Intrarectal Foley catheter-assisted high-intensity focused ultrasound ablation for benign uterine diseases beyond the treatment region

• Published in: International journal of hyperthermia 2023-12, Vol.40 (1), p.2219435-2219435
• Main Authors: Liu, Wei, Kim, Tae-Hee, Huang, Lihui, Chen, Xing, Feng, Chunping, Liu, Ling, Zhang, Li, Zhang, Wen, Zhou, Kun, Gan, Xiuni
• Format: Article
• Language: English
• Subjects: Benign uterine disease; Catheters; feasibility analysis; Female; high-intensity focused ultrasound; High-Intensity Focused Ultrasound Ablation; Humans; intrarectal Foley catheter; Leiomyoma - surgery; safety; Treatment Outcome; Uterine Diseases - diagnostic imaging; Uterine Diseases - surgery; Uterine Neoplasms - surgery
• ISSN: 0265-6736; 1464-5157
• DOI: 10.1080/02656736.2023.2219435

To evaluate the feasibility of using an intrarectal Foley catheter during ultrasound-guided high-intensity focused ultrasound (US-HIFU) in patients with benign uterine diseases of the posterior wall beyond the HIFU therapeutic range. Patients were treated with US-HIFU and lesion changes were monitored using contrast-enhanced MRI from June 2020 to September 2021. A Foley catheter was inserted into the rectum to facilitate a successful US-HIFU ablation. Complications and lesion responses were recorded during the treatment and follow-up. Thirteen patients with 14 lesions beyond the device's treatable area were enrolled. The average placement time and insertion depth of the intrarectal Foley catheter was 7.6 ± 2.7 min and 23.2 ± 7.6 cm, respectively. A median of 50 mL degassed water was injected into the Foley catheter balloon. All 14 lesions were successfully pushed into a treatable area and subjected to HIFU. The average treatment time, irradiation time, and total therapeutic energy of HIFU were 44.2 ± 17.3 min, 394.4 ± 295.7 s, and 73.3 ± 46.6 kJ, respectively. The mean non-perfusion volume (NPV) in all treated lesions was 23.2 ± 19.2 cm3, and the mean NPV ratio was 57.8 ± 16.9%. Major complications were not observed. Intrarectal Foley catheter-assisted US-HIFU is effective and safe. Its clinical application could benefit patients with benign uterine diseases outside the HIFU therapeutic range.