Analysis of the influencing factors on the ablation rate of uterine fibroid by using high intensity focused ultrasound

Share this content in WeChat

• Clinical Article •

CHEN Liping LÜ Fajin ZHENG Yineng XIONG Yulin LIU Xiaoxi

Cite this article as: Chen LP, Lü FJ, Zheng YN, et al. Analysis of the influencing factors on the ablation rate of uterine fibroid by using high intensity focused ultrasound. Chin J Magn Reson Imaging, 2020, 11(11): 1019-1022, 1028. DOI:10.12015/issn.1674-8034.2020.11.012.

Abstract

[Abstract] Objective: To explore the influencing factors of high intensity focused ultrasound (HIFU) in the treatment of uterine fibroid.Materials and Methods: Retrospectively collected clinical data of 130 patients with uterine fibroid admitted to the HIFU Center of the First Affiliated Hospital of Chongqing Medical University from January 2013 to December 2018, including the patient's age, volume of fibroids and mean meridian before treatment, fibroids location, fibroids type, MRI T2WI signal intensity and uniformity, T1WI enhancement intensity and uniformity, and uterine location, etc. The preoperative and postoperative MRI images were used to calculate the preoperative volume of the fibroids and the non-perfused area after the HIFU treatment to obtain the ablation rate. The indicators above were analyzed to find out the factors that affect the efficacy of HIFU ablation of uterine fibroids.Results: Of the 130 fibroids, 70 (53.8%) fibroids were sufficient ablated. Univariate analysis results showed that volume of fibroids, mean meridian of fibroids, T2WI signal intensity and uniformity, TIWI enhancement degree and uterine position had a statistically significant effect on ablation (P<0.05). Multivariate logistic regression analysis showed that T2WI signal intensity (P=0.035) and TIWI enhancement (P=0.038) of fibroids were more likely to achieve satisfactory ablation results.Conclusions: The volume of fibroids, the average meridian of fibroids, the intensity and uniformity of T2WI signal, the degree of T1WI enhancement, and the position of the uterus all have a certain effect on the efficacy of HIFU in treating uterine fibroids. This study has a certain predictive effect on predicting the efficacy of HIFU ablation of uterine fibroids.

[Keywords] high intensity focused ultrasound；uterine fibroid；Ablation therapy；treatment outcome；influencing factors

Contributor Information

CHEN Liping Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

LÜ Fajin^* Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

ZHENG Yineng Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

XIONG Yulin Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

LIU Xiaoxi Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

*Correspondence to: Lü FJ, E-mail: fajinlv@163.com

Conflicts of interest None.

Publication Information

Received 2020-06-12

Accepted 2020-09-28

DOI: 10.12015/issn.1674-8034.2020.11.012

Text

References

[1]

Juhasz-Boss I, Jungmann P, Radosa J, et al. Two novel classification systems for uterine fibroids and subsequent uterine reconstruction after myomectomy. Arch Gynecol Obstet, 2017, 295(3): 675-680. DOI: 10.1007/s00404-016-4268-6

[2]

Stewart EA, Cookson CL, Gandolfo RA, et al. Epidemiology of uterine fibroids: a systematic review. BJOG, 2017, 124 (10): 1501-1512. DOI: 10.1111/1471-0528.14640

[3]

Suzuki Y, II M, Saito T, et al. Establishment of a novel mouse xenograft model of human uterine leiomyoma. Sci Rep, 2018, 8(1): 8872. DOI: 10.1038/s41598-018-27138-1

[4]

Olejek A, Olszak-Wąsik K, Czerwinska-Bednarska A. Long-term intermittent pharmacological therapy of uterine fibroids - a possibility to avoid hysterectomy and its negative consequences. Prz Menopauzalny, 2016, 15(1): 48-51. DOI: 10.5114/pm.2016.58774

[5]

Taniguchi F, Koike N, Kikukawa T, et al. An evaluation of laparoscopic hysterectomy alone versus in combination with laparoscopic myomectomy for patients with uterine fibroids. Eur J Obstet Gynecol Reprod Biol, 2017, 210: 132-138. DOI: 10.1016/j.ejogrb.2016.12.005

[6]

American College of Obstetricians and Gynecologists. ACOG practice bulletin. Alternatives to hysterectomy in the management of leiomyomas. Obstet Gynecol, 2008, 112(2Pt 1): 387-400. DOI: 10.1097/AOG.0b013e318183fbab

[7]

Liu XF, Huang LH, Zhang C, et al. A comparison of the cost utility of ultrasound-guided high-intensity focused ultrasound and hysterectomy for adenomyosis: a retrospective study. BJOG, 2017, 124(Suppl 3): 40-45. DOI: 10.1111/1471-0528.14746

[8]

Lee JS, Hong GY, Lee KH, et al. 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, 2017, 124(Suppl 3): 18-22. DOI: 10.1111/1471-0528.14739

[9]

Cheung VY, Lam TP, Jenkins CR, et al. Ovarian reserve after ultrasound-guided high-intensity focused ultrasoundfor uterine fibroids：preliminary experience. J Obstet Gynaecol Can, 2016, 38 (4): 357-361. DOI: 10.1016/j.jogc.2016.02.006

[10]

Stewart EA, Gedroyc WM, Tempany CM, et al. Focused ultrasound treatment of uterine fibroid tumors: safety and feasibility of a noninvasive ther- moablative technique. Am J Obstet Gynecol, 2003, 189(1): 48-54. DOI: 10.1067/mob.2003.345

[11]

Mikami K, Murakami T, Okada A, et al. Magnetic resonance imaging-guided focused ultrasound ablation of uterine fibroids: early clinical experience. Radiat Med, 2008, 26(4): 198-205. DOI: 10.1007/s11604-007-0215-6

[12]

Cheng HL, Wang C, Tian J. Correlation between uterine fibroids with various magnetic resonance imaging features and therapeutic effects of high-intensity focused ultrasound ablation. Pak J Med Sci, 2015, 31(4): 869-873. DOI: 10.12669/pjms.314.7294

[13]

Peng S, Zhang L, Hu L, et al. Factors influencing the dosimetry for high-intensity focused ultrasound ablation of uterine leiomyoma s: a retrospective study. Medicine (Baltimore), 2015, 94(13): e650. DOI: 10.1097/MD.0000000000000650

[14]

Fan HJ, Cun JP, Zhao W, et al. Factors affecting effects of ultrasound guided high intensity focused ultrasound for single uterine fibroids: a retrospective analysis. Int J Hyperthermia, 2018, 35(1): 534-540. DOI: 10.1080/02656736.2018.1511837

[15]

秦娟，陈文直，陈锦云，等．超声消融子宫肌瘤后残余瘤组织的核磁共振影像学转归．中国肿瘤临床, 2013, 40(2): 111-115. DOI: 10.3969/j.issn.1000-8179.2013.02.013

[16]

Fennessy FM, Tempany CM, McDannold NJ, et al. Uterine leiomyomas: MR imaging-guided focused ultrasound surgery--results of different treatment protocols. Radiology, 2007, 243(3): 885-893. DOI: 10.1148/radiol.2433060267

[17]

Stewart EA, Gostout B, Rabinovici J, et al. Sustained relief of leiomyoma symptoms by using focused ultrasound surgery. Obstet Gynecol, 2007, 110(2Pt 1): 279-287. DOI: 10.1097/01.AOG.0000275283.39475.f6

[18]

潘文秋，汤蕊嘉，赵卫，等．高强度聚焦超声治疗子宫肌瘤临床疗效的影响因素．介入放射学杂志, 2019, 28(11): 1086-1090.

[19]

Funaki K, Fukunishi H, Funaki T, et al. Magnetic resonance-guided focused ultrasound surgery for uterine fibroids: relationship between the therapeutic effects and signal intensity of preexisting T2-weighted magnetic resonance images. Am J Obstet Gynecol, 2007, 196(2): 184. e1-6. DOI: 10.1016/j.ajog.2006.08.030

[20]

Zhao WP, Chen JY, Zhang L, et al. Feasibility of ultrasound-guided high intensity focused ultrasound ablating uterine fibroids with hyperintense on T2-weighted MR imaging. Eur J Radiol, 2013, 82(1): e43-49. DOI: 10.1016/j.ejrad.2012.08.020

[21]

Gong C, Setzen R, Liu Z, et al. High intensity focused ultrasound treatment of adenomyosis: The relationship between the features of magnetic resonance imaging on T2 weighted images and the therapeutic efficacy. Eur J Radiol, 2017, 89: 117-122. DOI: 10.1016/j.ejrad.2017.02.001

[22]

Zhang X, Zou M, Zhang C, et al. Effects of oxytocin on high intensity focused ultrasound (HIFU) ablation of adenomysis: a prospective study. Eur J Radiol, 2014, 83(9): 1607-1611. DOI: 10.1016/j.ejrad.2014.05.008

[23]

易根发，赵卫，范宏杰，等．不同子宫位置子宫肌瘤的高强度聚焦超声消融效果分析．介入放射学杂志, 2019, 28(03): 280-283.

PREV Magnetic resonance imaging as a tool to predict pathological complete response of rectal cancer after neoadjuvant chemoradiotherapy: a Meta-analysis

NEXT Limb remote ischemic preconditioning prolongs the existence window of graphic penumbra in cerebral ischemia rat model and its related mechanism: through inhibiting the expression of high mobility group protein 1

LINK

Tel & Fax: +8610-67113815 E-mail: editor@cjmri.cn