Image-guided thermal ablation in the management of symptomatic adenomyosis: a systematic review and meta-analysis

Liu L, Lu Liu, Tianfu Wang, Wang T, Baiying Lei, Lei B
International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group · 2021 · vol. 38(1) , pp. 948–962 · doi:10.1080/02656736.2021.1939443 · PMID:34139945 · W3172176575
Systematic review / meta-analysis OA: gold CC0 ⤵ 32 in-corpus citations
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This systematic review and meta-analysis of 38 studies found image-guided thermal ablation techniques like HIFU, PMWA, and RFA significantly reduce pain and bleeding in symptomatic adenomyosis patients.

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Abstract

OBJECTIVE: To evaluate the clinical effects of image-guided thermal ablation for the treatment of symptomatic adenomyosis (AD). DATA SOURCES: We searched PubMed, Web of Science, Cochrane Library, EMBASE, ClinicalTrials.gov and Google Scholar for literature from January 2000 to September 2020. METHODS OF STUDY SELECTION: We included all studies reporting clinical outcomes of image-guided thermal ablation for AD, involving high-intensity focused ultrasound (HIFU), percutaneous microwave ablation (PMWA) and radiofrequency ablation (RFA). Two independent researchers performed study selection according to the screening criteria. RESULTS: A total of 38 studies representing 15,908 women were included. Compared with those at baseline, the visual analog scale scores, the symptom severity scores and the menorrhagia severity scores decreased significantly after these thermal ablation therapies. The mean ablation time was 92.18 min, 24.15 min and 31.93 min during HIFU, PMWA and RFA, respectively. The non-perfused volume ratio of AD was 68.3% for HIFU, 82.5% for PMWA and 79.2% for RFA. The reduction rates of uterine volume were 33.6% (HIFU), 46.8% (PMWA) and 44.0% (RFA). The reduction rates of AD volume were 45.1% (HIFU), 74.9% (PMWA) and 61.3% (RFA). The relief rates of dysmenorrhea were 84.2% (HIFU), 89.7% (PMWA) and 89.2% (RFA). The incidence of minor adverse events was 39.0% (HIFU), 51.3% (PMWA) and 3.6% (RFA). The re-intervention rates were 4.0% (HIFU) and 28.7% (RFA). The recurrence rate was 10.2% after HIFU. The pregnancy rates were 16.7% (HIFU), 4.93% (PMWA) and 35.8% (RFA). CONCLUSION: Image-guided HIFU, PMWA and RFA may be effective and safe minimally invasive therapies for symptomatic AD.

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Condition tags

dysmenorrheaadenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis High-Intensity Focused Ultrasound Ablation High-Intensity Focused Ultrasound Ablation Menorrhagia Menorrhagia Radiofrequency Ablation Radiofrequency Ablation Dysmenorrhea Dysmenorrhea Female Female Humans Humans Pregnancy Pregnancy Treatment Outcome Treatment Outcome

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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