LNSLNS

Ultrasound-guided high-intensity focused ultrasound (USgHIFU) is another option for the treatment of uterine fibroids, as pointed out by Professor Strunk. As far as we know, this technology has been adopted by only one center in Germany to date.

The factors determining its suitability for the treatment of fibroids are almost identical with those for MR-guided focused ultrasound surgery (MRgFUS). The success rates and the unincreased abortion rate (1) can also be expected to be identical with those found for MRgFUS. However, visualization of the target tissue during sonication is significantly poorer with ultrasonography (only gray-scale changes) in comparison to MR imaging; as it is difficult to identify critical structures, such as the bowel or sacral nerves, with ultrasound scanners, ablation in close proximity to low energy density regions may be considered unsafe. Furthermore, in contrast to MRI, ultrasonography does not provide accurate temperature mapping; thus the information about the response of the target tissue to treatment is very limited when performing USgHIFU. Consequently, a subsequent MRI is required to document the result of the treatment “in retrospect”.

To date, no studies comparing the two techniques have been conducted. The availability of data from studies on USgHIFU is very limited compared with data on MRgFUS/MRgHIFU. The longest follow-up period after USgHIFU was 12 months (1). It remains to be seen whether this technology will be widely adopted and patients will gain unrestricted access to it.

DOI: 10.3238/arztebl.2015.0328b

Dr. med. Alexander Boosz

Frauenklinik, Städtisches Klinikum Karlsruhe

alex@dr-boosz.de

Prof. Dr. Andreas Müller

Frauenklinik, Städtisches Klinikum Karlsruhe

andreas.mueller.fk@klinikum-karlsruhe.de

Conflict of interest statement

The authors of both contributions declare that no conflict of interest exists.

1.
Qin J, Chen JY, Zhao WP, Hu L, Chen WZ, Wang ZB: Outcome of unintended pregnancy after ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroids. Int J Gynaecol Obstet 2012; 117: 273–7 CrossRef MEDLINE
2.
Boosz AS, Reimer P, Matzko M, Römer T, Müller A: The conservative and interventional treatment of fibroids. Dtsch Arztebl Int 2014; 111: 877–83 VOLLTEXT
1.Qin J, Chen JY, Zhao WP, Hu L, Chen WZ, Wang ZB: Outcome of unintended pregnancy after ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroids. Int J Gynaecol Obstet 2012; 117: 273–7 CrossRef MEDLINE
2.Boosz AS, Reimer P, Matzko M, Römer T, Müller A: The conservative and interventional treatment of fibroids. Dtsch Arztebl Int 2014; 111: 877–83 VOLLTEXT

Info

Specialities