{"paper_id":"8beaa61c-bbf1-427f-b4d0-b9a166130725","body_text":"Abstract\nPurpose\nTo evaluate the application of radiofrequency ablation (RFA) as a treatment method for abdominal wall endometriosis (AWE).\nMaterials and Methods\nThe characteristics of the AWE lesions in the patients were obtained using ultrasound (US). The patients received general and local anesthesia, and then, AWE lesions were divided into 1 cm3 sections visually, and each of these sections underwent US-guided RFA using the moving shot technique. Follow-up included outpatient appointments, including a US examination 1, 3, and 6 months after the treatment to assess the volume of the lesions. In addition, the level of pain experienced by the patients was measured using a visual analogue scale (VAS) before and the day after the procedure, as well as at each follow-up appointment.\nResults\nTen patients were treated with RFA. The procedural success was achieved in all of the patients. The median volume of the lesions decreased from 7.3 cm3 (IQR = 4.39,23.75) to 2.95 cm3 (IQR = 1.65,9.09) (P = 0.005). All patients reported reduced pain levels, and the median of their VAS score decreased from 9 (IQR = 8,9) to 0 (IQR = 0,1.25) (P = 0.004) at the end of the follow-up period. None of the patients experienced complications related to RFA treatment.\nConclusion\nBased on the study's findings, RFA appears to be a promising minimally invasive treatment for AWE. However, larger studies with longer follow-up periods are required for a more comprehensive understanding of its efficacy and safety.\nLevel of Evidence\nLevel 4, Case Series.\nGraphical Abstract\nReferences\nParasar P, Ozcan P, Terry KL. Endometriosis: Epidemiology, Diagnosis and Clinical Management. Curr Obstet Gynecol Rep. 2017;6(1):34–41.\nHorton JD, DeZee KJ, Ahnfeldt EP, Wagner M. Abdominal wall endometriosis: a surgeon’s perspective and review of 445 cases. The American Journal of Surgery. 2008;196(2):207–12.\nKang J, Baek JH, Lee WS, Cho TH, Lee JN, Lee WK, et al. Clinical manifestations of abdominal wall endometriosis: a single center experience. Arch Gynecol Obstet. 2013;287(2):301–5.\nMaillot J, Brun JL, Dubuisson V, Bazot M, Grenier N, Cornelis FH. Mid-term outcomes after percutaneous cryoablation of symptomatic abdominal wall endometriosis: comparison with surgery alone in a single institution. Eur Radiol. 2017;27(10):4298–306.\nLiu Y, Wen W, Qian L, Xu R. Safety and efficacy of microwave ablation for abdominal wall endometriosis: A retrospective study. Front Surg. 2023;10:1100381. https://doi.org/10.3389/fsurg.2023.1100381\nWelch BT, Ehman EC, VanBuren WM, Cope AG, Welch TL, Woodrum DA, et al. Percutaneous cryoablation of abdominal wall endometriosis: the Mayo Clinic approach. Abdominal Radiology. 2020;45(6):1813–7.\nSmith KA, Welch BT, Kurup AN, Schmitz JJ, VanBuren WM, Ehman EC, et al. Feasibility and safety of percutaneous image-guided cryoablation of abdominal wall endometriosis. Abdominal Radiology. 2022;47(8):2669–73.\nWang Y, Wang W, Wang L, Wang J, Tang J. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: Preliminary results. Eur J Radiol. 2011;79(1):56–9.\nZhu X, Chen L, Deng X, Xiao S, Ye M, Xue M. A comparison between high-intensity focused ultrasound and surgical treatment for the management of abdominal wall endometriosis. BJOG. 2017;124:53–8.\nXiao-Ying Z, Hua D, Jin-Juan W, Ying-Shu G, Jiu-Mei C, Hong Y, et al. Clinical analysis of high-intensity focussed ultrasound ablation for abdominal wall endometriosis: a 4-year experience at a specialty gynecological institution. Int J Hyperth. 2019;36(1):87–94.\nDedes I, Kolovos G, Arrigo F, Toub D, Vaineau C, Lanz S, et al. Radiofrequency Ablation for Adenomyosis. J Clin Med. 2023;12(9):3069.\nCarrafiello G, Fontana F, Pellegrino C, Mangini M, Cabrini L, Mariani D, et al. Radiofrequency Ablation of Abdominal Wall Endometrioma. Cardiovasc Intervent Radiol. 2009;32(6):1300–3.\nLuo S, Zhang C, Huang J, Huang G, He J. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: a retrospective study. BJOG. 2017;124:59–63.\nNirula R, Greaney GC. Incisional endometriosis: an underappreciated diagnosis in general surgery1. J Am Coll Surg. 2000;190(4):404–7.\nKhan Z, Zanfagnin V, El-Nashar SA, Famuyide AO, Daftary GS, Hopkins MR. Risk Factors, Clinical Presentation, and Outcomes for Abdominal Wall Endometriosis. J Minim Invasive Gynecol. 2017;24(3):478–84.\nSavelli L, Manuzzi L, Di Donato N, Salfi N, Trivella G, Ceccaroni M, et al. Endometriosis of the abdominal wall: ultrasonographic and Doppler characteristics. Ultrasound Obstet Gynecol. 2012;39(3):336–40.\nPurvis RS, Tyring SK. Cutaneous and Subcutaneous Endometriosis. J Dermatol Surg Oncol. 1994;20(10):693–5.\nFitzpatrick D, Pirie K, Reeves G, Green J, Beral V. Combined and progestagen-only hormonal contraceptives and breast cancer risk: A UK nested case–control study and meta-analysis. PLoS Med. 2023;20(3): e1004188.\nLi JX, Li XL, Zhu JE, Zhang HL, Yu SY, Xu HX. Ultrasound-guided microwave ablation for symptomatic abdominal wall endometriosis and treatment response evaluation with contrast-enhanced imaging: The first experience. Clin Hemorheol Microcirc. 2022;82(1):63–73.\nErinjeri JP, Clark TWI. Cryoablation: Mechanism of Action and Devices. J Vasc Interv Radiol. 2010;21(8):S187–91.\nJouffrieau C, Cazzato RL, Gabriele V, Faller E, Weiss J, Host A, et al. Percutaneous Imaging-guided Cryoablation of Endometriosis Scars of the Anterior Abdominal Wall. J Minim Invasive Gynecol. 2023;30(11):890–6.\nZhang X, Duan H. One-time high-intensity focused ultrasound ablation of abdominal wall endometriosis with concurrent uterine fibroids or adenomyosis: two cases and literature review. Quant Imaging Med Surg. 2020;10(2):511–7.\nIzadifar Z, Izadifar Z, Chapman D, Babyn P. An Introduction to High Intensity Focused Ultrasound: Systematic Review on Principles, Devices, and Clinical Applications. J Clin Med. 2020;9(2):460.\nHocquelet A, Balageas P, Laurent C, Blanc JF, Frulio N, Salut C, et al. Radiofrequency ablation versus surgical resection for hepatocellular carcinoma within the Milan criteria: A study of 281 Western patients. Int J Hyperth. 2015;31(7):749–57.\nYin G, Zhu T, Li J, Chen M, Yang S, Zhao X. Decreased expression of survivin, estrogen and progesterone receptors in endometrial tissues after radiofrequency treatment of dysfunctional uterine bleeding. World J Surg Oncol. 2012;10(1):100.\nAcknowledgements\nNone.\nFunding\nThis study was funded by Iranian Academic Center for Education Culture and Research (ACECR). ACECR is a public and academic institution which help us to conduct this study by covering the ultrasound follow-up appointments for the patients. The sponsor did not have any role in collection, analysis, and interpretation of data and in writing the manuscript.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nConflict of interest\nThe authors declare that they have no conflict of interest.\nEthical standards\nAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The protocol of the study was approved by the Research Ethics Committees of Avicenna Research Institute: IR.ACECR.AVICENNA.REC.1401.006 and was registered on the Iranian Registry of Clinical Trials: IRCT20220219054066N1.\nInformed consent\nInformed consent was obtained from all individual participants included in the study.\nConsent for publication\nConsent for publication was obtained for every individual person’s data included in the study.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nMahdavi, A., Forouzannia, S.A., Goudarzi, E. et al. Radiofrequency Ablation: A Promising Treatment Method for Abdominal Wall Endometriosis. Cardiovasc Intervent Radiol 47, 1009–1014 (2024). https://doi.org/10.1007/s00270-024-03755-4\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00270-024-03755-4","source_license":"CC0","license_restricted":false}