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Factors influencing the dosimetry for high-intensity focused ultrasound ablation of uterine fibroids: a retrospective study.

Peng S, Zhang L, Hu L, Chen J, Ju J, Wang X, Zhang R, Wang Z, Chen W - Medicine (Baltimore) (2015)

Bottom Line: The aim of this article is to analyze factors affecting sonication dose and build a dosimetry model of high-intensity focused ultrasound (HIFU) ablation for uterine fibroids.The energy efficiency factor (EEF) was set as dependent variable, and the factors possibly affecting sonication dose included age, body mass index, size of uterine fibroid, abdominal wall thickness, the distance from uterine fibroid dorsal side to sacrum, the distance from uterine fibroid ventral side to skin, location of uterus, location of uterine fibroids, type of uterine fibroids, abdominal wall scar, signal intensity on T2-weighted imaging (T2WI), and enhancement type on T1-weighted imaging (T1WI) were set as predictors to build a multiple regression model.The distance from fibroid ventral side to skin, enhancement type on T1WI, size of uterine fibroid, and signal intensity on T2WI were eventually incorporated into the dosimetry model.

View Article: PubMed Central - PubMed

Affiliation: From the State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology (SP, LZ, LH, JC, ZW), Chongqing Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University; HIFU Center for Tumor Therapy (JJ, XW, RZ), 1st Affiliated Hospital of Chongqing Medical University; and Clinical Center for Tumor Therapy (WC), 2nd Affiliated Hospital of Chongqing Medical University, Chongqing, China.

ABSTRACT
The aim of this article is to analyze factors affecting sonication dose and build a dosimetry model of high-intensity focused ultrasound (HIFU) ablation for uterine fibroids. Four hundred and three patients with symptomatic uterine fibroids who underwent HIFU were retrospectively analyzed. The energy efficiency factor (EEF) was set as dependent variable, and the factors possibly affecting sonication dose included age, body mass index, size of uterine fibroid, abdominal wall thickness, the distance from uterine fibroid dorsal side to sacrum, the distance from uterine fibroid ventral side to skin, location of uterus, location of uterine fibroids, type of uterine fibroids, abdominal wall scar, signal intensity on T2-weighted imaging (T2WI), and enhancement type on T1-weighted imaging (T1WI) were set as predictors to build a multiple regression model. The size of uterine fibroid, distance from fibroid ventral side to skin, location of uterus, location of uterine fibroids, type of uterine fibroids, signal intensity on T2WI, and enhancement type on T1WI had a linear correlation with EEF. The distance from fibroid ventral side to skin, enhancement type on T1WI, size of uterine fibroid, and signal intensity on T2WI were eventually incorporated into the dosimetry model. The distance from fibroid ventral side to skin, enhancement type on T1WI, size of uterine fibroid, and signal intensity on T2WI can be used as dosimetric predictors for HIFU for uterine fibroids.

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T2-weighted sagittal magnetic resonance imaging before treatment: (A) hypointense; (B) isointense; (C)–(E) hyperintense, in which (C) is heterogeneous and (D) and (E) are homogeneous; (D) slightly homogeneous hyperintense fibroid; and (E) markedly homogeneous hyperintense fibroid.
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Figure 2: T2-weighted sagittal magnetic resonance imaging before treatment: (A) hypointense; (B) isointense; (C)–(E) hyperintense, in which (C) is heterogeneous and (D) and (E) are homogeneous; (D) slightly homogeneous hyperintense fibroid; and (E) markedly homogeneous hyperintense fibroid.

Mentions: Uterine fibroids were conventionally classified into 3 types according to pretreatment T2-weighted MRI10—hypointense: signal intensity equal to that of skeletal muscle; isointense: signal intensity lower than that of myometrium but higher than that of skeletal muscle; and hyperintense: signal intensity equal to or higher than that of myometrium. The hyperintense fibroids were further classified into 3 groups by Zhao et al8: heterogeneous hyperintense fibroids: fibroids with bar (>5 mm) or lamellar, and with high signal intensity that approximates to that of endometrium, or bar (>5 mm) or lamellar, and with low signal intensity that approximates to that of skeletal muscle; markedly homogenous hyperintense fibroids: fibroids with uniformly distributed high signal intensity that was markedly higher than that of myometrium and approximates or equals to endometrium; and slightly homogenous hyperintense fibroids: fibroids with uniformly distributed high signal intensity equal to or slightly higher than that of myometrium (Fig. 2). Accordingly, uterine fibroids in this study were classified into 5 categories: hypointense, isointense, heterogeneous hyperintense, markedly homogenous hyperintense, and slightly homogenous hyperintense.


Factors influencing the dosimetry for high-intensity focused ultrasound ablation of uterine fibroids: a retrospective study.

Peng S, Zhang L, Hu L, Chen J, Ju J, Wang X, Zhang R, Wang Z, Chen W - Medicine (Baltimore) (2015)

T2-weighted sagittal magnetic resonance imaging before treatment: (A) hypointense; (B) isointense; (C)–(E) hyperintense, in which (C) is heterogeneous and (D) and (E) are homogeneous; (D) slightly homogeneous hyperintense fibroid; and (E) markedly homogeneous hyperintense fibroid.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554030&req=5

Figure 2: T2-weighted sagittal magnetic resonance imaging before treatment: (A) hypointense; (B) isointense; (C)–(E) hyperintense, in which (C) is heterogeneous and (D) and (E) are homogeneous; (D) slightly homogeneous hyperintense fibroid; and (E) markedly homogeneous hyperintense fibroid.
Mentions: Uterine fibroids were conventionally classified into 3 types according to pretreatment T2-weighted MRI10—hypointense: signal intensity equal to that of skeletal muscle; isointense: signal intensity lower than that of myometrium but higher than that of skeletal muscle; and hyperintense: signal intensity equal to or higher than that of myometrium. The hyperintense fibroids were further classified into 3 groups by Zhao et al8: heterogeneous hyperintense fibroids: fibroids with bar (>5 mm) or lamellar, and with high signal intensity that approximates to that of endometrium, or bar (>5 mm) or lamellar, and with low signal intensity that approximates to that of skeletal muscle; markedly homogenous hyperintense fibroids: fibroids with uniformly distributed high signal intensity that was markedly higher than that of myometrium and approximates or equals to endometrium; and slightly homogenous hyperintense fibroids: fibroids with uniformly distributed high signal intensity equal to or slightly higher than that of myometrium (Fig. 2). Accordingly, uterine fibroids in this study were classified into 5 categories: hypointense, isointense, heterogeneous hyperintense, markedly homogenous hyperintense, and slightly homogenous hyperintense.

Bottom Line: The aim of this article is to analyze factors affecting sonication dose and build a dosimetry model of high-intensity focused ultrasound (HIFU) ablation for uterine fibroids.The energy efficiency factor (EEF) was set as dependent variable, and the factors possibly affecting sonication dose included age, body mass index, size of uterine fibroid, abdominal wall thickness, the distance from uterine fibroid dorsal side to sacrum, the distance from uterine fibroid ventral side to skin, location of uterus, location of uterine fibroids, type of uterine fibroids, abdominal wall scar, signal intensity on T2-weighted imaging (T2WI), and enhancement type on T1-weighted imaging (T1WI) were set as predictors to build a multiple regression model.The distance from fibroid ventral side to skin, enhancement type on T1WI, size of uterine fibroid, and signal intensity on T2WI were eventually incorporated into the dosimetry model.

View Article: PubMed Central - PubMed

Affiliation: From the State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology (SP, LZ, LH, JC, ZW), Chongqing Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University; HIFU Center for Tumor Therapy (JJ, XW, RZ), 1st Affiliated Hospital of Chongqing Medical University; and Clinical Center for Tumor Therapy (WC), 2nd Affiliated Hospital of Chongqing Medical University, Chongqing, China.

ABSTRACT
The aim of this article is to analyze factors affecting sonication dose and build a dosimetry model of high-intensity focused ultrasound (HIFU) ablation for uterine fibroids. Four hundred and three patients with symptomatic uterine fibroids who underwent HIFU were retrospectively analyzed. The energy efficiency factor (EEF) was set as dependent variable, and the factors possibly affecting sonication dose included age, body mass index, size of uterine fibroid, abdominal wall thickness, the distance from uterine fibroid dorsal side to sacrum, the distance from uterine fibroid ventral side to skin, location of uterus, location of uterine fibroids, type of uterine fibroids, abdominal wall scar, signal intensity on T2-weighted imaging (T2WI), and enhancement type on T1-weighted imaging (T1WI) were set as predictors to build a multiple regression model. The size of uterine fibroid, distance from fibroid ventral side to skin, location of uterus, location of uterine fibroids, type of uterine fibroids, signal intensity on T2WI, and enhancement type on T1WI had a linear correlation with EEF. The distance from fibroid ventral side to skin, enhancement type on T1WI, size of uterine fibroid, and signal intensity on T2WI were eventually incorporated into the dosimetry model. The distance from fibroid ventral side to skin, enhancement type on T1WI, size of uterine fibroid, and signal intensity on T2WI can be used as dosimetric predictors for HIFU for uterine fibroids.

Show MeSH
Related in: MedlinePlus