Feasibility study on energy prediction of microwave ablation upon uterine adenomyosis and leiomyomas by MRI

Abstract

Objective: To evaluate the feasibility of energy prediction of percutaneous microwave ablation (PMWA) upon uterine leiomyomas and adenomyosis by MRI. Methods: 63 patients (49 patients with 49 uterine leiomyomas and 14 patients with adenomyosis) who underwent ultrasound-guided PMWA treatment were studied during the period from June 2011 to December 2012. Before PMWA, contrast-enhanced MRI (ceMRI) was performed for all of the patients. Based on the signal intensity (SI) of T 2 weighted MRI, uterine leiomyomas were classified as hypointense, isointense and hyperintense. During ablation, the output energy of the microwave was set at 50 W, and T11a microwave antennas were used. ceMRI was performed within 7 days after PMWA treatment. Non-perfused volume and energy required per unit volume were analysed statistically.Results: When unit volume of lesions was ablated, uterine adenomyosis needed more energy than did uterine leiomyomas, and hyperintense uterine leiomyomas needed more energy than did hypointense pattern.Conclusions: MRI SI of uterine leiomyomas and uterine adenomyosis can be used to predict PMWA energy. Advances in knowledge:The conclusions indicate that MRI SI can be used to perform pre-treatment planning, which will make the treatment more precise.

Effectiveness of ultrasound-guided percutaneous microwave ablation for symptomatic uterine fibroids: a multicentre study in China

“…US-guided percutaneous microwave ablation (PMWA) therapy utilises electromagnetic microwave heat to induce cellular death via coagulation necrosis. Single-centre research studies have confirmed the safety and efficacy of this treatment; it has been shown that this treatment is effective, minimally invasive and uterus-conserving with effective relief of clinical symptoms after therapy [4][5][6][7][8][9][10][11]. However, no multicentre study with a large sample has been conducted to confirm the conclusions of these single-centre investigations.…”

Ultrasound-guided percutaneous microwave ablation for adenomyosis: efficacy of treatment and effect on ovarian function

“…Ensuring the efficiency of treatment without negatively affecting ovarian function remains a longstanding challenge in these patients 4 . Ultrasound (US)-guided percutaneous microwave ablation (PMWA) has been used in the treatment of symptomatic adenomyosis and fibroids 5 6 7 8 9 , which has produced satisfactory clinical outcomes. However, changes in serum hormone levels after PMWA have not been thoroughly studied.…”

Unplanned pregnancy after ultrasound-guided percutaneous microwave ablation of uterine fibroids: A follow-up study

“…The UPMWA treatment protocol was based on previously published protocols 5 6 7 8 9 10 11 . In brief, ablation was performed under conscious intravenous sedation (intravenous infusion of flurbiprofen ester 2 mg/kg, supplemented by pumping 4 mg/(kg·h) –1 propofol).…”

“…Thus, treatment goals include not only alleviation of the symptoms, but also reservation or even amendment of the ability of fertility. Recently, ultrasound-guided percutaneous microwave ablation (UPMWA) has been widely used to treat symptomatic myomas and adenomyosis 5 6 7 8 9 10 11 . This has been shown to be a feasible and safe approach for treating symptomatic uterine fibroids; moreover, the procedure is easy, fast, and minimally invasive.…”