Using microbubble sonographic contrast agent to enhance the effect of high intensity focused ultrasound for the treatment of uterine fibroids

• Published in: Ultrasonics sonochemistry 2015-11, Vol.27, p.688-693
• Main Authors: Isern, J., Pessarrodona, A., Rodriguez, J., Vallejo, E., Gimenez, N., Cassadó, J., De Marco, J.A., Pedrerol, A.
• Format: Article
• Language: English
• Subjects: Adult; Contrast Media - therapeutic use; Female; HIFU; High-Intensity Focused Ultrasound Ablation - adverse effects; High-Intensity Focused Ultrasound Ablation - methods; Humans; Leiomyoma - surgery; Microbubbles; Middle Aged; Retrospective Studies; SonoVue; T2MRI signal; Treatment Outcome; Uterine fibroid
• ISSN: 1350-4177; 1873-2828
• DOI: 10.1016/j.ultsonch.2015.05.027

•Assessing the therapeutic effects of SonoVue on HIFU for different sub-types of uterine fibroids.•A retrospective study included 319 patients and 390 fibroids.•The therapeutic effects of SonoVue were evaluated via MRI.•The use of SonoVue during HIFU significantly decreased the ablation time and the energy requirement.•The addition of SonoVue to HIFU was safe. To evaluate the effects of the ultrasound contrast agent SonoVue in enhancing the ablative effects of Ultrasound-Guided high-intensity focused ultrasound (HIFU) on different sub-types of uterine fibroids. In this study, 390 fibroids from 319 patients were retrospectively evaluated, among which 155 were treated with SonoVue and 235 were without SonoVue during HIFU ablation. The efficacy of HIFU was evaluated using magnetic resonance scanning (MRI) in all patients. The total ablation time to achieve the same non-perfused volume was significantly shortened with SonoVue. The average energy used and the acoustic energy for treating 1mm3 (EEF) was less when SonoVue is used as enhancing agent. The non-perfused volume (NPV) was measured by post-HIFU MRI and the mean fractional ablation was calculated. Mean NPV was 74% (range: 15%–100%) in the HIFU-only group and 75% (range: 17%–100%) in the HIFU+ SonoVue group. However, for T2 MRI low intensity signal fibroids, NPV in the SonoVue group reached 83% (range: 20%–100%) that was significantly higher than in the HIFU-only group, which was 76% (range: 15%–100%). No differences in adverse events were observed between the two groups. Our observations demonstrate that the use of therapeutic SonoVue during the HIFU procedure can significantly decrease the ablation time and the energy requirement for the treatment of the same fibroid volume in all types of fibroids.