Comparison of High-Intensity Focused Ultrasound and Conventional Surgery for Patients with Uterine Myomas: A Systematic Review and Meta-Analysis

Tsai, Ming-Chieh; Chang, Lu-Te; Tam, Ka‐Wai

doi:10.1016/j.jmig.2021.06.002

Cited by 25 publications

(12 citation statements)

References 30 publications

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“…[ 24 ] Compared to conventional treatment modalities such as surgery, HIFU was also associated with lower morbidity and shorter length of stay. [ 27 28 ] The reintervention rate was 7.7% in our study which was also consistent with a rate of 8.1% based on a meta-analysis by Yu et al . [ 29 ]…”

Section: Discussionsupporting

confidence: 92%

High-intensity Focused Ultrasound for the Treatment of Fibroids

Jindal

Jung

Lee

et al. 2023

Gynecology and Minimally Invasive Therapy

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Objectives: Uterine fibroids and adenomyosis are common gynecological conditions that often require surgical treatment. Minimally invasive interventions such as ultrasound-guided high-intensity focused ultrasound (USgHIFU) are gaining popularity as they avoid surgical morbidity and conserve the uterus. We present a single-center experience on the use of USgHIFU for the treatment of fibroids and adenomyosis. Materials and Methods: This was a retrospective study of 167 patients who underwent USgHIFU for uterine fibroids and adenomyosis between July 2018 and December 2020. Relevant demographic data and pre- and post-intervention fibroid volume, symptom severity scores (SSS), and health-related quality of life (QOL) scores were collected and compared. The paired t -test or Wilcoxon signed-rank test was used to compare the difference before and after treatment. P < 0.001 was considered statistically significant. Results: One hundred and sixty-seven patients with fibroids or adenomyosis were included in this study. The mean age of the cohort was 42-year-old. USgHIFU treatment led to a reduction in mean fibroid volume, improvement in SSS, and health-related QOL scores. The average reduction in mean fibroid volume was 68% and 75% at 6 and 12 months, respectively. There was a significant reduction in SSS (46.9 [pre] vs. 15.6 [post], P < 0.001) and improvement in health-related QOL scores at 6 months (58 [pre] vs. 86 [post], P < 0.001). The re-intervention rate following USgHIFU was 7.7% and successful pregnancy post USgHIFU was reported in 6 patients. Conclusion: USgHIFU is safe and effective. In women who desire fertility or are not suitable for surgery, it is a good alternative option. It should be included in the armamentarium for the treatment of uterine fibroids and adenomyosis.

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Section: Discussionsupporting

confidence: 92%

High-intensity Focused Ultrasound for the Treatment of Fibroids

Jindal

Jung

Lee

et al. 2023

Gynecology and Minimally Invasive Therapy

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“…Можливі біль, опіки шкіри, вагінальні виділення, кровотечі та пошкодження сусідніх структур (включно з травмою кишечника). Ризик необхідності реінтервенції [71,80] Важливими чинниками для ухвалення рішень є місце розташування міоми та її розмір. Загалом міомектомія розглядається як стандартне лікування для групи жінок, коли пацієнтка може відтермінувати вагітність.…”

Section: малоінвазивна процедураunclassified

Uterine fibroids: synthesis of modern knowledge

Plaksiieva¹,

Tatarchuk²,

Косей³

et al. 2022

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Uterine fibroids is an extremely common tumor of the female reproductive system in the population. The problem of this pathology is the diversity of symptoms, mediated by the variety of sizes and locations of myomas, significant impact on reproductive function and frequent misunderstanding of the tumor nature, which leads to unwarranted hysterectomies, even among young women.Authors review the literature on the basis of modern guidelines, which reveals the potential of preserving methods of treatment of fibroids. It is also attempted to answer the most common questions about this pathology.The incidence of uterine fibroids increases with age. Fibroids are hormone dependent tumors, but the obvious cause has not yet been identified, although various risk factors are known, both modified (e.g., obesity, parity) and unmodified (race, age, etc.). Diagnosis of fibroids is simple – just an examination and ultrasound of the pelvis. Among the organ preservation methods of treatment are currently known medicinal (some of them can be used as mono-method or in combination with other methods), minimally invasive (among which stands out uterine artery embolization, as the most studied, effective and safe method) and surgical – conservative myomectomy, which can be performed by different approaches (laparoscopic, hysteroscopic or laparotomy) depending on the number and location of fibroids. This review considers the issues of fertility in uterine fibroids and after organ preservation technologies for its treatment. Differential diagnosis of uterine fibroids with leiomyosarcoma – a rare tumor and its diagnosis is quite difficult.The development of modern medical science, combining specialties with the formation of multidisciplinary teams (as in the case of collaboration with endovascular surgeons to perform uterine artery embolization) and use of an individual approach depending on the fibroids characteristics and patient needs helps reduce the proportion of hysterectomies for uterine fibroids, preservation of the organ and fertility.

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“…1 Focused ultrasound surgery is a new and widely used noninvasive method for the treatment of uterine fibroids. 2 Accurate segmentation of the uterine fibroids is an important part for guiding the therapy preoperatively, and doctors can clearly determine the location, shape, and size of uterine fibroids through magnetic resonance imaging (MRI). Uterine fibroids segmentation usually relies on manual labeling by radiologists, but this repeated mechanical labor is too time-consuming and laborious, so the segmentation results are easily affected by individual differences.…”

Section: Introductionmentioning

confidence: 99%

“…Uterine fibroid is a very common benign tumor, affecting up to 80% of all women in their reproductive age 1 . Focused ultrasound surgery is a new and widely used noninvasive method for the treatment of uterine fibroids 2 . Accurate segmentation of the uterine fibroids is an important part for guiding the therapy preoperatively, and doctors can clearly determine the location, shape, and size of uterine fibroids through magnetic resonance imaging (MRI).…”

Section: Introductionmentioning

confidence: 99%

DARU‐Net: A dual attention residual U‐Net for uterine fibroids segmentation on MRI

Zhang

Liu

Chen

et al. 2023

J Applied Clin Med Phys

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Uterine fibroid is the most common benign tumor in female reproductive organs. In order to guide the treatment, it is crucial to detect the location, shape, and size of the tumor. This study proposed a deep learning approach based on attention mechanisms to segment uterine fibroids automatically on preoperative Magnetic Resonance (MR) images. Methods: The proposed method is based on U-Net architecture and integrates two attention mechanisms: channel attention of squeeze-and-excitation (SE) blocks with residual connections, spatial attention of pyramid pooling module (PPM). We did the ablation study to verify the performance of these two attention mechanisms module and compared DARU-Net with other deep learning methods. All experiments were performed on a clinical dataset consisting of 150 cases collected from our hospital. Among them, 120 cases were used as the training set, and 30 cases are used as the test set. After preprocessing and data augmentation, we trained the network and tested it on the test dataset. We evaluated segmentation performance through the Dice similarity coefficient (DSC), precision, recall, and Jaccard index (JI). Results: The average DSC, precision, recall, and JI of DARU-Net reached 0.8066 ± 0.0956, 0.8233 ± 0.1255, 0.7913 ± 0.1304, and 0.6743 ± 0.1317. Compared with U-Net and other deep learning methods, DARU-Net was more accurate and stable. Conclusion: This work proposed an optimized U-Net with channel and spatial attention mechanisms to segment uterine fibroids on preoperative MR images. Results showed that DARU-Net was able to accurately segment uterine fibroids from MR images.

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Comparison of High-Intensity Focused Ultrasound and Conventional Surgery for Patients with Uterine Myomas: A Systematic Review and Meta-Analysis

Cited by 25 publications

References 30 publications

High-intensity Focused Ultrasound for the Treatment of Fibroids

High-intensity Focused Ultrasound for the Treatment of Fibroids

Uterine fibroids: synthesis of modern knowledge

DARU‐Net: A dual attention residual U‐Net for uterine fibroids segmentation on MRI

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