High intensity focused ultrasound treatment of adenomyosis: a comparative study

Figures & data

Table 1. Baseline characteristics of patients with adenomyosis treated with HIFU, HIFU combined with LNG-IUS or HIFU combined with GnRHa.

	HIFU alone (n = 45)	HIFU + LNG-IUS (n = 15)	HIFU + GnRH-a (n = 18)	p Value
Age (years)	42.42 ± 5.09	39.33 ± 4.30	41.44 ± 4.74	0.23776
Lesion volume (cm^3)	54196.00 ± 7945.30	34427.79 ± 10123.33	61667.14 ± 12981.36	0.29050
Uterus volume (cm^3)	150652.52 ± 12887.08	181083.73 ± 24597.88	175161.43 ± 19510.80	0.40002
Dysmenorrhea	7.93 ± 2.30	8.00 ± 2.45	8.39 ± 1.94	0.66119
Menstrual volume	4.22 ± 0.79	4.80 ± 0.41	4.39 ± 0.70	0.63340

Figure 1. Ultrasonography and MR imaging from a patient with adenomyosis.

A1. Pre-HIFU ultrasonography showed the hypoechoic lesion. A2. Real-time ultrasound imaging showed the significant grayscale change in the treated area. B1. Contrast-enhanced MRI obtained before HIFU showed the enhancement of the diffuse adenomyosis. B2. MRI obtained one day after HIFU showed the nonperfused area of the lesion without damage to the surrounding normal tissue.

Table 2. HIFU treatment parameters.

	HIFU alone (n = 45)	HIFU + LNG-IUS (n = 15)	HIFU + GnRH-a (n = 18)	p Value
HIFU average power	272.07 ± 7.34	277.21 ± 17.78	308.11 ± 12.41	0.05604
HIFU total energy	303510.29 ± 18634.14	286285.07 ± 37205.88	327793.89 ± 26690.71	0.63340
NPV ratio	79.07 ± 0.08	84.20 ± 0.12	78.44 ± 0.11	0.156

Table 3. Evaluation of treatment efficacy in patients with dysmenorrheal.

Follow-up time	HIFU alone (n = 45)	HIFU + LNG-IUS (n = 15)	HIFU + GnRH-a (n = 18)	p Value
Pre-HIFU	7.93 ± 2.30	8.00 ± 2.45	8.39 ± 1.94	0.762
1 Month	2.96 ± 1.21	2.80 ± 0.56	2.90 ± 0.58	0.865
6 Months	2.82 ± 0.51	1.80 ± 0.22*	1.89 ± 0.21	0.000
12 Months	2.11 ± 0.56	0.73 ± 0.18	0.72 ± 0.16	0.000
p Value	0.000	0.000	0.000

Table 4. Evaluation of treatment efficacy in patients with menorrhgea after HIFU treatment.

Follow-up time	HIFU alone (n = 45)	HIFU + LNG-IUS (n = 15)	HIFU + GnRH-a (n = 18)	p Value
Pre-HIFU	4.22 ± 0.79	4.56 ± 0.41	4.39 ± 0.70	0.259
1 Month	3.14 ± 0.46	2.93 ± 0.51	2.94 ± 0.42	0.128
6 Months	2.79 ± 0.53	2.33 ± 0.42	2.34 ± 0.36	0.000
12 Months	2.62 ± 0.53	2.07 ± 0.26	2.00 ± 0.00	0.000
p Value	0.000	0.000	0.000

Table 5. Comparison of the uterine volume reduction rate after HIFU treatment.

Follow-up time	HIFU alone (n = 45)	HIFU + LNG-IUS (n = 15)	HIFU + GnRH-a (n = 18)	p Value
1 Month	13.01 ± 3.11%	13.66 ± 4.05%	14.23 ± 3.84%	0.551
6 Months	22.06 ± 3.69%	27.81 ± 3.78%	28.03 ± 4.01%	0.000
12 Months	30.42 ± 5.31%	38.47 ± 4.49%	39.55 ± 5.53%	0.000
p Value	0.000	0.000	0.000

Table 6. Comparison of the shrinkage rate of the adenomyotic lesion after HIFU treatment in the three groups.

Follow-up time	HIFU alone (n = 45)	HIFU + LNG-IUS (n = 15)	HIFU + GnRH-a (n = 18)	p Value
1 Month	25.27 ± 4.45%	23.81 ± 4.33%	23.99 ± 3.64%	0.228
6 Months	31.72 ± 5.68%	42.52 ± 6.65%	39.23 ± 5.39%	0.000
12 Months	43.96 ± 7.38%	54.48 ± 5.72%	53.91 ± 6.38%	0.000
p Value	0.000	0.000	0.000