High-intensity focused ultrasound ablation of uterine localized adenomyosis

Dong X, Xiaojing Dong, Yang Z, Zhu Yang
Current opinion in obstetrics & gynecology · 2010 · vol. 22(4) , pp. 326–330 · doi:10.1097/gco.0b013e32833bea2e · PMID:20610999 · W2087694321
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High-intensity focused ultrasound (HIFU) shows promise as a noninvasive treatment for localized adenomyosis, causing coagulative necrosis and potentially offering a safer, less traumatic alternative to conservative therapies.

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This review examines the use of high-intensity focused ultrasound (HIFU) as a noninvasive treatment for uterine localized adenomyosis, highlighting its ability to induce coagulative necrosis in adenomyosis cells while preserving surrounding tissue. The authors note that MR-guided and ultrasound-guided HIFU ablation yield satisfactory results with low invasiveness, although acoustic intensity is a critical factor for efficacy and some studies report temporary lesion enlargement post-treatment. While current evidence suggests HIFU offers benefits such as reduced trauma and shorter hospital stays compared to conservative therapies, the paper explicitly states that further trials are necessary to evaluate long-term efficacy and cost-effectiveness. This paper is centrally about adenomyosis — specifically focusing on the application and outcomes of high-intensity focused ultrasound ablation for treating localized lesions.

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Abstract

PURPOSE OF REVIEW: To introduce recent developments in a noninvasive treatment of using high-intensity focused ultrasound (HIFU) for ablating uterine localized adenomyosis, and to discuss their potential in this application. RECENT FINDINGS: This literature roughly reviewed conservative therapy for uterine localized adenomyosis and emphasized using HIFU for ablating it. The main histological change of HIFU treatment was the coagulative necrosis of adenomyosis cells, with damage on small blood vessels of adenomyoma. MR-guided focused ultrasound surgery (MRgFUS) and ultrasound-guided HIFU ablation of focal adenomyosis were with satisfactory results. MRgFUS was less invasive and safely ablated adenomyosis tissue close to the endometrium or to serosal surface. HIFU might be safe and effective for treating patients with adenomyosis, and the acoustic intensity was a key factor for therapeutic efficacy as the severity of symptoms might correlate with lesion extent in some patients. At a given therapeutic dose, the influence of acoustic intensity on focal temperature rise was greater than that of exposure time. Some other experiments showed that the size of adenomyoma was increased 3-4 months after HIFU treatment. The reasons were related to the size of tumor, treatment parameters, operation procedure, and the blood supply of the targeted tissue. Although recent results have been very encouraging, further trials are essential to evaluate the long-term efficacy, and cost-effectiveness of HIFU ablation in localized adenomyosis. SUMMARY: Compared with current conservative treatments, HIFU may be a noninvasive approach and may offer complete ablation of adenomyoma, with less trauma, less complication, and low cost and short hospital stay for treating patients with uterine localized adenomyosis.
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High-intensity focused ultrasound ablation of uterine localized adenomyosis - Xiaojing Dong - Zhu Yang Purpose of review To introduce recent developments in a noninvasive treatment of using high-intensity focused ultrasound (HIFU) for ablating uterine localized adenomyosis, and to discuss their potential in this application. Recent findings This literature roughly reviewed conservative therapy for uterine localized adenomyosis and emphasized using HIFU for ablating it. The main histological change of HIFU treatment was the coagulative necrosis of adenomyosis cells, with damage on small blood vessels of adenomyoma. MR-guided focused ultrasound surgery (MRgFUS) and ultrasound-guided HIFU ablation of focal adenomyosis were with satisfactory results. MRgFUS was less invasive and safely ablated adenomyosis tissue close to the endometrium or to serosal surface. HIFU might be safe and effective for treating patients with adenomyosis, and the acoustic intensity was a key factor for therapeutic efficacy as the severity of symptoms might correlate with lesion extent in some patients. At a given therapeutic dose, the influence of acoustic intensity on focal temperature rise was greater than that of exposure time. Some other experiments showed that the size of adenomyoma was increased 3–4 months after HIFU treatment. The reasons were related to the size of tumor, treatment parameters, operation procedure, and the blood supply of the targeted tissue. Although recent results have been very encouraging, further trials are essential to evaluate the long-term efficacy, and cost-effectiveness of HIFU ablation in localized adenomyosis. Summary Compared with current conservative treatments, HIFU may be a noninvasive approach and may offer complete ablation of adenomyoma, with less trauma, less complication, and low cost and short hospital stay for treating patients with uterine localized adenomyosis.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Endometriosis High-Intensity Focused Ultrasound Ablation Uterine Diseases Endometriosis Female Humans Magnetic Resonance Imaging, Interventional Ultrasonography, Interventional Uterine Diseases

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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