Feasibility study on energy prediction of microwave ablation upon uterine adenomyosis and leiomyomas by MRI.

OBJECTIVE To evaluate the feasibility of energy prediction of percutaneous microwave ablation (PMWA) upon uterine leiomyomas and adenomyosis by MRI. METHODS 63 patients (49 patients with 49 uterine leiomyomas and 14 patients with adenomyosis) who underwent ultrasound-guided PMWA treatment were studied during the period from June 2011 to December 2012. Before PMWA, contrast-enhanced MRI (ceMRI) was performed for all of the patients. Based on the signal intensity (SI) of T2 weighted MRI, uterine leiomyomas were classified as hypointense, isointense and hyperintense. During ablation, the output energy of the microwave was set at 50 W, and T11a microwave antennas were used. ceMRI was performed within 7 days after PMWA treatment. Non-perfused volume and energy required per unit volume were analysed statistically. RESULTS When unit volume of lesions was ablated, uterine adenomyosis needed more energy than did uterine leiomyomas, and hyperintense uterine leiomyomas needed more energy than did hypointense pattern. CONCLUSIONS MRI SI of uterine leiomyomas and uterine adenomyosis can be used to predict PMWA energy. ADVANCES IN KNOWLEDGE The conclusions indicate that MRI SI can be used to perform pre-treatment planning, which will make the treatment more precise.

[1]  F. Orsi,et al.  Feasibility of MRI-guided high intensity focused ultrasound treatment for adenomyosis. , 2012, European journal of radiology.

[2]  Lei Feng,et al.  Imaging manifestation of conventional and contrast-enhanced ultrasonography in percutaneous microwave ablation for the treatment of uterine fibroids. , 2012, European journal of radiology.

[3]  H. Rhim,et al.  Volumetric MR-HIFU ablation of uterine fibroids: role of treatment cell size in the improvement of energy efficiency. , 2012, European journal of radiology.

[4]  Y. Kishi,et al.  Four subtypes of adenomyosis assessed by magnetic resonance imaging and their specification. , 2012, American journal of obstetrics and gynecology.

[5]  김만득,et al.  Uterine artery embolization for symptomatic fibroids with high signal intensity on T2-weighted MR imaging. , 2012 .

[6]  Lei Feng,et al.  Ultrasound-guided percutaneous microwave ablation for symptomatic uterine fibroid treatment – A clinical study , 2011, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[7]  M. Lumsden,et al.  Randomised comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5‐year results , 2011, BJOG : an international journal of obstetrics and gynaecology.

[8]  Min Ju Kim,et al.  MR imaging features of uterine adenomyomas , 2011, Abdominal Imaging.

[9]  L. Li,et al.  Numerical study on thermal field of microwave ablation with water-cooled antenna , 2009, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[10]  Ren Jin-ta.  Experimental study of microwave ablation for muscular tissues with water-cooling single needle antenna , 2009 .

[11]  K. Sniderman,et al.  Clinical failure after uterine artery embolization: evaluation of patient and MR imaging characteristics. , 2008, Journal of vascular and interventional radiology : JVIR.

[12]  T. Murakami,et al.  Magnetic resonance imaging-guided focused ultrasound ablation of uterine fibroids: early clinical experience , 2008, Radiation Medicine.

[13]  R. Ozminkowski,et al.  The Direct and Indirect Cost Burden of Clinically Significant and Symptomatic Uterine Fibroids , 2007, Journal of occupational and environmental medicine.

[14]  S Nahum Goldberg,et al.  Image-guided tumor ablation: standardization of terminology and reporting criteria. , 2005, Radiology.

[15]  F. Ghezzi,et al.  Laparoscopic radiofrequency thermal ablation: a new approach to symptomatic uterine myomas. , 2005, American journal of obstetrics and gynecology.

[16]  S Nahum Goldberg,et al.  Image-guided tumor ablation: standardization of terminology and reporting criteria. , 2005, Journal of vascular and interventional radiology : JVIR.

[17]  E. Wallach,et al.  Uterine Myomas: An Overview of Development, Clinical Features, and Management , 2004, Obstetrics and gynecology.

[18]  後藤 幸.  Usefulness of Gd-DTPA contrast-enhanced dynamic MRI and serum determination of LDH and its isozymes in the differential diagnosis of leiomyosarcoma from degenerated leiomyoma of the uterus , 2004 .

[19]  E. Outwater,et al.  Uterine leiomyomas: histopathologic features, MR imaging findings, differential diagnosis, and treatment. , 1999, Radiographics : a review publication of the Radiological Society of North America, Inc.

[20]  C. Wood,et al.  Surgical and medical treatment of adenomyosis. , 1998, Human reproduction update.

[21]  Y. Yamashita,et al.  Hyperintense uterine leiomyoma at T2-weighted MR imaging: differentiation with dynamic enhanced MR imaging and clinical implications. , 1993, Radiology.

[22]  K. Kawamoto,et al.  Uterine leiomyoma: correlation between signal intensity on magnetic resonance imaging and pathologic characteristics. , 1992, Radiation medicine.

[23]  A. Shitzer,et al.  On the relationship between blood perfusion, metabolism and temperature in biological tissue heat balance. , 1980, Journal of biomechanical engineering.

[24]  H. H. Penns.  Analysis of tissue and arterial blood temperatures in the resting human forearm , 1948 .