Safety and efficacy of US-guided high-intensity focused ultrasound for treatment of submucosal fibroids

To evaluate the safety and efficacy of US-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of submucosal fibroids A total of 76 women with 78 submucosal uterine fibroids (68 type II fibroids, 10 type I fibroids) underwent US-guided HIFU ablation. The pretreatment fibroid diameter ranged from 2.4 to 13.5 cm (mean 5.7 +/- 2.3 cm). The fibroids were ablated using a power output of 420-520 W. During follow-up, the volume shrinkage of the ablated fibroids was continuously observed on contrast-enhanced MR and/or contrast-enhanced ultrasound (CEUS). The change of symptoms was evaluated by using the symptom severity score questionnaire. HIFU ablation was well tolerated in all patients. No major complications occurred. The mean nonperfused ablation ratio was 80 +/- 12 % on CEUS. During follow-up, the ablated fibroids shrank significantly over time. The symptoms were alleviated significantly. No patients had amenorrhoea after treatment. Vaginal expulsion of necrotic tissue was seen in 58 % (44/76) of patients after HIFU ablation which disappeared after 2-4 menstrual cycles. Four patients received repeated HIFU ablation for enlarged residual fibroids. US-guided HIFU ablation may be a safe and effective treatment for submucosal fibroids. Further studies are warranted to observe its influence on fertility. aEuro cent High-intensity focused ultrasound (HIFU) is a new minimally invasive therapeutic technique. aEuro cent HIFU ablation may be safe and effective for treatment of submucosal fibroids aEuro cent Treatment is minimally invasive and repeatable. aEuro cent Vaginal expulsion of necrotic tissue is common after treatment.