Non-contrast enhanced MRI for assessment of uterine fibroids’ early response to ultrasound-guided high-intensity focused ultrasound thermal ablation

Liao, Dongfang; Xiao, Zhibo; Lv, Fajin; Chen, Jinyun; Qiu, Lanyu

doi:10.1016/j.ejrad.2019.108670

Cited by 19 publications

(8 citation statements)

References 30 publications

(35 reference statements)

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“…It is widely accepted that the DWI signal, using a b value of 800 s/mm 2 , primarily reflects the diffusion of water molecules. Hyperintense areas may indicate cytotoxic edema associated with early ischemia and restricted diffusion of surrounding water molecules 15 , 24 , while hypointense areas may associated with water liberation following cell membrane rupture caused by intense tissue damage after excessive energy accumulation 13 , 23 , 25 . To confirm the accuracy of DWI in detecting necrotic lesions post-ablation, we compared the volume of ablated necrotic lesions and corresponding NPV ratios measured by DWI and CE T1-weighted imaging.…”

Section: Discussionmentioning

confidence: 99%

“…Diffusion-weighted imaging (DWI) can rapidly detect tissue changes after thermotherapy within minutes 10 – 12 , offering a potential non-gadolinium method for evaluating MRgFUS treatment between sonications. Research indicates that DWI accurately maps the fibroid ablation area, showing a strong correlation with CE T1-weighted images and histopathological findings 13 – 15 . However, previous studies did not conduct DWI during treatment or on the treatment-table, and the time elapsed between focused ultrasound treatment and DWI scanning range from a few hours to two days.…”

Section: Introductionmentioning

confidence: 86%

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Diffusion-weighted imaging as a potential non-gadolinium alternative for immediate assessing the hyperacute outcome of MRgFUS ablation for uterine fibroids

Huang,

Zhou,

et al. 2024

Sci Rep

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The aim of this study was to investigate the value of diffusion-weighted imaging (DWI) as a potential non-gadolinium alternative for promptly assessing the hyperacute outcome of magnetic resonance-guided focused ultrasound (MRgFUS) treatment for uterine fibroids. In this retrospective study we included 65 uterine fibroids from 44 women, who underwent axial DWI (b-value: 800 s/mm2) and contrast-enhanced (CE) MR within 15 min post-ablation. Two blinded observers independently reviewed the DWI findings of ablated necrotic lesions and measured their volumes on DWI and CE images. The post-ablation DWI images revealed clear depiction of ablative necrotic lesions in all fibroids, which were classified into two types: the bull’s eye sign (type 1) and the bright patch sign (type 2). The inter-observer intraclass correlation coefficient for classifying DWI signal types was 0.804 (p < 0.001). Volumetric analysis of ablated necrosis using DWI and CE T1-weighted imaging showed no significant variance, nor did the non-perfused volume ratios (all p > 0.05). Bland–Altman analysis revealed a mean difference of 2.38% and 1.71% in non-perfused volume ratios between DWI and CE, with 95% limits of agreement from − 19.06 to 23.82% and − 18.40 to 21.82%, respectively. The findings of this study support the potential of DWI as a viable non-gadolinium alternative for evaluating the hyperacute outcomes of MRgFUS ablation in uterine fibroids.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 86%

Diffusion-weighted imaging as a potential non-gadolinium alternative for immediate assessing the hyperacute outcome of MRgFUS ablation for uterine fibroids

Huang,

Zhou,

et al. 2024

Sci Rep

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“…Our study confirmed that HIFU is a safe and low-risk procedure. While the method is per se noninvasive and no serious complications or permanent damage were observed, the procedure itself is associated with peri-procedural pain in up to 80% of patients [35]. This pain almost immediately disappeared after treatment returning to pretreatment levels within a few hours post-procedure [33,36].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for uterine fibroids: an observational single-center study

Marinova

Ghaei

Recker

et al. 2021

International Journal of Hyperthermia

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Introduction: To evaluate treatment response of uterine fibroids after ultrasound guided high-intensity focused ultrasound (USgHIFU) with a special focus on fibroid size and characterization based on Funaki classification scheme, as well as clinical response to treatment of leading fibroid-associated symptoms. Materials and methods: Uterine fibroids treated by USgHIFU were assigned to Funaki type 1-3 based on T2-w-MRI. Differences in size, non-perfused volume ratio (NPVR) and volume reduction over time were determined using T1-/T2-w MRI sequences and contrast-enhanced sonography. Treatment effects on three leading fibroid-associated symptoms were also evaluated. Measurements were compared by mixed model, Bland-Altman's plot and Spearman's correlation. Results: In this prospective single-center study, 35 patients with 44 symptomatic uterine fibroids were treated by USgHIFU (n ¼ 22, n ¼ 12 and n ¼ 10 assigned to Funaki type 1, 2 and 3, respectively). NPVRs of Funaki type 1 and 2 fibroids were significantly higher compared to type 3 (p ¼ .0023). A significant fibroid shrinkage was observed independent of Funaki type compared to baseline: 38.8 ± 26.9%, 46.7 ± 30.3% and 54.5 ± 29.3% at 3, 6 and 12 months, respectively (each p < .05). Moreover, patients experienced a significant improvement of fibroid-associated hypermenorrhea (3.9 ± 1.3 vs. 2.3 ± 1.3), pressure in the pelvic area (3.5 ± 1.3 vs. 2.1 ± 0.9) and frequent urination (2.8 ± 1.5 vs. 1.9 ± 0.8) one year post-procedure (each p < .05), regardless of fibroid Funaki type. Conclusion: Following USgHIFU, a significant shrinkage of uterine fibroids and improvement of leading fibroid-associated symptoms were demonstrated regardless of the Funaki type.

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“…reported a decrease in tissue ADC following ablation in the prostate[48][49][50], uterine fibroids[8,9,47,51], and brain[52][53][54]. The treated lesion size, as measured on diffusion MRI, has been found to correlate well with contrastenhanced T1w images (Figure1(e)) and histopathology.…”

mentioning

confidence: 83%

“…These competing effects can make diffusion-based contrast difficult to interpret [ 47 ]. However, several studies have reported a decrease in tissue ADC following ablation in the prostate [ 48 – 50 ], uterine fibroids [ 8 , 9 , 47 , 51 ], and brain [ 52 – 54 ]. The treated lesion size, as measured on diffusion MRI, has been found to correlate well with contrast-enhanced T1w images ( Figure 1(e) ) and histopathology.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

A Review of Imaging Methods to Assess Ultrasound-Mediated Ablation

et al. 2022

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Ultrasound ablation techniques are minimally invasive alternatives to surgical resection and have rapidly increased in use. The response of tissue to HIFU ablation differs based on the relative contributions of thermal and mechanical effects, which can be varied to achieve optimal ablation parameters for a given tissue type and location. In tumor ablation, similar to surgical resection, it is desirable to include a safety margin of ablated tissue around the entirety of the tumor. A factor in optimizing ablative techniques is minimizing the recurrence rate, which can be due to incomplete ablation of the target tissue. Further, combining focal ablation with immunotherapy is likely to be key for effective treatment of metastatic cancer, and therefore characterizing the impact of ablation on the tumor microenvironment will be important. Thus, visualization and quantification of the extent of ablation is an integral component of ablative procedures. The aim of this review article is to describe the radiological findings after ultrasound ablation across multiple imaging modalities. This review presents readers with a general overview of the current and emerging imaging methods to assess the efficacy of ultrasound ablative treatments.

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Non-contrast enhanced MRI for assessment of uterine fibroids’ early response to ultrasound-guided high-intensity focused ultrasound thermal ablation

Cited by 19 publications

References 30 publications

Diffusion-weighted imaging as a potential non-gadolinium alternative for immediate assessing the hyperacute outcome of MRgFUS ablation for uterine fibroids

Diffusion-weighted imaging as a potential non-gadolinium alternative for immediate assessing the hyperacute outcome of MRgFUS ablation for uterine fibroids

Efficacy of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for uterine fibroids: an observational single-center study

A Review of Imaging Methods to Assess Ultrasound-Mediated Ablation

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