title: High intensity focused ultrasound treatment of adenomyosis: The relationship between the features of magnetic resonance imaging on T2 weighted images and the therapeutic efficacy.
abstract: OBJECTIVE
  To investigate the relationship between the features of magnetic resonance imaging (MRI) on T2 weighted images (T2WI) and the therapeutic efficacy of high intensity focused ultrasound (HIFU) on adenomyosis.
  
  
  METHODS
  From January 2011 to November 2015, four hundred and twenty-eight patients with symptomatic adenomyosis were treated with HIFU. Based on the signal intensity and the number of hyperintense foci in the adenomyotic lesions on T2WI, the patients were classified into groups. The day after HIFU ablation patients underwent contrast-enhanced MRI and a comparison was made of non-perfused volume (NPV) ratio, energy efficiency factor (EEF), treatment time, sonication time, and adverse effects.
  
  
  RESULTS
  No significant difference in terms of HIFU treatment settings and results was observed between the group of patients with hypointense adenomyotic lesions and the group with isointense adenomyotic lesions (P>0.05). However, the sonication time and EEF were significantly higher in the group with multiple hyperintense foci compared to the group with few hyperintense foci. The NPV ratio achieved in the lesions with multiple hyperintenese foci was significantly lower than that in the lesions with few hyperintense foci (P<0.05). No significant difference was observed in the rate of adverse effects between the two groups.
  
  
  CONCLUSIONS
  Based on our results, the response of the adenomyotic lesions to HIFU treatment is not related to the signal intensity of adenomyotic lesions on T2WI. However, the number of the high signal intensity foci in the adenomyotic lesions on T2WI can be considered as a predictive factor to help select patients for HIFU treatment.
authors.affiliation: State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Haifu Hospital, College of Biomedical Engineering, Chongqing Medical University, Chongqing, PR China.
authors.forename: Chunmei
authors.initials: C
authors.lastname: Gong
authors.affiliation: Department of Obstetrics and Gynecology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
authors.forename: Raymond
authors.initials: R
authors.lastname: Setzen
authors.affiliation: State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Haifu Hospital, College of Biomedical Engineering, Chongqing Medical University, Chongqing, PR China.
authors.forename: Zhongqiong
authors.initials: Z
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Haifu Hospital, College of Biomedical Engineering, Chongqing Medical University, Chongqing, PR China.
authors.forename: Yunchang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Ultrasound, Huanggang Central Hospital, Huanggang City, Hubei 438000, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Xie
authors.affiliation: Shanghai First Maternity and Infant Health Hospital, Shanghai, PR China. Electronic address: 1819483078@qq.com.
authors.forename: Aixingzi
authors.initials: A
authors.lastname: Aili
authors.affiliation: State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Haifu Hospital, College of Biomedical Engineering, Chongqing Medical University, Chongqing, PR China. Electronic address: lianwzhang@yahoo.com.
authors.forename: Lian
authors.initials: L
authors.lastname: Zhang
mesh_terms: D062788:Adenomyosis / Q000601:surgery*; D000328:Adult; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Ablative efficiency; Adenomyosis; High intensity focused ultrasound (HIFU); Magnetic resonance imaging (MRI); Signal characteristics