MR-guided focused ultrasound for the treatment of adenomyosis: current insights

Figures & data

Table 1 Summary of studies

Authors	Year	Type of study	Guidance modality	Number of cases	Main outcome(s)	Mean % reduction in uterine volume	Mean NPVR	Mean % reduction in symptom severity (calculated from study results where necessary for comparison)	Clinical relief rate (percentage of patients with some degree of symptom relief) (%) Menorrhagia/Dysmenorrhea
Lee et al^Citation41	2015	Retrospective analysis	US	346	Sustained radiological and symptom reduction effect at 12 months	53.98	NR	57.98 (85.07 increase in QOL)	NR
Shui et al^Citation35	2015	Retrospective analysis	US	224	2-year follow-up - sustained clinical improvement in large majority of cases	NR - imaging on day 1 only	72.7	NR	78.9/82.3 Complete relief: 62.4/21.7
Zhang et al^Citation42	2014	RCT - oxytocin vs saline infusion during HIFU	us	86	Oxytocin could decrease energy requirement and enhance treatment efficiency No significant difference in symptom relief	NR	80.7/70.8 (oxytocin/no oxytocin)	NR	Oxytocin 60/68 No oxytocin 59/60
Zhang et al^Citation33	2014	Retrospective analysis	us	202	Up to 18 months follow-up. Comparison of focal vs diffuse adenomyosis. Significant reduction in menorrhagia/dysmenorrhea. Higher rate of complete relief of dysmenorrhea in focal group at 3 months. No other difference	NR	71.6	NR	Dysmenorrhea 79.8 Complete relief of dysmenorrhea 46.6%
Polina et al^Citation52	2012	Case report	MR	2	Focal adenomyosis good symptomatic relief at 3 and 6 months	N/A	N/A	N/A	N/A
Fan et al^Citation36	201 1	Prospective study	MR	10	MRgFUS is feasible and safe, and effective; 12-month follow-up	24	62.5	25	NR
Zhou et al^Citation35	201 1	Prospective clinical trial	US	78	Some clinical effect in 89% of cases. One successful pregnancy No serious complications 18- to 36-month follow-up	NR	NR (68% had ≥50% NPVR)	NR	At 3 months: Dysmenorrhea 89.9 Complete relief of dysmenorrhea 39.1
Kim et al^Citation38	201 1		MR	35	6-month follow-up. Reduction in pain and symptoms. One successful pregnancy	NR	NR	41	89 (combined symptom relief)
Wang et al^Citation40	2009	Prospective study	US	12	Higher ultrasound intensity produced a larger nonperfused volume and greater symptom relief	NR	NR	NR	Dysmenorrhea 25–83 (4 power categories)
Fukunishi et al^Citation37	2008	Prospective study	MR	20	12.7% reduction in uterine volume and symptom improvement at 6 months (SSS 48.4–26.7). No significant complications	12.7	NR	45	NR
Rabinovici^Citation46	2006	Case report	MR		Successful pregnancy after MRgFUS of adenomyosis	N/A	N/A	N/A	N/A

Abbreviations: HIFU, high-intensity focused ultrasound; MR, magnetic resonance; MRgFUS, Magnetic resonance-guided focused ultrasound; NPVR, nonperfused volume ratio; NR, not reported; QOL, Quality of Life Score; RCT, randomized controlled trial; SSS, Symptom Severity Score; US, ultrasound; N/A, not applicable.

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