+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Ultrasound guided high-intensity focused ultrasound combined with gonadotropin releasing hormone analogue (GnRHa) ablating uterine leiomyoma with homogeneous hyperintensity on T 2 weighted MR imaging



Ultrasound guided high-intensity focused ultrasound combined with gonadotropin releasing hormone analogue (GnRHa) ablating uterine leiomyoma with homogeneous hyperintensity on T 2 weighted MR imaging



British Journal of Radiology 90(1073): 20160760



The study aimed to evaluate the safety and efficiency of ultrasound-guided high-intensity focused ultrasound (USgHIFU) combined with gonadotropin-releasing hormone analogue (GnRHa)-ablating symptomatic uterine leiomyoma with homogeneous hyperintensity on T2 weighted MRI prospectively. A total of 34 patients with 42 symptomatic uterine leiomyomas with homogeneous hyperintensity on T2 weighted MRI were enrolled in our study. In the patient who had multiple uterine leiomyomas, only one dominant leiomyoma was treated. According to the principles of voluntariness, 18 patients underwent a 3-month therapy of GnRHa (once a month) before the high-intensity focused ultrasound (HIFU) treatment, while 16 patients received only HIFU treatment. Enhanced MRI was performed before and after GnRHa and HIFU treatment. Evaluation of the main indicators included treatment time, sonication time, treatment efficiency, non-perfused volume (NPV) (indicative of successful ablation) ratio and energy effect ratio; adverse events were also recorded. The treatment time and sonication time of the combination group were 102.0 min (55.8-152.2 min) and 25.4 min (12.2-34.1 min); however, they were 149.0 min (87.0-210.0 min) and 38.9 min (14.0-46.7 min) in the simple USgHIFU group. The treatment and sonication time for the combination group was significantly shorter than that for the simple USgHIFU group. Treatment efficiency, NPV ratio and energy effect ratio were 46.7 mm3 s-1 (28.5-95.8 mm3 s-1), 69.2 ± 29.8% (35.5-97.4%) and 9.9 KJ mm-3 (4.5-15.7 KJ mm-3) in the combination group, respectively; but, the lowest treatment efficiency, lowest NPV ratio and more energy effect ratio were observed in the simple HIFU group, which were 16.8 mm3 s-1 (8.9-32.9 mm3 s-1), 50.2 ± 27.3% (0-78.6%) and 23.8 KJ mm-3 (12.4-46.2 KJ mm-3), respectively. Pain scores in the combination group were 3.0 ± 0.5 points (2-4 points)-significantly less than the simple USgHIFU group. There were no significant adverse reactions in either group. Our data suggest that USgHIFU combined with GnRHa may be performed to ablate symptomatic uterine leiomyoma with homogeneous hyperintensity on T2 weighted MRI. Advances in knowledge: The conclusions indicate that GnRHa can improve the effectiveness of the USgHIFU treatment of a homogeneous hyperintense leiomyoma on T2 weighted MRI, and combination treatment could be a promising alternative treatment for the uterine leiomyoma.

(PDF emailed within 0-6 h: $19.90)

Accession: 060436641

Download citation: RISBibTeXText

PMID: 28256923

DOI: 10.1259/bjr.20160760


Related references

Feasibility of ultrasound-guided high intensity focused ultrasound ablating uterine fibroids with hyperintense on T2-weighted MR imaging. European Journal of Radiology 82(1): E43-E49, 2013

Pilot study: safety and effectiveness of simple ultrasound-guided high-intensity focused ultrasound ablating uterine leiomyoma with a diameter greater than 10 cm. British Journal of Radiology 91(1082): 20160950, 2017

Comparison between diffusion-weighted imaging, T2-weighted, and postcontrast T1-weighted imaging after MR-guided, high intensity, focused ultrasound treatment of uterine leiomyomata: preliminary results. Medical Physics 37(9): 4768-4776, 2010

Effect of biological characteristics of different types of uterine fibroids, as assessed with T2-weighted magnetic resonance imaging, on ultrasound-guided high-intensity focused ultrasound ablation. Ultrasound in Medicine and Biology 41(2): 423-431, 2015

Feasibility of magnetic resonance imaging-guided high intensity focused ultrasound therapy for ablating uterine fibroids in patients with bowel lies anterior to uterus. European Journal of Radiology 73(2): 396-403, 2010

Proton, diffusion-weighted imaging, and sodium (23Na) MRI of uterine leiomyomata after MR-guided high-intensity focused ultrasound: a preliminary study. Journal of Magnetic Resonance Imaging 29(3): 649-656, 2009

T2*-weighted imaging in the assessment of the non-perfused volume of uterine fibroids following magnetic resonance-guided high-intensity focused ultrasound ablation. International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics 132(1): 100-102, 2016

Diffusion-weighted magnetic resonance imaging using different b-value combinations for the evaluation of treatment results after volumetric MR-guided high-intensity focused ultrasound ablation of uterine fibroids. European Radiology 24(9): 2118-2127, 2015

Changes in anti-müllerian hormone levels as a biomarker for ovarian reserve after ultrasound-guided high-intensity focused ultrasound treatment of adenomyosis and uterine fibroid. Bjog 124 Suppl 3: 18-22, 2017

Intraprocedure contrast enhanced ultrasound: the value in assessing the effect of ultrasound-guided high intensity focused ultrasound ablation for uterine fibroids. Ultrasonics 58: 123-128, 2015

Efficacy, Efficiency, and Safety of Magnetic Resonance-Guided High-Intensity Focused Ultrasound for Ablation of Uterine Fibroids: Comparison with Ultrasound-Guided Method. Korean Journal of Radiology 19(4): 724-732, 2018

EP32.06: Study of contrast-enhanced ultrasound in evaluating clinical therapeutic response with high intensity focused ultrasound for uterine leiomyoma and follow-up result. Ultrasound in Obstetrics & Gynecology 48 Suppl 1: 392-393, 2016

Ultrasound-guided high-intensity focused ultrasound ablation for treating uterine arteriovenous malformation. Bjog 124 Suppl 3: 93-96, 2017

Ultrasound guided high intensity focused ultrasound (USgHIFU) ablation for uterine fibroids: Do we need the microbubbles?. International Journal of Hyperthermia 31(3): 233-239, 2016

Ultrasound-guided high-intensity focused ultrasound vs laparoscopic myomectomy for symptomatic uterine myomas. Journal of Minimally Invasive Gynecology 21(2): 279-284, 2015