Factors influencing the ablative efficiency of high intensity focused ultrasound (HIFU) treatment for adenomyosis: A retrospective study

Abstract

Objectives The aim of this study was to investigate factors affecting ablative efficiency of high intensity focused ultrasound (HIFU) for adenomyosis. Materials and methods In all, 245 patients with adenomyosis who underwent ultrasound guided HIFU (USgHIFU) were retrospectively reviewed. All patients underwent dynamic contrast-enhanced magnetic resonance imaging (MRI) before and after HIFU treatment. The non-perfused volume (NPV) ratio, energy efficiency factor (EEF) and greyscale change were set as dependent variables, while the factors possibly affecting ablation efficiency were set as independent variables. These variables were used to build multiple regression models. Results A total of 245 patients with adenomyosis successfully completed HIFU treatment. Enhancement type on T1 weighted image (WI), abdominal wall thickness, volume of adenomyotic lesion, the number of hyperintense points, location of the uterus, and location of adenomyosis all had a linear relationship with the NPV ratio. Distance from skin to the adenomyotic lesion’s ventral side, enhancement type on T1WI, volume of adenomyotic lesion, abdominal wall thickness, and signal intensity on T2WI all had a linear relationship with EEF. Location of the uterus and abdominal wall thickness also both had a linear relationship with greyscale change. Conclusion The enhancement type on T1WI, signal intensity on T2WI, volume of adenomyosis, location of the uterus and adenomyosis, number of hyperintense points, abdominal wall thickness, and distance from the skin to the adenomyotic lesion’s ventral side can all be used as predictors of HIFU for adenomyosis.

Keywords:

• Ablative efficiency
• adenomyosis
• high intensity focused ultrasound (HIFU)
• magnetic resonance imaging (MRI)

Acknowledgements

We thank Wendy Zhang, a native English speaker from the University of California at San Diego, who has done a thorough review and correction of the English of this paper.

Disclosure statement

This work was partially supported by the National Basic Research Programme of China (2011CB707900), The National Natural Science Fund by the Chinese National Science Foundation (81127901, 11274404, 11574039), the National Key Technology R&D Programme (grant no. 2011BAI14B01). L.Z. is a senior consultant to Chongqing Haifu Company. The other authors have no conflict of interest to declare. The authors alone are responsible for the content and writing of the paper.