Safety and Efficacy of Sonographically Guided High‐Intensity Focused Ultrasound for Symptomatic Uterine Fibroids
Objectives We aimed to assess the safety and efficacy of sonographically guided high‐intensity focused ultrasound for treating patients with symptomatic uterine fibroids using a modified protocol. Methods This work was part of an ongoing prospective phase 1 study. Twenty patients with 22 symptomatic...
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| Veröffentlicht in: | Journal of ultrasound in medicine 2014-10, Vol.33 (10), p.1811-1818 |
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| creator | Leung, Joyce H. Y. Yu, Simon C. H. Cheung, Eva C. W. Wong, Alyssa S. W. Tong, Mabel M. B. Ho, Stella S. Y. Leung, Vivian Y. F. Ahuja, Anil T. |
| description | Objectives
We aimed to assess the safety and efficacy of sonographically guided high‐intensity focused ultrasound for treating patients with symptomatic uterine fibroids using a modified protocol.
Methods
This work was part of an ongoing prospective phase 1 study. Twenty patients with 22 symptomatic fibroids were treated with sonographically guided high‐intensity focused ultrasound under no anesthesia. The modified protocol consisted of repeated and shortened ( |
| doi_str_mv | 10.7863/ultra.33.10.1811 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_wiley</sourceid><recordid>TN_cdi_proquest_miscellaneous_1808635617</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1808635617</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1761-fee9ff641f795a67bf2d123e69034ab7d57e2b2003159219538d5dd1be42b7963</originalsourceid><addsrcrecordid>eNotkL1OxDAQhC0EEsdBT-mSJofXTuKkoECn-0OHKI7UkRPbd0ZJHOxEKB2PwDPyJCRAtdrZ2RnpQ-gWyIInMbvvq86JBWOLUYAE4AzNIIpIkMbAztGMUJ4EIU35Jbry_o0QSoCHM-QOQqtuwKKReKW1KUU5YKvxwTb26ER7GpWqGvCmN1JJvDXH0_fn167pVOPN-Le2Ze_HQzbVe9uPMdo6fBjqtrO16EyJs0450yi8NoWzRvprdKFF5dXN_5yjbL16XW6D_ctmt3zcByXwGAKtVKp1HILmaSRiXmgqgTIVp4SFouAy4ooWlBAGUUohjVgiIymhUCEteBqzObr7y22dfe-V7_La-FJVlWiU7X0OCRnBRTHw0frwZ_0wlRry1plauCEHkk9s81-2OWOTMLHNn7LnkV_IGJBpZz_ZAXPh</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1808635617</pqid></control><display><type>article</type><title>Safety and Efficacy of Sonographically Guided High‐Intensity Focused Ultrasound for Symptomatic Uterine Fibroids</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Leung, Joyce H. Y. ; Yu, Simon C. H. ; Cheung, Eva C. W. ; Wong, Alyssa S. W. ; Tong, Mabel M. B. ; Ho, Stella S. Y. ; Leung, Vivian Y. F. ; Ahuja, Anil T.</creator><creatorcontrib>Leung, Joyce H. Y. ; Yu, Simon C. H. ; Cheung, Eva C. W. ; Wong, Alyssa S. W. ; Tong, Mabel M. B. ; Ho, Stella S. Y. ; Leung, Vivian Y. F. ; Ahuja, Anil T.</creatorcontrib><description>Objectives
We aimed to assess the safety and efficacy of sonographically guided high‐intensity focused ultrasound for treating patients with symptomatic uterine fibroids using a modified protocol.
Methods
This work was part of an ongoing prospective phase 1 study. Twenty patients with 22 symptomatic fibroids were treated with sonographically guided high‐intensity focused ultrasound under no anesthesia. The modified protocol consisted of repeated and shortened (<25 minutes) treatment sessions of high‐input acoustic intensity (1000–1500 W/cm2) and intensified sonication pulses (1500–2000) at each spot. The primary end points were periprocedural complications. The secondary end points were symptomatic improvement and radiologic evidence of treatment responses, including the degree of fibroid infarction and volume shrinkage 3 months after treatment. Symptomatic improvement was assessed by a pain score, a pictorial chart menstrual score, the Urogenital Distress Inventory short form, and the Incontinence Impact Questionnaire short form. The degree of fibroid infarction was assessed by the nonperfused ratio on contrast‐enhanced magnetic resonance imaging, defined as the ratio of the nonperfused fibroid volume to the total fibroid volume.
Results
Nineteen patients tolerated the treatment well, with no major adverse events. One patient who received treatment for a fibroid located within 6 cm from the skin had third‐degree skin burns at 2 sites of 1 cm in diameter. Fibroid‐related abdominal pain, pictorial chart, Urogenital Distress Inventory, and Incontinence Impact Questionnaire scores were significantly improved (P < .05). The median nonperfused ratio at 3 months was 20% (95% confidence interval, 5%–32.5%). Median volume shrinkage at 3 months was 17.2% (95% confidence interval, 4.3%–26.6%).
Conclusions
Sonographically guided high‐intensity focused ultrasound using a modified protocol may be safe and effective for symptomatic uterine fibroids in selected patients to avoid skin burns.</description><identifier>ISSN: 0278-4297</identifier><identifier>EISSN: 1550-9613</identifier><identifier>DOI: 10.7863/ultra.33.10.1811</identifier><language>eng</language><publisher>American Institute of Ultrasound in Medicine</publisher><subject>ablation therapy ; gynecologic ultrasound ; high-intensity focused ultrasound ; uterine fibroid</subject><ispartof>Journal of ultrasound in medicine, 2014-10, Vol.33 (10), p.1811-1818</ispartof><rights>2016 by the American Institute of Ultrasound in Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1761-fee9ff641f795a67bf2d123e69034ab7d57e2b2003159219538d5dd1be42b7963</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.7863%2Fultra.33.10.1811$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.7863%2Fultra.33.10.1811$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids></links><search><creatorcontrib>Leung, Joyce H. Y.</creatorcontrib><creatorcontrib>Yu, Simon C. H.</creatorcontrib><creatorcontrib>Cheung, Eva C. W.</creatorcontrib><creatorcontrib>Wong, Alyssa S. W.</creatorcontrib><creatorcontrib>Tong, Mabel M. B.</creatorcontrib><creatorcontrib>Ho, Stella S. Y.</creatorcontrib><creatorcontrib>Leung, Vivian Y. F.</creatorcontrib><creatorcontrib>Ahuja, Anil T.</creatorcontrib><title>Safety and Efficacy of Sonographically Guided High‐Intensity Focused Ultrasound for Symptomatic Uterine Fibroids</title><title>Journal of ultrasound in medicine</title><description>Objectives
We aimed to assess the safety and efficacy of sonographically guided high‐intensity focused ultrasound for treating patients with symptomatic uterine fibroids using a modified protocol.
Methods
This work was part of an ongoing prospective phase 1 study. Twenty patients with 22 symptomatic fibroids were treated with sonographically guided high‐intensity focused ultrasound under no anesthesia. The modified protocol consisted of repeated and shortened (<25 minutes) treatment sessions of high‐input acoustic intensity (1000–1500 W/cm2) and intensified sonication pulses (1500–2000) at each spot. The primary end points were periprocedural complications. The secondary end points were symptomatic improvement and radiologic evidence of treatment responses, including the degree of fibroid infarction and volume shrinkage 3 months after treatment. Symptomatic improvement was assessed by a pain score, a pictorial chart menstrual score, the Urogenital Distress Inventory short form, and the Incontinence Impact Questionnaire short form. The degree of fibroid infarction was assessed by the nonperfused ratio on contrast‐enhanced magnetic resonance imaging, defined as the ratio of the nonperfused fibroid volume to the total fibroid volume.
Results
Nineteen patients tolerated the treatment well, with no major adverse events. One patient who received treatment for a fibroid located within 6 cm from the skin had third‐degree skin burns at 2 sites of 1 cm in diameter. Fibroid‐related abdominal pain, pictorial chart, Urogenital Distress Inventory, and Incontinence Impact Questionnaire scores were significantly improved (P < .05). The median nonperfused ratio at 3 months was 20% (95% confidence interval, 5%–32.5%). Median volume shrinkage at 3 months was 17.2% (95% confidence interval, 4.3%–26.6%).
Conclusions
Sonographically guided high‐intensity focused ultrasound using a modified protocol may be safe and effective for symptomatic uterine fibroids in selected patients to avoid skin burns.</description><subject>ablation therapy</subject><subject>gynecologic ultrasound</subject><subject>high-intensity focused ultrasound</subject><subject>uterine fibroid</subject><issn>0278-4297</issn><issn>1550-9613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNotkL1OxDAQhC0EEsdBT-mSJofXTuKkoECn-0OHKI7UkRPbd0ZJHOxEKB2PwDPyJCRAtdrZ2RnpQ-gWyIInMbvvq86JBWOLUYAE4AzNIIpIkMbAztGMUJ4EIU35Jbry_o0QSoCHM-QOQqtuwKKReKW1KUU5YKvxwTb26ER7GpWqGvCmN1JJvDXH0_fn167pVOPN-Le2Ze_HQzbVe9uPMdo6fBjqtrO16EyJs0450yi8NoWzRvprdKFF5dXN_5yjbL16XW6D_ctmt3zcByXwGAKtVKp1HILmaSRiXmgqgTIVp4SFouAy4ooWlBAGUUohjVgiIymhUCEteBqzObr7y22dfe-V7_La-FJVlWiU7X0OCRnBRTHw0frwZ_0wlRry1plauCEHkk9s81-2OWOTMLHNn7LnkV_IGJBpZz_ZAXPh</recordid><startdate>201410</startdate><enddate>201410</enddate><creator>Leung, Joyce H. Y.</creator><creator>Yu, Simon C. H.</creator><creator>Cheung, Eva C. W.</creator><creator>Wong, Alyssa S. W.</creator><creator>Tong, Mabel M. B.</creator><creator>Ho, Stella S. Y.</creator><creator>Leung, Vivian Y. F.</creator><creator>Ahuja, Anil T.</creator><general>American Institute of Ultrasound in Medicine</general><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope></search><sort><creationdate>201410</creationdate><title>Safety and Efficacy of Sonographically Guided High‐Intensity Focused Ultrasound for Symptomatic Uterine Fibroids</title><author>Leung, Joyce H. Y. ; Yu, Simon C. H. ; Cheung, Eva C. W. ; Wong, Alyssa S. W. ; Tong, Mabel M. B. ; Ho, Stella S. Y. ; Leung, Vivian Y. F. ; Ahuja, Anil T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1761-fee9ff641f795a67bf2d123e69034ab7d57e2b2003159219538d5dd1be42b7963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>ablation therapy</topic><topic>gynecologic ultrasound</topic><topic>high-intensity focused ultrasound</topic><topic>uterine fibroid</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leung, Joyce H. Y.</creatorcontrib><creatorcontrib>Yu, Simon C. H.</creatorcontrib><creatorcontrib>Cheung, Eva C. W.</creatorcontrib><creatorcontrib>Wong, Alyssa S. W.</creatorcontrib><creatorcontrib>Tong, Mabel M. B.</creatorcontrib><creatorcontrib>Ho, Stella S. Y.</creatorcontrib><creatorcontrib>Leung, Vivian Y. F.</creatorcontrib><creatorcontrib>Ahuja, Anil T.</creatorcontrib><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Journal of ultrasound in medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leung, Joyce H. Y.</au><au>Yu, Simon C. H.</au><au>Cheung, Eva C. W.</au><au>Wong, Alyssa S. W.</au><au>Tong, Mabel M. B.</au><au>Ho, Stella S. Y.</au><au>Leung, Vivian Y. F.</au><au>Ahuja, Anil T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety and Efficacy of Sonographically Guided High‐Intensity Focused Ultrasound for Symptomatic Uterine Fibroids</atitle><jtitle>Journal of ultrasound in medicine</jtitle><date>2014-10</date><risdate>2014</risdate><volume>33</volume><issue>10</issue><spage>1811</spage><epage>1818</epage><pages>1811-1818</pages><issn>0278-4297</issn><eissn>1550-9613</eissn><abstract>Objectives
We aimed to assess the safety and efficacy of sonographically guided high‐intensity focused ultrasound for treating patients with symptomatic uterine fibroids using a modified protocol.
Methods
This work was part of an ongoing prospective phase 1 study. Twenty patients with 22 symptomatic fibroids were treated with sonographically guided high‐intensity focused ultrasound under no anesthesia. The modified protocol consisted of repeated and shortened (<25 minutes) treatment sessions of high‐input acoustic intensity (1000–1500 W/cm2) and intensified sonication pulses (1500–2000) at each spot. The primary end points were periprocedural complications. The secondary end points were symptomatic improvement and radiologic evidence of treatment responses, including the degree of fibroid infarction and volume shrinkage 3 months after treatment. Symptomatic improvement was assessed by a pain score, a pictorial chart menstrual score, the Urogenital Distress Inventory short form, and the Incontinence Impact Questionnaire short form. The degree of fibroid infarction was assessed by the nonperfused ratio on contrast‐enhanced magnetic resonance imaging, defined as the ratio of the nonperfused fibroid volume to the total fibroid volume.
Results
Nineteen patients tolerated the treatment well, with no major adverse events. One patient who received treatment for a fibroid located within 6 cm from the skin had third‐degree skin burns at 2 sites of 1 cm in diameter. Fibroid‐related abdominal pain, pictorial chart, Urogenital Distress Inventory, and Incontinence Impact Questionnaire scores were significantly improved (P < .05). The median nonperfused ratio at 3 months was 20% (95% confidence interval, 5%–32.5%). Median volume shrinkage at 3 months was 17.2% (95% confidence interval, 4.3%–26.6%).
Conclusions
Sonographically guided high‐intensity focused ultrasound using a modified protocol may be safe and effective for symptomatic uterine fibroids in selected patients to avoid skin burns.</abstract><pub>American Institute of Ultrasound in Medicine</pub><doi>10.7863/ultra.33.10.1811</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | ablation therapy gynecologic ultrasound high-intensity focused ultrasound uterine fibroid |
| title | Safety and Efficacy of Sonographically Guided High‐Intensity Focused Ultrasound for Symptomatic Uterine Fibroids |
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