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OBJECTIVE: To investigate the effect of high intensity focused ultrasound(HIFU)on pregnancy outcomes inpatients with uterine fibroids.METHODS:From October 2010 to October 2017,241 patients with uterine fibroids whowere pregnant after HIFU treatment in Suining Central Hospital and Chongqing Haifu Hospital were retrospectivelyanalyzed.The efficacy of HIFU ablation and the patient′s pregnancy outcomes were investigated.RESULTS:Among thesepatients,9 of them were conceived within 2 month after HIFU,24 were conceived between 2 and 4 months after HIFU,33 patients were conceived between 4 and 6 months,and 175 patients were conceived after 6 months of HIFU treatment.The median conception time was 9 months after HIFU(range:1 to 26 months).Among them,152 patients had deliveredbabies successfully,12 patients are still in pregnancy,3 patients had ectopic pregnancy,2 patients had incisionalpregnancy,72 patients had abortions,including 66 cases of induced abortion and 6 cases of spontaneous abortion.Causesof induced abortion included:embryonic development stopping(8 cases),increased vaginal bleeding(5 cases),hypothyroidism(1 case),use of drugs during pregnancy and being fear of fetal malformation(6 cases),and unplannedpregnancy(52 cases).Of the 152 patients who had delivered,147 had 148 full-term deliveries(1 had full-term deliverytwice)and 5 had preterm birth.No uterine rupture occured during pregnancy or childbirth,and the newborn is healthy.Before HIFU treatment,136 of 241 patients had a history of abnormal pregnancy,and only 17 of these patients hadabnormal pregnancy after HIFU treatment.The incidence of spontaneous abortion in patients after HIFU treatment wassignificantly lower than before treatment(P<0.05).CONCLUSION:HIFU is a safe and effective treatment for patients whowish to have children.It can also improve the fertility of patients with a history of abnormal pregnancy,with no additionalobstetric risks.
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Objective: To explore the effect of transcatheter arterial chemoembolization(TACE) combined with high intensity focused ultrasound (HIFU) ablation on patients with middle and advanced liver cancer and to analyze its anti-tumor value. Methods: 126 patients with middle and advanced liver cancer who received palliative treatment were selected in the research. According to the different treatment program, they were divided into TACE groups (66 cases) which patients received TACE and TACE combined with HIFU ablation group (60 cases) which patients received the treatment of TACE combined with HIFU ablation. After 4 weeks of treatment, the therapeutic effect of solid tumor and the change of immune function indicator of the two groups were compared. At the same time, the results of follow-up visit were recorded, and adverse reaction of antineoplaston and survival situation were further compared. Results:After treatment, the immune function both of two groups were enhanced, and the cluster of differentiation (CD)3+, CD4+, and CD4+/ CD8+of TACE combined with HIFU ablation group was significantly higher than that of TACE group (t=6.303, t=6.049, t=2.148, P<0.05). While the clinical benefit rate of TACE combined with HIFU ablation group was significantly higher than that of TACE group (Z=2.975, P<0.05), and the survival rate of 1 year and survival rate of 2 years of TACE combined with HIFU ablation group were significantly higher than that of TACE group (x2=3.99, x2=4.33, P<0.05), respectively. On the other hand, the differences of complications, included skin burn, liver function damage and abdominal discomfort, between the two groups were no significant (x2=2.235, x2=0.847, x2=0.019, P>0.05). Conclusion:The technique of TACE combined with HIFU ablation can enhance immune function and the therapeutic effect of antineoplastic, and its advantages includes obvious effect of antineoplastic and safety of usage. Therefore, its application value should be paid higher attention in oncotherapy of solid tumor as this paper's suggestion.
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Objective: To compare the effects between uterine fibroid ablation of high intensity focused ultrasound (HIFU) and laparoscopic myomectomy for gravidity of postoperative patients. Methods: 120 patients with uterine fibroid were divided into ultrasound ablation group (60 cases) and laparoscopy group (60 cases) as random number table. And the patients of ultrasound ablation group were treated by using HIFU and the patients of laparoscopy group received the treatment of laparoscopic myomectomy. The operative situation, curative effect and post-operative situation of gravidity of the two groups were compared and researched. Results: The effective rate of laparoscopy group was significantly higher than that of ultrasound ablation group (x2=3.56, P<0.05), while operation time, bleeding volume and postoperative recovery time of laparoscopy group were significantly higher than that of ultrasound ablation group, respectively (t=1.560, t=1.975, t=1.896, P<0.05). On the other hand, the postoperative gravidity rate of ultrasound ablation group was significantly higher than that of laparoscopy group (x2=3.65, P<0.05). Conclusion:Although the effective rate of HIFU for ablation of uterine fibroids is lower than that of laparoscopic myomectomy, its recovery time is shorter and its postoperative gravidity rate is higher than that of laparoscopic myomectomy. Therefore, it has popularized worthy in clinical practice.
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Focused ultrasound surgery (FUS) technology has been used for clinical treatment more than 20 years. Since 2011, relying on the "high intensity focused ultrasound tumor therapy training base", focusing ultrasound surgeons on the treatment of uterine fibroids, based on the basic theories and skills provided by interns who have just access to the qualification of licensed physicians, the training courses are set such as engineering technology principles, biological effects and mechanisms, micro and non-invasive concepts and clinical thinking, image recognition ability, operation training, and postoperative complications management etc.. After strict quality training and performance evaluation, the initial training of focused ultrasound surgeons has been completed. Moreover, the training object can consolidate learning effect through continuing education in order to acquire stable skills and skills.
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A lipodistrofia localizada representa uma das principais condições inestéticas responsáveis pela insatisfação de parte da população que tem como preocupação sua autoimagem. No âmbito da Biomedicina Estética, diversos procedimentos que visam à redução da adiposidade localizada são oferecidos e, entre as abordagens não invasivas mais promissoras, destaca-se o ultrassom focalizado de alta intensidade (HIFU) que utiliza altas intensidades de energia para promover a destruição de adipócitos, com consequente redução da espessura do tecido subcutâneo. Diante disso, esse estudo teve como objetivo avaliar e comparar a eficiência da técnica de lipocavitação focalizada na destruição de células adipocitárias por meio de análises histológicas qualitativas e quantitativas de fragmentos de tecido suíno, além de avaliar os danos teciduais e celulares causados após a exposição desses tecidos ao ultrassom focalizado de alta intensidade às estruturas adjacentes. Foram empregados nesse estudo dois equipamentos de marcas distintas, Lipofocus (Bioset) e Liposoon (Tonederm), mas que apresentam a mesma tecnologia HIFU. As análises qualitativas e quantitativas das lâminas histológicas demonstraram que houve uma redução significativa do número de adipócitos em comparação com as amostras-controle, com preservação da integridade de estruturas circunvizinhas. (AU)
Localized lipodystrophy is one of major unaesthetic conditions responsible for the dissatisfaction of the population whose concern their self-image. Within the Aesthetic Biomedicine, several procedures aimed at reducing localized adiposity are offered and among non-invasive approaches more promising, the High Intensity Focused Ultrasound (HIFU) stands out using high intensities of energy to promote the destruction of adipocytes, with a resulting reduction in the thickness of the subcutaneous tissue. Therefore, this study aimed to evaluate and compare the efficiency of focused high frequency technique in destroying adipocytes through qualitative and quantitative histological analyzes of pig tissue fragments, in addition to evaluate the tissue and cellular damage caused after exposure of these tissues of high intensity focused ultrasound to adjacent structures. Were used in this study two different brands of equipment, Lipofocus (Bioset) and Liposoon (Tonederm), whih use the same technology HIFU. The qualitative and quantitative analysis of histological sections showed that there was a significant reduction in adipocytes number compared to control samples, preserving the integrity of surrounding structures.(AU)
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Animals , Lipodystrophy , Ultrasonics , BeautyABSTRACT
Objective To observe the clinical effect of high intensity focused ultrasound (HIFU ) in treating spontaneous hy-poglycemic insulinoma .Methods Ten patients with typical repeated spontaneous hypoglycemic insulinoma without predisposing causes were treated by HIFU .The changes of insulin and blood sugar were observed after treatment .Results HIFU could non-in-vasively and directly ablate insulinoma .The insulin level and fasting blood glucose level recovered to the normal levels at postopera-tive 1 week and significantly improved compared with before operation (P<0 .05) .Conclusion HIFU is a non-invasive ,safe and ef-fective method for treating insulinoma .
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Objective To investigate the safety and efficacy of stent insertion combined with high-intensity focused ultrasound(HIFU) ablation for malignant obstructive jaundice caused by pancreatic carcinoma.Methods From January 2013 to February 2017,a total of 80 patients with malignant obstructive jaundice caused by pancreatic carcinoma underwent biliary stent insertion in our center,who were divided into combined treatment(stent insertion with HIFU ablation) group(n=38) and solitary stent insertion group(n=42).The stent patency time and survival time were compared between the two groups.Results Relief of jaundice were archived in all patients in both groups.Cholangitis was observed in 7 cases in both two groups.Reobstruction of stent was observed in 15 patients in both two groups.The median stent patency time was 179 days in combined treatment group and 119 days in solitary stent insertion group(P<0.01);the median survival time was 209 days in combined treatment group and 145 days in solitary stent insertion group,the differences were significant(P<0.01).Based on the univariate and multivariate Cox regression analyses,the predictors of prolonging survival included subsequent HIFU ablation after stent insertion and earlier tumor stage(P<0.05).Conclusion Combined biliary stent insertion and HIFU ablation is a safe and effective method for malignant obstructive jaundice caused by pancreatic carcinoma,and seems to extend stent patency time and survival when compared with biliary stent only.
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Background & objectives: Uterine leiomyomas (fibroids) are common cause of morbidity in women of reproductive age group. High intensity focused ultrasound with the imaging guidance of magnetic resonance imaging (MRI) known as magnetic resonance guided focused ultrasound sonication (MRgFUS) is now available. However, there are no available studies with this non invasive modality of treatment in Indian subjects. The objective of this study was to determine the safety and clinical efficacy of MRgFUS in the treatment of uterine fibroids. Methods: This prospective study included 32 consecutive women with clinically symptomatic uterine fibroids who were treated with MRgFUS from February 2011 to October 2011. Pre and post treatment symptom severity scores (SSS) were assessed at the time of enrolment and at one, three and six months follow up using a validated uterine fibroid symptom - quality of life questionnaire (UFS-QOL). Pre and post treatment fibroid volumes were compared immediately after treatment and at six months follow up using contrast enhanced MRI scan. Non perfused volume (NPV) ratios were calculated and correlated with fibroid volume reductions immediately after the treatment and at the end of six months follow up. Results: This procedure was well tolerated by the patients and procedure related adverse effects were non significant. Significant reductions in SSS were seen at one, three and six month intervals after the treatment (P<0.01). Significant reductions were noticed in fibroid volumes at six months follow up compared to pretreatment fibroid volumes (P<0.01). Significant positive correlations were observed between NPV ratios and reduction in fibroid volumes at six months follow-up (r=0.659, P<0.01). Interpretation & conclusions: MRgFUS is relatively a safe and effective non invasive treatment modality for treating uterine fibroids in selected patients. Its long term efficacy is yet to be tested and compared with other available minimally invasive treatment options.
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Objective The aim of this study is to establish a practical VX2 tumour model less than or equal to 10 mm from large blood vessel(as standard) for HIFU ablation .Methods 15 New Zealand rabbits were involved ,VX2 tumour blocks were inoculated near postcava through spine path ,and tumour rate was observed two weeks later by anatomy and MRI .Results Three experimental rabbits did not survive ,all the rest of the 12 into the tumour ,assembly tumour rate was 100% (12/12);The tumour rate reaching the standard accounted for 75% (9/12) ,the average distance between the tumour and the inferior vena cava was (5 .6 ± 3 .4)mm . Conclusion It is feasible to establish the VX2 tumor model less than or equal to 10 mm from large blood vessel through spine path .
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Objective To evaluate the feasibility of high intensity focused ultrasound (HIFU) associated microbubble-enhancing contrast (“SonoVue”) therapeutic ablation of uterine fibroids in patients with pelvic operation history. Methods A total of 100 patients with uterine fibroid from October 2010 to December 2012 in Suining Central Hospital of Sichuan were treated with HIFU associated SonoVue. Among them, 50 patients had pelvic operation history. The no-perfused volume, median fractional ablation, ablation power rate, ablation dose, treatment time and adverse reaction were recorded. Results There was no statistical significance between patients with operation history and without in no-perfused volume and ablation does. The ablation power was lower in patients with operation than without. The treatment time and room time were longer in patients with operation than without. The adverse reactions were higher in patients with operation than without, especially skin pain and lower abdominal pain ( <0.05) . According to short- and long-term follow-up results, no major complications were observed in any patients. Conclusion Pelvic operation history increases the difficulty in treatment of HIFU ablation uterine fibroids. HIFU associated contrast agent SonoVue ablation can be considered a safe and feasible approach to the management of uterine fibroids in patients with pelvic operation history after grasping the indications and contraindications.
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Propósito: Presentar el ultrasonido focalizado de alta intensidad ( HIFU) como alternativa en el tratamiento del cáncer prostático localizado conceptos físicos y terapéuticos, proyecciones futuras y exponer los resultados del Centro Piloto del Hospital Edouard Herroit Lyon-Francia. Material y Métodos: Ochocientos setenta y dos pacientes portadores de cáncer prostático clínicamente localizado, con antígeno prostático máximo 30ng/ml, fueron tratados en primera intención con terapia HIFU ( Abletherm EDAP-Lyon).El seguimiento incluía controles de PSA y biopsias prostáticas efectuadas a los 3 meses postratamiento y fueron repetidas en casos de elevación del PSA. La falla terapéutica HIFU, fue detectada con biopsias prostáticas positivas o PSA>nadir+2ng/ml (criterio ASTRO-Phoenix), o en los casos clínicos que requirieron tratamiento adyuvante con hormonoterapia y/o radioterapia. Resultados: Este estudio incluyó pacientes con seguimiento promedio de 45 meses (12-148 meses, mediana de 40 meses).Setenta y siete por ciento de los pacientes presentó biopsias negativas en el seguimiento post- HIFU.Posterapia HIFU,la mediana del nadir alcanzado fue de 01 ng/ml.La sobrevida global fue de 98 por ciento en le seguimiento a largo plazo. Los mejores resultados oncológicos fueron obtenidos con pacientes portadores de cáncer prostático de riesgo bajo y medio (clasificación d´Amico).Las complicaciones posoperatorias como incontinencia y estenosis del cuello vesical disminuyeron al estandarizar el procedimiento y efectuar una resección transuretral prostática (RTU-P),conjuntamente con la terapia HIFU en el mismo tiempo quirúrgico. Conclusión: Los resultados a largo plazo con la terapia HIFU en cáncer de próstata localizado, permiten un control adecuado de la enfermedad, con baja morbimortalidad.
Purpose: To present the procedure high-intensity focused ultrasound (HIFU) as an alternative in the treatment of localized prostate cancer and therapeutic physical concepts, future projections and expose the results of the Pilot Center Edouard Herriot Hospital Ce Lyon France Methods: 872 patients with clinically localized prostate cancer with PSA 30 ng/ml most were treated as primary therapy with HIFU (Abletherm EDAP-Lyon). The follow up monitoring of PSA and prostate biopsies performed at 3 months post treatment (repeated in cases of PSA elevation).Treatment failure was detected with positive prostate biopsies or PSA> nadir +2 ng / ml (ASTRO-Phoenix definition) or in cases requiring adjuvant hormonal therapy or radiotherapy Result: This study included patients with follow-up average of 45 months (12-148 months, median 40 months).67 percent of patients present negative biopsies at follow-up post-HIFU. Post therapy, the median nadir was reached 01 ng / ml. Overall survival was 86 percent, with disease free survival rate of 98 percent in long term follow up. The best oncological results were obtained in patients with low and intermediate risk (d'Amico classification).Post operative complications as incontinence and bladder neck stenosis declined when the procedure was transurethral resection of prostate (HIFU therapy),. Conclusion: HIFU therapy in localized prostate cancer, offered hight disease control in long term follow up, with low morbidity and mortality.
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Humans , Male , Prostatic Neoplasms , Ultrasonic Therapy/methodsABSTRACT
Presentamos un caso en el que se revela la importancia que puede tener la utilización de la tecnología PET-FDG en el control del tratamiento del carcinoma pancreático con metástasis hepáticas mediante el HIFU (ultrasonidos enfocados de alta intensidad). Esta novedosa técnica de tratamiento será de gran ayuda a otras técnicas terapéuticas existentes en dicho tipo de patologías. A pesar de ello, nuevos estudios tanto de los resultados de esta técnica como de la utilidad del PET en el seguimiento de sus resultados serán necesarios para tener una mayor fidelidad de los mismos.
In our text we show a case that reveal the importance of FDG-PET technology in the treatment control of pancreatic carcinoma with hepatic metastases by means of HIFU (High Intensity Focused Ultrasound). This novelty treatment technique will be an important aid to another treatments in being in this kind of pathologies. In spite of this fact, newer studies are needed to check the results of HIFU and the utility of PET in the continuation of HIFU results will be necessary in order to obtain a bigger fidelity in these ones.
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Humans , Female , Middle Aged , Carcinoma , Carcinoma/therapy , Liver Neoplasms , Liver Neoplasms/therapy , Pancreatic Neoplasms , Pancreatic Neoplasms/therapy , Ultrasonic Therapy , Carcinoma/pathology , Carcinoma , Liver Neoplasms/secondary , Liver Neoplasms , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms , Radiopharmaceuticals , Positron-Emission TomographyABSTRACT
High-intensity focused ultrasound therapy is a novel, emerging, therapeutic modality that uses ultrasound waves, propagated through tissue media, as carriers of energy. This completely non-invasive technology has great potential for tumor ablation as well as hemostasis, thrombolysis and targeted drug/gene delivery. However, the application of this technology still has many drawbacks. It is expected that current obstacles to implementation will be resolved in the near future. In this review, we provide an overview of high-intensity focused ultrasound therapy from the basic physics to recent clinical studies with an interventional radiologist's perspective for the purpose of improving the general understanding of this cutting-edge technology as well as speculating on future developments.
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Humans , Drug Delivery Systems , Gene Targeting , Hemostatic Techniques , Thrombolytic Therapy/methods , Ultrasonic Therapy/methodsABSTRACT
0.05). Conclusion:The treatment system of MR Imaging guided HIFU is feasible and effective.
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To investigate the safety, feasibility and effectiveness of transrectal high-intensity focused ultrasound (HIFU) in the ablation of canine prostate, 20 dogs were divided randomly into 5 groups.Sixteen canine prostates were treated with the third-generation transrectal HIFU device (Sonablate-500 TM). Transrectal ultrasound images of the prostate and prostatic urethra were observed preoperatively and postoperatively. Serial study was performed 30 min, 30 days, 60 days and 180 days after the therapy. The rectum, periprostatic tissues, and prostate were excised en bloc and the tissues were fixed for gross and histological analysis. Our results showed that the average maximal diameter of prostatic urethra was 0.59±0.11 cm before the operation and 2.57±0.98 cm 60 days after the operation. The volume of prostate was 6.5±3.12 cm3 before the treatment while the volume was 4.13±0.23 cm3 60 days after the treatment and the differences were statistically significant (P＜0.05).Histologically, there was a clear demarcation between the necrotic area of the treated tissues and the unaffected surrounding tissues. All the necrotic tissues in the targeted zone broke off and the prostatic urethra became cavitary 60 days later. The more frequent complications were urinary retention and frequency and hematuria. No rectal injury occurred during the treatment. It is concluded that the third-generation transrectal HIFU is capable of destroying prostatic tissue, substantially increasing the width of the prostatic urethra without causing injury to the adjacent tissues. The risk of postoperative complications associated with HIFU was low. HIFU may become a safe, effective and minimally invasive alternative for the treatment of prostatic diseases..
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To evaluate the safety and efficacy of transrectal high-intensity focused ultrasound (HIFU) in the treatment of benign prostatic hyperplasia (BPH), serial studies were conducted in 150 BPH pa- tients before and 30 min, 1, 2, 6 and 12 month(s) after Sonablate-500TM HIFU treatment. A sili- con-coated indwelling 16F latex catheter was placed during the determination of the therapy zone. Preoperative and postoperative evaluations were made by using the international prostate symptom score (IPSS), quality of life (QOL), uroflowmetric findings and transrectal ultrasound, and incidence of complications. The cystourethrography was done in 23 patients within 1 year postoperatively. The results showed that after HIFU treatment, IPSS and QOL scores were significantly decreased at 1, 2, 6 and 12 month(s) (P<0.01). Maximum urine flow rate (6.0 to 17.2 mL/s, P<0.01), PVR (75.0 to 30.3,P<0.01) and prostatic volume (65.0 to 38.1 mL, P<0.05) were significantly improved 12 months after the operation. Recurrent urinary retention (n=2) and urethrorectal fistula (n=1) occurred at the 15th postoperative day. The duration of the HIFU prostate ablation was 25-90 rain. The mean time for an indwelling catheter was 3-19 days. These data demonstrate that treatment of BPH with Sonab- late-500TM HIFU is safe and effective.
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Objective To observe the effectiveness of high-intensity focused ultrasound(HIFU)in the treatment of lichen sclerosus of vulva.Methods 63 patients with lichen sclerosus of vulva between July 2005 to December 2005 were divided into two groups at random,ultrasound group and control group.Patients in ultrasound group were treated with HIFU.Those in control group were treated with hormone.Results The scores of itch had difference after treatment in both group(P
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Objective To evaluate the recent curative efficacy and security of High Intersity Focused Ultrasound(HIFU)in treating patients with advanced pancretic carcinoma.Methods 17patients with cancer of pancreas were treated by FEP-BY02,received 135(average 8)times.Results The overall response rate was 70%(CR+PR),including11.76%(2/17)complete response(CR)and 58.82%(10/17)partial response(PR).The clinical benefit response(CBR)was 82.36%.The inefficiency was 17.64%(3/17).The cancer pain was relieved in 80% patients(8/10).Nocomplications occurred.such as pancreatic juice leakage,bleeding,perforation of gastrointestinal tracts,scalding of skin in the group.Conclusions The preliminary results show that HIFU has a high efficacy and quite safety for advanced pancreatic carcinoma,it is worthy of futher clinical trail.
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Objective:To explore,on the basis of principles of bibliometrics,the distribution of the writers,institutions,regions and journals of the publications on HIFU and the literature amount,and to learn the situation of cross discipline study on HIFU and of the different regions where the articles on HIFU came in order to make a clear view of the characteristics and the status of co-operations in HIFU work and to determine,among them,the key authors,key institutes and key regions so that the progress of HIFU study was turned out.Method:Based on the information drawn from VIP-database,bibliometric method was used to analyze all the data on HIFU before the year of 2007.Result:833 articles were published before the year of 2007,in which 686(72.87%) were written by more than one authors,with a degree of collaboration as 2.78.The number of articles by mono-author was 312(37.45%).186 articles(22.33%) were from Chongqing,taking the first place in number.134 of the key authors published 410 papers(49.22%).10 of the institutes with more than 9 articles turned out 249 papers(29.89%).2000 saw an obvious change in the situation of publications on HIFU and the collaboration among the authors and from that year to 2006,792 papers were published with a degree of collaboration as 3.72 and the average rate of co-authership as 81.12%.Conclusion:The authors on HIFU,with a group as their key authors who were advanced in academy,productive in papers and influential on various journals in medical field,were widely distributed and had a high cooperative rate.But it was also revealed that the researchers in the field of HIFU were unevenly distributed,with the institutions in Chonqing taking the lead.
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As an emerging tumor therapy, high intensity focused ultrasound (HIFU) therapy has difficulty in controlling its dosage due to the complex human tissues. The dosage is related to the tumor such as its depth, size, characteristics and the tissue performances of its growth site. The existing cases are applied to establishing a repository with the above-mentioned parameters of the tumor analyzed. Then reasoning and self-learning are performed. So, the therapeutic dosage can be provided to the clinician when a new case occurs.