Ultrasound guided high intensity focused ultrasound (USgHIFU) ablation for uterine fibroids: Do we need the microbubbles?

Figures & data

Table 1. Characteristics of the 33 patients who underwent USgHIFU, and mean volumes before treatment.

	Group A (n = 17)		Group B (n = 16)
Variable	Mean (SD)	Range	Mean (SD)	Range
Age (years)	43.1 (5.3)	29–51	42.0 (5.4)	32–52
Volume (cm^3)	419.24 (409)	47.3–1865.0	189.58 (190)	34.6–709.5

Table 2. Clinical parameters included in the UFS-QOL [11].

During the previous 3 months how distressed were you by…	Heavy bleeding, passing blood clots, fluctuation in the duration and length of the menstrual cycle, feeling tightness or pressure, frequent day time and night time urination, feeling fatigued?
During the previous 3 months, how often have your symptoms related to uterine fibroids…	Made you feel anxious, interfered with your activities, caused you to feel tired or worn out, made you feel less productive, interfered with your social activities, made you feel irritable, diminished your sexual desire, caused you to avoid sexual relations?

Figure 1. Plain US images collected (A) before and (B) after HIFU treatment show the difference in fibroid ecogenicity. In (B) disomogeneous hyperchoic changes of treated fibroid are visible.

Figure 2. CEUS imaging before (A) and after (B) USgHIFU of 48 mm highly perfused uterine fibroma (*). In (B) CEUS shows a complete devascularisation of the treated fibroma. Arrow = left common femoral vein; arrowhead = bowel loop.

Figure 3. CEUS imaging during USgHIFU of a 75-mm highly perfused uterine fibroma shows a still highly perfused tissue (arrowheads) around the central, already treated, devascularised area (*).

Figure 4. Fibroid volume changes and their confidence interval for both randomisation groups.

Table 3. Fibroid volume observed before (time 0) and after HIFU ablation (1, 3, 6 and 12 months): mean and standard deviation by randomisation group.

	Group A (Fibroids n = 20)		Group B (Fibroids n = 17)
Time	Mean (SD)	% change from baseline	Mean (SD)	% change from baseline	p*
0	419.24 (409)	–	189.58 (190)	–	–
1	351.58 (317)	−16.1	180.47 (189)	−4.8	0.01
3	315.37 (278)	−24.8	157.28 (178)	−17.0	0.17
6	283.77 (262)	−32.3	129.11 (148)	−31.9	0.50
12	249.27 (257)	−40.5	100.01 (144)	−47.2	0.85

*Differences between the two groups of the volume change from baseline were tested using a linear mixed model of repeated measures adjusting for the baseline value.

Spies JB, Coyne K, Guaou N, Boyle D, Skyrnarz-Murphy K, Gonzalves SM. The UFS–QOL, A new disease specific symptom and health-related quality of life questionnaire for leiomyomata. Obstet Gynecol 2002; 9:290–300

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