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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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Dynamic contrast-enhanced axial T1-weight magnetic resonance imaging before treatment: A1–A3, B1–B3, and C1–C3 are images acquired at 20, 40, and 60 seconds after contrast injection (from left to right), respectively. (A) Fibroid shows slight enhancement; (B) fibroid shows irregular enhancement; and (C) fibroid shows progressive enhancement.
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Figure 3: Dynamic contrast-enhanced axial T1-weight magnetic resonance imaging before treatment: A1–A3, B1–B3, and C1–C3 are images acquired at 20, 40, and 60 seconds after contrast injection (from left to right), respectively. (A) Fibroid shows slight enhancement; (B) fibroid shows irregular enhancement; and (C) fibroid shows progressive enhancement.

Mentions: The arterial vessels within tumors appeared 10 to 30 seconds after intravenous injection of gadolinium, immediately following the perfusion of myometrial vessels, and disappeared 60 seconds after injection.11 So, according to the degree of enhancement of uterine fibroids compared to myometrium within 60 seconds after gadolinium injection, the enhanced TIWI were divided into light enhancement, irregular enhancement, and progressive enhancement. The classification was detailed as follows: slight enhancement: the enhancement degree of uterine fibroid was lower than that of myometrium, either homogeneous or heterogeneous; progressive enhancement: the distribution of signal enhancement was homogeneous, the signal enhancement degree equal to or higher than that of the myometrium of uterus; and irregular enhancement: distribution of signal enhancement was heterogeneous, with alternate distribution of enhanced signal or slightly enhanced signal or spotted and lamellar nonenhanced signal. (Fig. 3)


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)

Dynamic contrast-enhanced axial T1-weight magnetic resonance imaging before treatment: A1–A3, B1–B3, and C1–C3 are images acquired at 20, 40, and 60 seconds after contrast injection (from left to right), respectively. (A) Fibroid shows slight enhancement; (B) fibroid shows irregular enhancement; and (C) fibroid shows progressive enhancement.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Dynamic contrast-enhanced axial T1-weight magnetic resonance imaging before treatment: A1–A3, B1–B3, and C1–C3 are images acquired at 20, 40, and 60 seconds after contrast injection (from left to right), respectively. (A) Fibroid shows slight enhancement; (B) fibroid shows irregular enhancement; and (C) fibroid shows progressive enhancement.
Mentions: The arterial vessels within tumors appeared 10 to 30 seconds after intravenous injection of gadolinium, immediately following the perfusion of myometrial vessels, and disappeared 60 seconds after injection.11 So, according to the degree of enhancement of uterine fibroids compared to myometrium within 60 seconds after gadolinium injection, the enhanced TIWI were divided into light enhancement, irregular enhancement, and progressive enhancement. The classification was detailed as follows: slight enhancement: the enhancement degree of uterine fibroid was lower than that of myometrium, either homogeneous or heterogeneous; progressive enhancement: the distribution of signal enhancement was homogeneous, the signal enhancement degree equal to or higher than that of the myometrium of uterus; and irregular enhancement: distribution of signal enhancement was heterogeneous, with alternate distribution of enhanced signal or slightly enhanced signal or spotted and lamellar nonenhanced signal. (Fig. 3)

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