Reference
29 and 32 are the same so it is also corrected with
this correction. The corrected details are given below.
(a) Page 1: In the 10th line, the second paragraph of under
the heading “Introduction” should be changed from
"Noninvasive high-intensity focused ultrasound (HIFU)
ablation has emerged as an alternative option to sur -
gery for uterine fibroids, offering minimal invasiveness
without an incision that can be performed as a uterine-
conserving outpatient treatment in most types of uter -
ine fibroids [11– 14]." to “Noninvasive high-intensity
focused ultrasound (HIFU) ablation has emerged as an
alternative option to surgery for uterine fibroids, offer-
ing minimal invasiveness without an incision that can
be performed as a uterine-conserving outpatient treat-
ment in most types of uterine fibroids [11–13].”
(b) Page 2: In the 2nd line of Introduction section should be
changed from "Compared to the uterine artery embo-
lization, another minimalinvasive treatment option,
HIFU is preferred if clinicians and patients have con-
cerns for low vascularity fibroids, high risk for anes-
thesia/sedation, radiation exposure, impaired renal
function, allergy to iodine contrast medium, bleed-
ing tendency, or difficult vascular access [15– 17]." to
"Compared to the uterine artery embolization, another
minimalinvasive treatment option, HIFU is preferred if
clinicians and patients have concerns for low vascular-
ity fibroids, high risk for anesthesia/sedation, radiation
exposure, impaired renal function, allergy to iodine
contrast medium, bleeding tendency, or difficult vas-
cular access [12, 14, 15]."
(c) Page 2: In the 5th line under the heading “Introduc-
tion” should be changed from “Localized ablation is
achieved by concentrating acoustic waves at a focal
point to cause heat and raise focal temperature to over
55 °C, without affecting the surrounding tissues [18,
19].” to “Localized ablation is achieved by concentrat-
ing acoustic waves at a focal point to cause heat and
raise focal temperature to over 55 °C, without affecting
the surrounding tissues [16, 17].”
(d) Page 3: In the second paragraph under the heading
“Patients” heading should be changed from “The
diagnostic criteria for adenomyosis using MRI included
(1) low signal intensity of myometrium, with indistinct
margins and (2) diffuse or focal junctional zone exceed-
ing 12 mm [20].” to “The diagnostic criteria for adeno-
myosis using MRI included (1) low signal intensity of
myometrium, with indistinct margins and (2) diffuse or
focal junctional zone exceeding 12 mm [18].”
(e) Page 3: Under the heading “Pretreatment screening
and preparation” should be changed from “Other pre-
procedural preparations included an 8-h fasting period
and enema administrations to exclude air and other
possible obstacles (e.g., bowel loops anterior to the
The original article can be found online at https:// doi. org/ 10. 1007/
s00261- 021- 03203-8.
* Chin-Jung Wang
[email protected]
1 Division of Gynecologic Endoscopy, Department
of Obstetrics and Gynecology, Chang Gung Memorial
Hospital at Linkou, Taoyuan, Taiwan
2 Chang Gung University College of Medicine, Taoyuan,
Taiwan
3 Department of Medical Imaging and Intervention, Chang
Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
491Abdominal Radiology (2022) 47:490–493
1 3
uterus), and abdominal and pubic hair shaving to allow
the skin to connect with the ultrasound beam closely
to prevent the skin burn [21–23].” to “Other pre-proce-
dural preparations included an 8-h fasting period and
enema administrations to exclude air and other possible
obstacles (e.g., bowel loops anterior to the uterus), and
abdominal and pubic hair shaving to allow the skin to
connect with the ultrasound beam closely to prevent the
skin burn [19–21],”
(f) Page 4: Under the heading “ MRgHIFU treatment”
should be changes from “These temperature maps were
calculated from raw data centered in the k-space matrix
and based on the proton resonance frequency shift [24,
25],” to “These temperaturemaps were calculated from
raw data centered in the k-space matrix and based on
the proton resonance frequency shift [22, 23],”
(g) Page 4: Under the heading “Assessments and data
analysis”
i) “Classification of the benign uterine tumor by fibroid
(i.e., subserosal, intramural, submucosal, or adenomy-
osis) and Funaki type was based on the signal intensity
of the T2-weighted MR images [ 26],” should read as
“Classification of the benign uterine tumor by fibroid
(i.e., subserosal, intramural, submucosal, or adenomy-
osis) and Funaki type was based on the signal intensity
of the T2-weighted MR images [24],”
ii) “The SF-36 questionnaire was used for evaluating
quality of life as described in the previous research.
Higher scores indicated better quality of life [27].”
should read as “The SF-36 questionnaire was used for
evaluating quality of life as described in the previous
research. Higher scores indicated better quality of life
[25].”
(h) Page 5, 6 and 7: Under heading “Discussion”
(i) “Despite the non-invasive feature of HIFU, many
Limitations
related to technique and mechanical design
have prevented its widespread application [22, 28].”
should read as “Despite the non-invasive feature of
HIFU, many limitations related to technique and
mechanical design have prevented its widespread
application [20, 26].”
(ii) “Current MRgHIFU treatment protocols suggest an
ablation rate (i.e., nonperfused volume [NPV] ratio) of
70–80% to achieve the desired treatment outcomes [21,
29].” should read as “Current MRgHIFU treatment
protocols suggest an ablation rate (i.e., nonperfused
volume [NPV] ratio) of 70–80% to achieve the desired
treatment outcomes [19, 27].”
(iii) “The effectiveness of ArcBlate MRgHIFU seemed
not to be inferior to that of other MRgHIFU systems,
which demonstrated mean fibroid volume shrinkage
rates of 12.6–18.1% at 3 months [30, 31].” should read
as “The effectiveness of ArcBlate MRgHIFU seemed
not to be inferior to that of other MRgHIFU systems,
which demonstrated mean fibroid volume shrinkage
rates of 12.6–18.1% at 3 months [28, 29].”
(iv) “A higher NPV ratio was found to be correlated
with greater tumor volume shrinkage. Keserci et al.
discovered that if the NPV achieved a ratio of at least
90%, the mean fibroid reduction ratio would be as high
as 54 ± 13% [31]. A report of 80 patients with leio-
myoma suggested that a larger NPV ratio would result
in greater shrinkage and improved relief of symptoms
[32].” should read as “A higher NPV ratio was found
to be correlated with greater tumor volume shrinkage.
Keserci et al. discovered that if the NPV achieved a
ratio of at least 90%, the mean fibroid reduction ratio
would be as high as 54 ± 13% [29]. A report of 80
patients with leiomyoma suggested that a larger NPV
ratio would result in greater shrinkage and improved
relief of symptoms [27].”
(v) “According to the literature, treating Funaki type
3 fibroid tissue by HIFU is difficult because of high -
vascularization which results in decreasing therapeu-
tic effects of heating [23, 33, 34], yet our intramural
case was identified to be Funaki type 3.” should read
as “According to the literature, treating Funaki type
3 fibroid tissue by HIFU is difficult because of high
vascularization which results in decreasing therapeutic
effects of heating [21, 24, 30], yet our intramural case
was identified to be Funaki type 3.”
(vi) “Despite the decreased estrogen level in this
patient (49 years) who approached menopause may
also have influenced the treatment outcome [ 35],”
should read as “Despite the decreased estrogen level
in this patient (49 years) who approached menopause
may also have influenced the treatment outcome [31],”
(vii) “No real-time monitoring in thermal damage in
tissue was one of the limitations in ultrasonography-
guided HIFU therapy [36], while it could be resolved
under MR guidance. Besides, patients having pelvic
endometriosis, adhesions locating between the uterus
and bowel, or > 10-mm abdominal surgical scar are not
recommended to receive HIFU therapy [37]. However,
one patient with adenomyosis in our study showed a
lower shrinkage rate after 3 months than another study
(our study vs. another study: 5.5% vs. 46.3%) [38].”
should read as “No real-time monitoring in thermal
damage in tissue was one of the limitations in ultra -
sonography-guided HIFU therapy [32], while it could
be resolved under MR guidance. Besides, patients hav-
ing pelvic endometriosis, adhesions locating between
the uterus and bowel, or > 10-mm abdominal surgical
492 Abdominal Radiology (2022) 47:490–493
1 3
scar are not recommended to receive HIFU therapy
[33]. However, one patient with adenomyosis in our
study showed a lower shrinkage rate after 3 months
than another study (our study vs. another study: 5.5%
vs. 46.3%) [34].”
(viii) “[39] Considering the treatment outcome among
patients by Funaki classification, quality of life scores
in the type 3 cohort seemed to decrease slightly after
the treatment,” should read as “Considering the treat-
ment outcome among patients by Funaki classification,
quality of life scores in the type 3 cohort seemed to
decrease slightly after the treatment,”
(ix) “The most common adverse effect of HIFU treat-
ment is skin burn [30, 39];” should read as “The most
common adverse effect of HIFU treatment is skin burn
[28, 35];”
(x) “Much research has shown that rectal and bladder
filling are very useful practices for avoiding adverse
effects and for mitigating bowelrelated side effects
after MRgHIFU treatment [40, 41].” should read as
“Much research has shown that rectal and bladder
filling are very useful practices for avoiding adverse
effects and for mitigating bowelrelated side effects
after MRgHIFU treatment [11, 36].”
(xi) “In addition, endometrial ablation has been used to
treat submucosal fibroids [42] but it may cause severe
endometrial impairment and reduce possibilities of
future pregnancy [43].” should read as “In addition,
endometrial ablation has been used to treat submu-
cosal fibroids [37] but it may cause severe endome-
trial impairment and reduce possibilities of future
pregnancy [38].”
References
1. Prayson RA, Hart WR (1995) Pathologic considerations of uter -
ine smooth muscle tumors. Obstet Gynecol Clin North Am. 22
(4):637-657.
2. Stewart EA (2001) Uterine fibroids. Lancet. 357 (9252):293-298.
3. Wise LA, Laughlin-Tommaso SK (2016) Epidemiology of uterine
fibroids: from menarche to menopause. Clin Obstet Gynecol. 59
(1):2-24.
4. Okolo S (2008) Incidence, aetiology and epidemiology of uterine
fibroids. Best Pract Res Clin Obstet Gynaecol. 22 (4):571-588.
5. Schwartz SM, Marshall LM, Baird DD (2000) Epidemiologic con-
tributions to understanding the etiology of uterine leiomyomata.
Environ Health Perspect. 108 Suppl 5:821-827.
6. Wilde S, Scott-Barrett S (2009) Radiological appearances of uter-
ine fibroids. Indian J Radiol Imaging. 19 (3):222-231.
7. Parker WH (2007) Etiology, symptomatology, and diagnosis of
uterine myomas. Fertil Steril. 87 (4):725-736.
8. Downes E, Sikirica V, Gilabert-Estelles J et al (2010) The bur -
den of uterine fibroids in five European countries. Eur J Obstet
Gynecol Reprod Biol. 152 (1):96-102.
9. Borah BJ, Nicholson WK, Bradley L Stewart EA (2013) The
impact of uterine leiomyomas: a national survey of affected
women. Am J Obstet Gynecol. 209 (4):319.e1-20.
10. Havryliuk Y, Setton R, Carlow JJ et al (2017) Symptomatic
fibroid management: systematic review of the literature. JSLS. 21
(3):e2017.00041. doi: https:// doi. org/ 10. 4293/ JSLS. 2017. 00041.
11. Kim YS, Bae DS, Park MJ et al (2014) Techniques to expand
patient selection for MRI-guided high-intensity focused ultra-
sound ablation of uterine fibroids. Am J Roentgenol 202
(2):443-451.
12. Jeong JH, Hong GP, Kim YR, Ha JE, Lee KS (2016) Clinical
consideration of treatment to ablate uterine fibroids with mag-
netic resonance imaging-guided high intensity focused ultrasound
(MRgFUS): sonalleve. J Menopausal Med. 22 (2):94-107.
13. Yu SC, Cheung EC, Leung VY, Fung LW (2019) Oxytocin-
augmented and non-sedating high-intensity-focused ultrasound
(HIFU) for uterine fibroids showed promising outcome as com -
pared to HIFU alone or uterine artery embolization. Ultrasound
Med Biol. 45 (12):3207-3213.
14. Sieroń D, Wiggermann P, Skupiński J Kukawska-Sysio K Lisek
U, Koczy A (2011) Uterine artery embolisation and magnetic res-
onance-guided focused ultrasound treatment of uterine fibroids.
Pol J Radiology. 76 (2):37-39.
15. Leonhardt H, Aziz A, Lönn L (2005) Post-embolization syndrome
and complete expulsion of a leiomyoma after uterine artery embo-
lization. Acta Obstet Gynecol Scand. 84 (3):303-305.
16. Rabkin BA, Zderic V, Crum LA Vaezy S (2006) Biological and
physical mechanisms of HIFU-induced hyperecho in ultrasound
images. Ultrasound Med Biol. 32 (11):1721-1729.
17. Haar GT, Coussios C (2007) High intensity focused ultra-
sound: physical principles and devices. Int J Hyperthermia. 23
(2):89-104.
18. Cunningham RK, Horrow MM, Smith RJ Springer J (2018)
Adenomyosis: a sonographic diagnosis. Radiographics. 38
(5):1576-1589.
19. Fennessy FM, Tempany CM, McDannold NJ et al (2007) Uter -
ine leiomyomas: MR imaging–guided focused ultrasound sur -
gery-results of different treatment protocols. Radiology. 243
(3):885-893.
20. Tempany CM, Stewart EA, McDannold N, Quade BJ, Jolesz FA,
Hynynen K (2003) MR imaging-guided focused ultrasound sur -
gery of uterine leiomyomas: a feasibility study. Radiology. 226
(3):897-905.
21. Funaki K, Sawada K, Maeda F, Nagai S (2007) Subjective effect
of magnetic resonance‐guided focused ultrasound surgery for uter-
ine fibroids. J Obstet Gynaecol Res. 33 (6):834-839.
22. Hindman JC (1966) Proton resonance shift of water in the gas and
liquid states. J Chem Phys. 44 (12):4582-4592.
23. Peters RD, Hinks RS, Henkelman RM (1998) Ex vivo tissue‐type
independence in proton‐resonance frequency shift MR thermom-
etry. Magn Reson Med. 40 (3):454-459.
24. Funaki K, Fukunishi H, Funaki T, Sawada K, Kaji Y, Maruo T
(2007) Magnetic resonance-guided focused ultrasound surgery for
uterine fibroids: relationship between the therapeutic effects and
signal intensity of preexisting T2-weighted magnetic resonance
images. Am J Obstet Gynecol. 196 (2):184. e1-6.
25. Brazier JE, Harper R, Jones NM et al (1992) Validating the SF-36
health survey questionnaire: new outcome measure for primary
care. BMJ. 305 (6846):160-164.
26. Lee JS, Hong GY, Park BJ, Kim TE (2015) Ultrasound-guided
high-intensity focused ultrasound treatment for uterine fibroid &
adenomyosis: a single center experience from the Republic of
Korea. Ultrason Sonochem. 27:682-687.
27. LeBlang SD, Hoctor K, Steinberg FL (2010) Leiomyoma shrink-
age after MRI-guided focused ultrasound treatment: report of 80
patients. Am J Roentgenol. 194 (1):274-280.
493Abdominal Radiology (2022) 47:490–493
1 3
28. Cheung VYT (2018) High-intensity focused ultrasound therapy.
Best Pract Res Clin Obstet Gynaecol. 46:74-83.
29. Keserci B, Duc NM (2018) Magnetic resonance imaging param-
eters in predicting the treatment outcome of high-intensity focused
ultrasound ablation of uterine fibroids with an immediate nonper-
fused volume ratio of at least 90. Acad Radiol. 25 (10):1257-1269.
30. Suomi V, Komar G, Sainio T, Joronen K, Perheentupa A, Blanco
Sequeiros R (2019) Comprehensive feature selection for classify-
ing the treatment outcome of high-intensity ultrasound therapy
in uterine fibroids. Sci Rep. 9 (1):10907. doi: https:// doi. org/ 10.
1038/ s41598- 019- 47484-y.
31. Rein MS, Barbieri RL, Friedman AJ (1995) Progesterone: a
critical role in the pathogenesis of uterine myomas. Am J Obstet
Gynecol. 172 (1 Pt 1):14-18.
32. Chin W, Walbridge JR, Quinn SD (2015) MR-guided focused
ultrasound for the treatment of adenomyosis: current insights. Res
Rep Focused Ultrasound. 2016 (4):1-8. https:// doi. org/ 10. 2147/
RRFU. S95901.
33. Zhang L, Rao F, Setzen R (2017) High intensity focused ultra-
sound for the treatment of adenomyosis: selection criteria,
efficacy, safety and fertility. Acta Obstet Gynecol Scand. 96
(6):707-714.
34. Jeng CJ, Ou KY, Long CY, Chuang L, Ker CR (2020) 500 cases of
high-intensity focused ultrasound (HIFU) ablated uterine fibroids
and adenomyosis. Taiwan J Obstet Gynecol. 59 (6):865-871.
35. Stewart EA, Rabinovici J, Tempany CM et al (2006) Clinical out-
comes of focused ultrasound surgery for the treatment of uterine
fibroids. Fertil Steril. 85 (1):22-29.
36. Mindjuk I, Trumm CG, Herzog P, Stahl R, Matzko M (2015) MRI
predictors of clinical success in MR-guided focused ultrasound
(MRgFUS) treatments of uterine fibroids: results from a single
centre. Eur Radiol. 25 (5):1317-1328.
37. Moroni RM, Martins WP, Messina MDL et al (2016) High‐
intensity focused ultrasound for symptomatic uterine fibroids.
Cochrane Database Syst Rev. https:// doi. org/ 10. 1002/ 14651 858.
CD012 444.
38. Duc NM, Keserci B (2018) Review of influential clinical factors
in reducing the risk of unsuccessful MRI-guided HIFU treatment
outcome of uterine fibroids. Diagn Interv Radiol. 24 (5):283-291.
Publisher's Note Springer Nature remains neutral with regard to
jurisdictional claims in published maps and institutional affiliations.