinical Center for Tumor Therapy, The 2nd Hospital, Chongqing Medical University, 76 Linjiang Road, Chongqing 400010, China.
authors.forename: Wenzhi
authors.initials: W
authors.lastname: Chen
authors.affiliation: HIFU Center for Tumor Therapy, 1st Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhang
authors.affiliation: HIFU Center for Tumor Therapy, 1st Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Wang
authors.affiliation: The State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing 400016, China. Electronic address: chenjinyun2006@126.com.
authors.forename: Jinyun
authors.initials: J
authors.lastname: Chen
mesh_terms: D062788:Adenomyosis / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012449:Safety; D055815:Young Adult
keywords: Ablation; Adenomyosis; Safety; Ultrasound-guided high-intensity focused ultrasound (HIFU)