Safety of ultrasound-guided high-intensity focused ultrasound ablation for diffuse adenomyosis: A retrospective cohort study

Yujie Feng; Liang Hu; Wenzhi Chen; Rong Zhang; Xi Wang; Jinyun Chen

doi:10.1016/j.ultsonch.2016.11.022

Safety of ultrasound-guided high-intensity focused ultrasound ablation for diffuse adenomyosis: A retrospective cohort study

Ultrason Sonochem. 2017 May:36:139-145. doi: 10.1016/j.ultsonch.2016.11.022. Epub 2016 Nov 18.

Authors

Yujie Feng¹, Liang Hu¹, Wenzhi Chen², Rong Zhang³, Xi Wang³, Jinyun Chen⁴

Affiliations

¹ The State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing 400016, China.
² The State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing 400016, China; Clinical Center for Tumor Therapy, The 2nd Hospital, Chongqing Medical University, 76 Linjiang Road, Chongqing 400010, China.
³ HIFU Center for Tumor Therapy, 1st Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China.
⁴ The State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, Chongqing 400016, China. Electronic address: chenjinyun2006@126.com.

PMID: 28069193
DOI: 10.1016/j.ultsonch.2016.11.022

Abstract

Objectives: To evaluate the safety of ultrasound-guided high-intensity focused ultrasound (HIFU) ablation for patients with diffuse adenomyosis.

Methods: This was a retrospective cohort study. The data was collected from 417 symptomatic adenomyosis patients who underwent ultrasound-guided HIFU between January 2012 and December 2015 at 1st Affiliated Hospital of Chongqing Medical University, Chongqing, China. Among them were 260 patients with diffuse adenomyosis (Group D) and 157 patients with focal adenomyosis (Group F). All patients underwent contrast-enhanced magnetic resonance imaging (MRI) one week before and the day after HIFU treatment. Successful treatment with HIFU was measured by the non-perfused volume ratio (NPVR). Intraprocedural and postprocedural adverse effects and complications were recorded to assess the safety of the procedure. Patients were followed-up for three months post-treatment. Complications were given a grade A through F according to the SIR Standards.

Results: All patients successfully completed the procedure, non-perfused regions appeared in 415 (99.5%) patients. The non-perfused volume ratio (NPVR) of Group D was significantly lower than that of Group F (P<0.05). During the procedure, the odds ratio of skin-burning pain was 1.7 (OR=1.617, 95% CI: 1.103-2.532), when comparing Group D with Group F, while the odds ratio of inguinal pain was equal to 2.0 (OR=2.038, 95% CI: 1.161-3.580), when Group F was compared to Group D. 97 patients (23.3%) received nominal therapy due to complications ([Society of interventional radiology, SIR]-B grade), among them, there were 62 cases (23.8%) in Group D and 35 cases (22.3%) in Group F. No significant difference was found between the two groups (P>0.05) and neither of the reported complications of SIR-C-SIR-F occurred within the two groups.

Conclusions: Based on our results, ultrasound-guided HIFU is safe for the treatment of diffuse adenomyosis, and controlling the ablation zone is crucial to ensure patients' safety.

Keywords: Ablation; Adenomyosis; Safety; Ultrasound-guided high-intensity focused ultrasound (HIFU).

MeSH terms

Adenomyosis / surgery*
Adolescent
Adult
Female
High-Intensity Focused Ultrasound Ablation / adverse effects*
Humans
Middle Aged
Retrospective Studies
Risk Assessment
Safety*
Young Adult