Ultrasound-guided percutaneous microwave ablation for adenomyosis with abnormal uterine bleeding: clinical outcome and associated factors

Abstract

Objective

To investigate the factors affecting the efficacy of ultrasound (US)-guided percutaneous microwave ablation (PMWA) for adenomyosis with abnormal uterine bleeding (AUB-A).

Methods

Baseline data of patients with AUB-A who underwent US-guided PMWA treatment between October 2020 and October 2021, including demography characteristics, laboratory and imaging examination results were retrospectively analyzed. 3D reconstruction of magnetic resonance imaging (MRI) was applied to quantitatively assess the local treatment responses, including ratio of non-perfusion volume to adenomyosis volume (NPVr), ablation rate of the endometrial-myometrial junction (EMJ), and surface area (SA) of the ablated part of the EMJ. Patients were followed up at 3, 6, and 12 months after treatment, and divided into two groups: group with complete relief (CR), and group with partial relief (PR) or no relief (NR). Data were compared between them.

Results

Thirty-one patients were analyzed with a mean age of 38.7 ± 6.8 years (range: 24–48): 48.4% (15/31), 63.3% (19/30), and 65.5% (19/29) achieved CR at 3, 6, and 12 months, respectively. In univariate analysis, compared with the PR/NR group, serum CA125 levels were significantly lower in CR group at 3 months, while ablation rates of EMJ and SA of the ablated part of the EMJ were significantly higher at the three time points. Other baseline characteristics and NPVr did not differ between the two groups.

Conclusion

Baseline CA125 and ablation rate of the EMJ and SA of the ablated part of the EMJ are associated with the outcome of AUB-A patients after US-guided PMWA treatment.

KEYSWORDS:

• Adenomyosis
• abnormal uterine bleeding
• ultrasound-guided microwave ablation

Acknowledgments

The authors thank Taylor & Francis for the English language editing and the reviewers for their helpful comments.

Disclosure statement

No conflict of interest was reported.

Additional information

Funding

This work was supported by the Science and Technology Commission of Shanghai Municipality under Grant 21Y11910800 and 19DZ2251100, Shanghai Municipal Health Commission under Grant 2019LJ21 and SHSLCZDZK 03502, and the Scientific Research and Development Fund of Zhongshan Hospital of Fudan University under Grant 2022ZSQD07.