Efficacy and safety of ultrasound-guided high-intensity focused ultrasound for uterine adenomyosis: Preliminary experience from a case series

Vincent Y.T. Cheung, Tina Lam, Shuk Wan Lam
In: World Journal of Advanced Research and Reviews 13(2) 359-366 · 2022 · doi:10.5281/zenodo.6349816 · W4226089781
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Ultrasound-guided high-intensity focused ultrasound reduced menstrual pain and adenomyosis volumes in ten premenopausal women, though 20% experienced complications and 30% required subsequent surgery.

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This prospective cohort study evaluated the efficacy and safety of ultrasound-guided high-intensity focused ultrasound in treating symptomatic uterine adenomyosis among ten premenopausal women. Researchers measured symptom severity and lesion volumes using magnetic resonance imaging at baseline, three months, six months, and twelve months post-treatment. Results indicated significant reductions in menstrual pain and uterine volume at six months, although two patients experienced complications and three required subsequent surgical interventions. The authors concluded that while the procedure offers symptomatic relief, its long-term effectiveness and safety require evaluation in larger cohorts due to the small sample size and observed adverse events. This paper is centrally about adenomyosis — specifically the application of non-invasive thermal ablation techniques for managing this condition.

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Abstract

Objective: This prospective cohort study was to evaluate the efficacy and safety of ultrasound-guided High-Intensity Focused Ultrasound (HIFU) in the treatment of uterine adenomyosis. Methods: Ten premenopausal women with symptomatic adenomyosis underwent ultrasound-guided HIFU therapy. Their symptoms were compared using symptom severity scores before and at 3, 6 and 12 months after treatment. The sizes of their uteri and adenomyotic lesions at 6 months after treatment were compared with those of pre-treatment as determined by magnetic resonance imaging. Results: The menstrual pain scores were reduced by 45.5% (-83.3–100%) at 3-month, 57.3% (-83.3–100%) at 6-month and 27.9% (-100–100%) at 12-month after treatment. The modified Uterine Fibroid Symptom and Quality of Life scores were reduced by 50.0% (9.1–69.7%) at 3-month, 40.9% (27.3–66.7%) at 6-month and 39.5% (0–70.0%) at 12-month after treatment. The uterus and adenomyosis volumes were reduced by 24.4% (1.2–42.0%) and 46.3% (2.1-78.4%) at 6-month after treatment, respectively. Two patients (20%) had significant treatment-related complications and three patients (30%) required subsequent surgical interventions. Conclusions: Although ultrasound-guided HIFU appears to provide symptomatic relief to most patients with adenomyosis, its long-term effectiveness and safety require further evaluation in a larger cohort of patients, and may improve with clinical experience.
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Objective

This prospective cohort study was to evaluate the efficacy and safety of ultrasound-guided High-Intensity Focused Ultrasound (HIFU) in the treatment of uterine adenomyosis.

Methods

Ten premenopausal women with symptomatic adenomyosis underwent ultrasound-guided HIFU therapy. Their symptoms were compared using symptom severity scores before and at 3, 6 and 12 months after treatment. The sizes of their uteri and adenomyotic lesions at 6 months after treatment were compared with those of pre-treatment as determined by magnetic resonance imaging.

Results

The menstrual pain scores were reduced by 45.5% (-83.3–100%) at 3-month, 57.3% (-83.3–100%) at 6-month and 27.9% (-100–100%) at 12-month after treatment. The modified Uterine Fibroid Symptom and Quality of Life scores were reduced by 50.0% (9.1–69.7%) at 3-month, 40.9% (27.3–66.7%) at 6-month and 39.5% (0–70.0%) at 12-month after treatment. The uterus and adenomyosis volumes were reduced by 24.4% (1.2–42.0%) and 46.3% (2.1-78.4%) at 6-month after treatment, respectively. Two patients (20%) had significant treatment-related complications and three patients (30%) required subsequent surgical interventions.

Conclusions

Although ultrasound-guided HIFU appears to provide symptomatic relief to most patients with adenomyosis, its long-term effectiveness and safety require further evaluation in a larger cohort of patients, and may improve with clinical experience. Files WJARR-2022-0158.pdf Files (1.3 MB) | Name | Size | Download all | |---|---|---| | md5:d94014484a063c2b090464e50dcf3008 | 1.3 MB | Preview Download |

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