High-intensity focused ultrasound ablation in the treatment of recurrent ovary cancer and metastatic pelvic tumors: a feasibility study

Figures & data

Figure 1. The real-time ultrasound image obtained from a 46-year-old patient with metastatic pelvic tumor from endometrial cancer. (A). A pre-HIFU ultrasound image showed a recurrent lesion of 112 cm × 72cm × 71cm, with mixed echoic (arrow); (B). During HIFU treatment, a significant gray scale changed area was observed in the pelvic lesion (arrow); (C) ultrasound image obtained at 1301 s of sonication showed the gray scale changed area covered the pelvic lesion (arrow).

Table 1. Baseline characteristics of patients with metastatic pelvic tumors.

Case	Age	BMI	Primary tumor	Tumor volume （cm^3）	Symptoms before HIFU	Pre-HIFU QOL score	Follow-up time	Status
1	71	25	Ovarian cancer	43.9	Lower abdominal pain	90	12 months	Survived
2	63	20	Rectal cancer	1218.5	asymptomatic	80	12 months	Survived
3	47	24	Endometrial cancer	299.6	Lower abdominal pain	80	12 months	Survived
4	76	24	Ovarian cancer	112.1	Lower abdominal pain	50	2 months	Passed away
5	46	21	Ovarian cancer	130.6	asymptomatic	90	12 months	Survived
6	33	20	Cervical cancer	72.8	asymptomatic	70	12 months	Survived
7	52	20	Ovarian cancer	21.8	Lower abdominal pain	80	3 months	Passed away
8	46	17	Ovarian cancer	4.6	asymptomatic	90	12 months	Survived

QOL: quality of life.

Figure 2. Pre- and post-HIFU MRI images obtained from a 71-year-old patient with pelvic recurrence and metastasis from ovarian cancer. (A). Pre-HIFU MRI image showed a lesion adjacent to the bladder. The size of the lesion was 33 cm × 42cm × 45cm with significantly enhancement (red arrow). (B). One month after HIFU, contrast-enhanced MR showed a non-enhanced area of 30 cm × 33cm × 36cm (arrow).

Table 2. HIFU treatment results for metastatic pelvic tumors.

Case	No. of treated lesions	Average power (w)	Treatment time（min）	Sonication time (s)	Treatment intensity (s/h)	Therapeutic dose（J）	NPV ratio	Gray scale change
1	1	358	36	245	408	87710	81	Significant
2	2	399	354	3018	512	1204182	68	Significant
3	1	400	96	1301	813	520400	76	Significant
4	1	400	255	2148	505	859200	78	Significant
5	2	400	245	2958	724	1183200	91	Significant
6	1	400	68	360	318	144000	52	Significant
7	3	332	134	718	321	238376	60	Significant
8	1	166	24	86	215	14276	24	Significant

Table 3. Adverse effects evaluation of HIFU for metastatic pelvic tumors.

Case	Skin burn	Surrounding structure injury	Pain in treatment area	Intestinal injury	Nerve injury	Others
1	None	None	2	None	None	None
2	None	None	3	None	None	None
3	None	None	2	None	None	None
4	None	None	1	None	None	None
5	None	None	1	None	None	None
6	None	None	2	None	None	None
7	None	None	2	None	None	None
8	None	None	1	None	None	None

Table 4. Comparison of pain scores during follow-up period.

Case	Before	1-month	3-month	6-months	12-month
1	0	1	1	2	2
2	4	2	1	1	3
3	3	2	1	1	2
4	6	Declined	Passed away
5	0	0	0	0	0
6	1	0	1	1	1
7	2	7	Declined	Passed away
8	0	0	1	1	1