Volumetric MRI-guided, high-intensity focused ultrasound ablation of uterine leiomyomas: ASEAN preliminary experience

Keserci B, Bilgin Keserci, Duc NM, Nguyen Minh Duc, Nadarajan C, Chandran Nadarajan, Huynh Quang Huy, Huy HQ, Aishah Saizan, Saizan A, Wan Aireene Wan Ahmed, Wan Ahmed WA, Khalid Osman, Osman K, Mohd Shafie Abdullah, Abdullah MS
Diagnostic and interventional radiology (Ankara, Turkey) · 2020 · vol. 26(3) , pp. 207–215 · doi:10.5152/dir.2019.19157 · PMID:32209511 · PMC7239360
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Volumetric MRI-guided high-intensity focused ultrasound ablation effectively reduced leiomyoma volume and symptom severity scores in ASEAN patients with symptomatic uterine fibroids, demonstrating clinical acceptability without major adverse events.

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This study evaluated the safety and efficacy of volumetric MRI-guided high-intensity focused ultrasound ablation for treating symptomatic uterine leiomyomas in 33 women from Association of Asian Nations countries. Researchers assessed tissue characteristics via MRI and measured outcomes using immediate nonperfused volume ratios, volume reduction, and symptom severity scores at six months. The results showed a median immediate nonperfused volume ratio of 89.8%, with significant decreases in both fibroid volume and symptom severity scores, alongside no major adverse events. This paper is centrally about uterine fibroids; relevance to endometriosis or adenomyosis: listed as a differential diagnosis or comorbid condition often considered during pelvic imaging, though the paper's main focus is leiomyoma treatment.

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Abstract

PURPOSE: We sought to present our preliminary experience on the effectiveness and safety of magnetic resonance imaging (MRI)-guided, high-intensity focused ultrasound (HIFU) therapy using a volumetric ablation technique in the treatment of Association of Asian Nations (ASEAN) patients with symptomatic uterine leiomyomas. METHODS: This study included 33 women who underwent HIFU treatment. Tissue characteristics of leiomyomas were assessed based on T2- and T1-weighted MRI. The immediate nonperfused volume (NPV) ratio and the treatment effectiveness of MRI-guided HIFU on the basis of the degrees of volume reduction and improvement in transformed symptom severity score (SSS) were assessed. RESULTS: The median immediate NPV ratio was 89.8%. Additionally, the median acoustic sonication power and HIFU treatment durations were 150 W and 125 min, respectively. At six-month follow-up, the median leiomyoma volume had decreased from 139 mL at baseline to 84 mL and the median transformed SSS had decreased from 56.2 at baseline to 18.8. No major adverse events were observed. CONCLUSION: The preliminary results demonstrated that volumetric MRI-guided HIFU therapy for the treatment of symptomatic leiomyomas in ASEAN patients appears to be clinically acceptable with regard to treatment effectiveness and safety.
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Abstract

PURPOSE We sought to present our preliminary experience on the effectiveness and safety of magnetic resonance imaging (MRI)-guided, high-intensity focused ultrasound (HIFU) therapy using a volumetric ablation technique in the treatment of Association of Asian Nations (ASEAN) patients with symptomatic uterine leiomyomas.

Methods

This study included 33 women who underwent HIFU treatment. Tissue characteristics of leiomyomas were assessed based on T2- and T1-weighted MRI. The immediate nonperfused volume (NPV) ratio and the treatment effectiveness of MRI-guided HIFU on the basis of the degrees of volume reduction and improvement in transformed symptom severity score (SSS) were assessed.

Results

The median immediate NPV ratio was 89.8%. Additionally, the median acoustic sonication power and HIFU treatment durations were 150 W and 125 min, respectively. At six-month follow-up, the median leiomyoma volume had decreased from 139 mL at baseline to 84 mL and the median transformed SSS had decreased from 56.2 at baseline to 18.8. No major adverse events were observed.

Conclusion

The preliminary results demonstrated that volumetric MRI-guided HIFU therapy for the treatment of symptomatic leiomyomas in ASEAN patients appears to be clinically acceptable with regard to treatment effectiveness and safety.

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MeSH descriptors

High-Intensity Focused Ultrasound Ablation Leiomyoma Magnetic Resonance Imaging Magnetic Resonance Imaging, Interventional Uterine Neoplasms Adult Aftercare Asia Asia Asia Female High-Intensity Focused Ultrasound Ablation High-Intensity Focused Ultrasound Ablation Humans Leiomyoma Magnetic Resonance Imaging Magnetic Resonance Imaging, Interventional Middle Aged Retrospective Studies Safety

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