Effect of pre-treatment with gonadotropin-releasing hormone analogue GnRH-α on high-intensity focussed ultrasound ablation for diffuse adenomyosis: a preliminary study

Abstract

Objectives: To evaluate the efficacy and safety of GnRH-α pre-treatment with HIFU ablation for diffuse adenomyosis.

Methods: From January 2014 to December 2016, 61 patients were divided into two groups. Twenty-three patients with larger uteri received pre-treatment with GnRH-α and were then subjected to HIFU, and 38 patients underwent HIFU alone. The technical parameters included treatment time, sonication time, average sonication power, treatment intensity, total energy, non-perfusion volume (NPV) and NPV ratio. Intra-, post-procedural complaints, the relief rate of dysmenorrhoea and clinical effectiveness were followed up.

Results: Although the lesion volume in the HIFU + GnRH group was larger than in the HIFU-only group, higher NPV, NPVR%, treatment intensity and total energy with shorter treatment and sonication times in the HIFU + GnRH group were obtained than that in the HIFU-only group. Significant differences were evident for NPV, NPVR%, average power, and total intensity energy (p < 0.05), but not for other parameters between the two groups (p > 0.05).

Although no differences in the intra-, post-procedural VAS scores, in the adverse effects and in the relief rate or clinical effectiveness were apparent between the two groups (p > 0.05), the relief rate was better in the HIFU + GnRH group than that in the HIFU group from 6 to 12 months after treatment. Self-comparison of differences occurred in the two groups before and after treatment (p < 0.05) and were between the two groups after only 6 months (p < 0.05).

Conclusion: The combination of HIFU with GnRH-α is more effective than HIFU alone for ablation of diffuse adenomyosis. Moreover, the GnRH-α pre-treatment with HIFU is safe.

Keywords:

• High-intensity focussed ultrasound
• diffuse adenomyosis
• thermal ablation
• GnRH-α
• pre-treatment

Disclosure statement

All authors are responsible for and have the same rights to the article. All authors have read and approved the article for publication and have no potential conflicts of interest to disclose.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China [Grant No. 81270680].