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CardioVascular and Interventional Radiology

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01-10-2014 | Clinical Investigation

Enhancing Ablation Effects of a Microbubble-Enhancing Contrast Agent (“SonoVue”) in the Treatment of Uterine Fibroids With High-Intensity Focused Ultrasound: A Randomized Controlled Trial

Authors: Nan Jiang, Bin Xie, Xin Zhang, Min He, Kequan Li, Jin Bai, Zhibiao Wang, Jia He, Lian Zhang

Published in: CardioVascular and Interventional Radiology | Issue 5/2014

Abstract

Purpose

To evaluate the role of the ultrasound contrast agent SonoVue in enhancing the ablation effects of ultrasound-guided high-intensity focused ultrasound (HIFU) on uterine fibroids.

Methods

Eighty patients with solitary uterine fibroids at a single center were randomly assigned to a control or SonoVue group. Of these, 40 were treated using HIFU alone; 40 who were pretreated with SonoVue received a bolus before the HIFU procedure. All patients underwent magnetic resonance imaging (MRI) scan before and after HIFU treatment.

Results

The post-HIFU MRI showed the nonperfused volume (NPV) in all of the treated uterine fibroids; the mean fractional ablation (NPV ratio) was 90.4 ± 8.3 % (range 66.4–100 %) in the SonoVue group and 82.8 ± 13.3 % (range 53.4–100 %) in the control group. The frequency of massive gray-scale changes that occurred during HIFU was greater in the group that received SonoVue than the group that did not. The average sonication time to reach massive gray-scale changes was significantly shorter in the group receiving SonoVue than the group without SonoVue. The acoustic energy for treating 1 mm³ of uterine fibroid was less in the SonoVue group than the control group. No any major complication occurred in this study.

Conclusion

Based on the results of this randomized controlled trial, SonoVue could be safely used to enhance the effects of HIFU treatment for uterine fibroids.

Wang W, Liu WY, Zhou JM et al (2002) High-intensity focused ultrasound treatment for symptomatic uterine fibroids: preliminary results. Chin J Ultrasonogr 11:161–163

Zhang L, Chen WZ, Liu YJ et al (2010) Feasibility of magnetic resonance imaging-guided high intensity focused ultrasound therapy for ablating uterine fibroids in patients with bowel lies anterior to uterus. Eur J Radiol 73:396–403PubMedCrossRef

Tempany CM, Stewart EA, McDannold N et al (2003) MR imaging-guided focused ultrasound surgery of uterine leiomyomas: a feasibility study. Radiology 226:897–905PubMedCrossRef

Orsi F, Zhang L, Arnone P et al (2010) High-intensity focused ultrasound ablation: effective and safe therapy for solid tumors in difficult locations. Am J Roentgenol 195:W245–W252CrossRef

Hesley GK, Gorny KR, Woodrum DA (2013) MR-guided focused ultrasound for the treatment of uterine fibroids. Cardiovasc Intervent Radiol 36(1):5–13PubMedCrossRef

Stewart EA, Gostout B, Rabinovici J et al (2007) Sustained relief of leiomyoma symptoms by using focused ultrasound surgery. Obstet Gynecol 110:279–287PubMedCrossRef

LeBlang SD, Hoctor K, Steinberg FL (2010) Leiomyoma shrinkage after MRI-guided focused ultrasound treatment: report of 80 patients. Am J Roentgenol 194:274–280CrossRef

Froeling V, Meckelburg K, Scheurig-Muenkler C et al (2013) Midterm results after uterine artery embolization versus MR-guided high-intensity focused ultrasound treatment for symptomatic uterine fibroids. Cardiovasc Intervent Radiol 36(6):1508–1513PubMedCrossRef

Funaki K, Fukunish H, Sawada K (2009) Clinical outcomes of magnetic resonance-guided focused ultrasound surgery for uterine myomas: 24-month follow-up. Ultrasound Obstet Gynecol 34:584–589PubMedCrossRef

10.

Zhao WP, Chen JY, Zhang L et al (2013) Feasibility of ultrasound guided high intensity focused ultrasound ablating uterine fibroids with hyperintense on T2-weighted MR imaging. Eur J Radiol 82(1):e43–e49PubMedCrossRef

11.

Solbiati L, Tonolini M, Cova L et al (2001) The role of contrast-enhanced ultrasound in the detection of focal liver lesions. Eur Radiol 11(Suppl 3):E15–E26PubMedCrossRef

12.

Wen YL, Kudo M, Zheng RQ et al (2003) Radiofrequency ablation of hepatocellular carcinoma: therapeutic response using contrast-enhanced coded phase-inversion harmonic sonography. Am J Roentgenol 181:57–63CrossRef

13.

Kennedy JE, ter Haar GR, Wu F et al (2004) Contrast-enhanced ultrasound assessment of tissue response to high-intensity focused ultrasound. Ultrasound Med Biol 30:851–854PubMedCrossRef

14.

Peng S, Xiong Y, Li K et al (2012) Clinical utility of a microbubble-enhancing contrast (“SonoVue”) in treatment of uterine fibroids with high intensity focused ultrasound: a retrospective study. Eur J Radiol 81(12):3832–3838PubMedCrossRef

15.

Kaneko Y, Maruyama T, Takegami K et al (2005) Use of a microbubble agent to increase the effects of high intensity focused ultrasound on liver tissue. Eur Radiol 15:1415–1420PubMedCrossRef

16.

Chung DJ, Cho SH, Lee JM et al (2012) Effect of microbubble contrast agent during high intensity focused ultrasound ablation on rabbit liver in vivo. Eur J Radiol 81(4):e519–e523PubMedCrossRef

17.

Luo W, Zhou X, Ren X et al (2007) Enhancing effects of SonoVue, a microbubble sonographic contrast agent, on high-intensity focused ultrasound ablation in rabbit livers in vivo. J Ultrasound Med 26(4):469–476PubMed

18.

Luo W, Zhou X, He G et al (2008) Ablation of high intensity focused ultrasound combined with SonoVue on rabbit VX2 liver tumors: assessment with conventional gray-scale ultrasound, conventional color/power Doppler ultrasound, contrast-enhanced color Doppler ultrasound, and contrast-enhanced pulse-inversion harmonic ultrasound. Ann Surg Oncol 15(10):2943–2953PubMedCrossRef

19.

Farny CH, Glynn Holt R, Roy RA (2010) The correlation between bubble-enhanced HIFU heating and cavitation power. IEEE Trans Biomed Eng 57:175–184PubMedCrossRef

20.

Takegami K, Kaneko Y, Watanabe T et al (2005) Erythrocytes, as well as microbubble contrast agents, are important factors in improving thermal and therapeutic effects of high-intensity focused ultrasound. Ultrasound Med Biol 31:385–390PubMedCrossRef

21.

Kajiyama K, Yoshinaka K, Takagi S et al (2010) Micro-bubble enhanced HIFU. Phys Procedia 3:305–314CrossRef

22.

Van Camp G, Droogmans S, Cosyns B (2007) Bio-effects of contrast ultrasound agents in daily clinical practice: fact or fiction? Eur Heart J 28:1190–1192PubMedCrossRef

Title: Enhancing Ablation Effects of a Microbubble-Enhancing Contrast Agent (“SonoVue”) in the Treatment of Uterine Fibroids With High-Intensity Focused Ultrasound: A Randomized Controlled Trial
Authors: Nan Jiang
Bin Xie
Xin Zhang
Min He
Kequan Li
Jin Bai
Zhibiao Wang
Jia He
Lian Zhang
Publication date: 01-10-2014
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 5/2014
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-013-0803-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Enhancing Ablation Effects of a Microbubble-Enhancing Contrast Agent (“SonoVue”) in the Treatment of Uterine Fibroids With High-Intensity Focused Ultrasound: A Randomized Controlled Trial

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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