Short-term results of magnetic resonance imaging-guided focused ultrasound surgery for patients with adenomyosis: symptomatic relief and pain reduction

Kim, Kyoung Ah; Yoon, Sang-Wook; Lee, Chan; Seong, Seok Ju; Yoon, Bo Sung; Park, Hyun

doi:10.1016/j.fertnstert.2010.09.024

Cited by 35 publications

(35 citation statements)

References 23 publications

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“…Early studies examined the safety and efficacy of this technique. [36][37][38][39][40] More recently, the focus has moved to examine the level of reduction of symptoms in treated patients. 33,35,41 Treatment adjuncts have also been explored in an attempt to further enhance clinical effectiveness and improve efficiency.…”

Section: Studiesmentioning

confidence: 99%

“…41 Reported symptom reduction ranges from 25% to 83%. [36][37][38]41 Overall clinical effectiveness (defined as any degree of improvement in symptoms) ranges from 79% to 89%, with a significant proportion experiencing complete symptom relief (39%-46%). 33,35,[38][39][40]42 These effects appear to be sustained for at least 1-2 years 35,41 (Table 1).…”

Section: Reduction Of Symptomsmentioning

confidence: 99%

“…33 Another found that the reduction in pain score was greater for focal adenomyosis at 6-month follow-up. 38 …”

Section: Reduction Of Symptomsmentioning

confidence: 99%

“…Three pregnancies had no complications and term vaginal deliveries. 38,41,46 One delivery occurred by cesarean section at 32 weeks due to hemorrhage secondary to a major placenta previa. 39 One study has also reported two miscarriages.…”

Section: Pregnancy After Hifumentioning

confidence: 99%

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MR-guided focused ultrasound for the treatment of adenomyosis: current insights

Chin¹,

Walbridge²,

Quinn³

2015

RRFU

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Adenomyosis is a benign gynecological condition causing significant morbidity among women of reproductive age. The available treatments are currently limited in number and efficacy. While hysterectomy is curative, it is unacceptable to many women, particularly those wishing to conserve their fertility. Magnetic resonance-guided focused ultrasound surgery is a noninvasive treatment method that has been used to effectively treat uterine leiomyomata, but until recently has not been routinely used to treat adenomyosis. This review summarizes the current understanding of adenomyosis and high-intensity focused ultrasound, and the recent research into the safety and efficacy of this technique.

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Section: Studiesmentioning

confidence: 99%

Section: Reduction Of Symptomsmentioning

confidence: 99%

“…33 Another found that the reduction in pain score was greater for focal adenomyosis at 6-month follow-up. 38 …”

Section: Reduction Of Symptomsmentioning

confidence: 99%

Section: Pregnancy After Hifumentioning

confidence: 99%

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MR-guided focused ultrasound for the treatment of adenomyosis: current insights

Chin¹,

Walbridge²,

Quinn³

2015

RRFU

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“…3 Previous studies showed that HIFU ablation is a safe and effective treatment for adenomyosis; 4–9 however, little studies have focused on the long-term value of the HIFU ablation treatment for >3 years. In addition, relevant factors that can help in selecting appropriate candidates for the treatment are still undefined.…”

Section: Introductionmentioning

confidence: 99%

Clinical Predictors of Long-term Success in Ultrasound-guided High-intensity Focused Ultrasound Ablation Treatment for Adenomyosis

Liu

Wang²,

Wang³

et al. 2016

Medicine

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The long-term outcomes of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation treatment for adenomyosis and the relevant factors affecting the durability of symptom relief were assessed in this study.A total of 230 women with adenomyosis who were treated with USgHIFU ablation between January 2007 and December 2013 were retrospectively analyzed. The contrast-enhanced ultrasonography (CEUS) was performed immediately after the treatment to evaluate the ablation effect, and the nonperfused volume (NPV) ratio was then calculated. Regular follow-up was conducted and the visual analog scale (VAS) score was used to assess the changes in dysmenorrhea. The effect of treatment was evaluated after an average follow-up length of 3 months and the factors affecting clinical success and symptom relapse were identified.Of the 230 treated patients, 208 (90.4%) were followed up regularly, with a median follow-up length of 40 months (range, 18–94 months). Mean value of the NPV ratio calculated immediately after the treatment was 57.4 ± 24.4%. Varying degrees of symptomatic relief of dysmenorrhea based on the VAS scores were observed in 173 (83.2%) patients and 71.0% of the patients were asymptomatic during follow-up. Women with higher NPV ratio (OR = 0.964, 95% CI = 0.947–0.982, P = 0.000) and older age (OR = 0.342, 95% CI = 0.143–0.819, P = 0.016) were more likely to achieve clinical success. Dysmenorrhea recurred in 45 (26%) out of 173 cases; the median recurrence time was 12 months after treatment. The lower BMI (OR = 1.221, 95% CI = 1.079–1.381, P = 0.001) and the higher acoustic power (OR = 0.992, 95% CI = 0.986–0.998, P = 0.007) were associated with less risk of relapse. Twelve of the 14 patients who were retreated by USgHIFU ablation after experiencing dysmenorrhea recurrence achieved clinical success.USgHIFU ablation is an effective uterus-conserving treatment for symptomatic adenomyosis with an acceptable long-term success rate. Higher chance of clinical success can be achieved in patients with larger NPV ratio and older age, whereas higher BMI and lower acoustic power may result in a higher chance of recurrence. These factors are helpful in selecting suitable patients for USgHIFU and in predicting the durability of symptom relief.

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Diagnosis and Surgical Management of Adenomyosis

Chang

Goodman

2022

Reproductive Surgery

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Short-term results of magnetic resonance imaging-guided focused ultrasound surgery for patients with adenomyosis: symptomatic relief and pain reduction

Cited by 35 publications

References 23 publications

MR-guided focused ultrasound for the treatment of adenomyosis: current insights

MR-guided focused ultrasound for the treatment of adenomyosis: current insights

Clinical Predictors of Long-term Success in Ultrasound-guided High-intensity Focused Ultrasound Ablation Treatment for Adenomyosis

Diagnosis and Surgical Management of Adenomyosis

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