Research of dose-effect relationship parameters of percutaneous microwave ablation for uterine leiomyomas - a quantitative study

Eighty eight patients with 91 uterine leiomyomas who underwent ultrasound-guided percutaneous microwave ablation (PMWA) treatment were prospectively included in the study in order to study the dose-effect relationship parameters (DERP) of PMWA for uterine leiomyomas and its relationship with T2-weighted MR imaging (T2WI). Based on the signal intensity of T2WI, uterine leiomyomas were classified as hypointense, isointense, and hyperintense. During ablation, leiomyomas were treated with quantitative microwave ablation (QMWA) energy of 50 w × 300 s or 60 w × 300 s. After QMWA, contrast-enhanced ultrasound (CEUS) was performed to evaluate DERP. No matter under 50 w × 300 s or 60 w × 300 s, quantitative microwave ablation volume (QMAV) of hyperintense leiomyoma was smaller than that of hypointense and isointense leiomyoma (P<0.016). For hypointense and isointense leiomyoma, QMAV of 60 w × 300 s was larger than that of 50 w × 300 s (P<0.05). DERPs obtained by T2WI can be used to guide the treatment of uterine leiomyoma by PMWA.

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

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

[3]  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.

[4]  W. Hehenkamp,et al.  Review of nonsurgical/minimally invasive treatments for uterine fibroids , 2012, Current opinion in obstetrics & gynecology.

[5]  Elizabeth A Stewart,et al.  Clinical outcomes of focused ultrasound surgery for the treatment of uterine fibroids. , 2006, Fertility and sterility.

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

[7]  M. Dueholm,et al.  Ultrasound‐guided radiofrequency ablation of symptomatic uterine fibroids: short‐term evaluation of effect of treatment on quality of life and symptom severity , 2012, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[8]  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.

[9]  Suyon Chang,et al.  Uterine Artery Embolization for Symptomatic Fibroids with High Signal Intensity on T2-Weighted MR Imaging , 2012, Korean journal of radiology.

[10]  J. Macer,et al.  Radiofrequency volumetric thermal ablation of fibroids: a prospective, clinical analysis of two years’ outcome from the Halt trial , 2013, Health and Quality of Life Outcomes.

[11]  R. Coleman,et al.  Analysis of prognostic factors for patients with leiomyoma treated with uterine arterial embolization. , 2008, American journal of obstetrics and gynecology.

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

[13]  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.

[14]  H. H. Pennes.  Analysis of tissue and arterial blood temperatures in the resting human forearm. , 1948, Journal of applied physiology.

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

[16]  Ö. Etlik,et al.  Predictive value of magnetic resonance imaging signal and contrast-enhancement characteristics on post-embolization volume reduction of uterine fibroids , 2006, Acta radiologica.

[17]  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.

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

[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]  K. Funaki,et al.  Subjective effect of magnetic resonance‐guided focused ultrasound surgery for uterine fibroids , 2007, The journal of obstetrics and gynaecology research.

[21]  Kimberly K Amrami,et al.  Magnetic resonance-guided focused ultrasound of uterine leiomyomas: review of a 12-month outcome of 130 clinical patients. , 2011, Journal of vascular and interventional radiology : JVIR.

[22]  M. Carcangiu,et al.  Does pelvic magnetic resonance imaging differentiate among the histologic subtypes of uterine leiomyomata? , 1998, Fertility and sterility.

[23]  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.

[24]  Kullervo Hynynen,et al.  Uterine leiomyomas: MR imaging-guided focused ultrasound surgery--imaging predictors of success. , 2008, Radiology.