Clinical Study On High-intensity Focused Ultrasound Ablation To Adenomyosis

Background Focused ultrasound ablation(FUA)is a new method to achieve thermal ablation in tissue by using extracorporeal low power ultrasound beams,which may be focused on the targeted tissue in depth in human body.At present FUA has been widely used in the clinical treatment of benign prostatic hypertrophy,hepatocarcinoma,bone tumor,breast cancer and soft tissue sarcoma,etc.Studies on focused ultrasound ablation in the treatment of some benign tumor such as myoma of uterus and breast fibroadenoma also had carried out.Adenomyosis,a benign disease of the uterus characterized by ectopic endometrial glands and stroma within the myometrium with adjacent smooth muscle hyperplasia,has been treated by hysterectomy.Whether the disease can be treated by focused ultrasound ablation or not,there is not any conclusion yet.In this study,we performed systematical research on the safty,feasibility,efficacy and the early outcome of focused ultrasound ablation treatment to adenomyosis.Materials And Methods 20 cases ofpremenopausal women with symptomatic uterine adenomyosis were recruited by strict enrollment protocol. All women who signed the informed consent document were considered enrolled. They completed the UFS-QOL questionnaire and procedures of imaging examination include MRI,TVS and CEUS,and serum CA125,CA19-9.Treatment is planed according to imaging data.All women were treated with JC-1 high-intensity focused ultrasound tumor treatment system(Haifu Ltd. Chongqing,China)under transvenous conscious sedation after careful preparation. Data were collected to evaluate the safety,efficacy of focused ultrasound ablation.1.Vital signs and physical and mental response during and after the treatment.2.Data of MRI,TVS and CEUS before and after treatment prompt and 3 months posttreatment.3.The symptom severity scores and health-related quality of life scores of baseline and 3 months after were measured in all women to evaluate the theraptic effect of focused ultrasound ablation to adenomyosis.Results 1.no side effects were found in all women except burns on skin. Most of them returned to normal life about 48 hours.3 moths thereafter no serious adverse event were reported.2.Contrast-enhanced MRI and CEUS both are the accurate modality to show the nonperfusive region in leision after treatment.CEUS can be used as a altemative to MRI to assess the efficacy of FUA.3.Uterine volume and adenomyotic leision volume decreased in 3 months after FUA.The symptom severity scores decreased by 14 and HRQOL scores increased by 21.All women reported the improvement in their physical and mental in different degrees.Conclusion Focused ultrasound ablation is a new altemative to adenomyosis.This method can improve the life quality of women suffered adenomyosis and appear to be safety and efficacy.MRI and CEUS are reliable to evaluate the ablation results.