International Journal of Hyperthermia

Factors associated with thermal injury of abdominal skin in focused ultrasound ablation of uterine fibroids

To investigate the factors which may cause thermal injury of abdominal skin in patients with uterine fibroids (UFs) who underwent ultrasound-guided focused ultrasound ablation surgery (FUAS). A total of 123 patients were enrolled in the injury group. In contrast, 246 patients without thermal injury were assigned to the non-injury group. The relationship between patient and treatment parameters and injury were explored using univariate analysis and multiple logistic regression analyses. In addition, the factors influencing the degree of thermal injury were analyzed using Kruskal-Wallis H. (1) Abdominal scars ( Based on our limited results, the following conclusion was made. (1) Abdominal scars, abdominal wall thickness, fundus fibroids, UFs with T2WI hyperintense/mixed signals, AP and TT were independent risk factor. (2) Neither too thick nor too thin abdominal walls would be recommended, as both might increase the risk of skin injury. (3) Noticeably, the risk of skin injury might increase considerably when the ST was longer and the sonication area was more fixed.

Comparison of reproductive outcomes after ultrasound-guided high-intensity focused ultrasound and myomectomy for patients with uterine fibroids

To compare the reproductive outcomes in patients with uterine fibroids (UFs) after ultrasound-guided high-intensity focused ultrasound (USgHIFU) and myomectomy, and to evaluate reproductive outcomes after re-intervention following initial USgHIFU. In this retrospective study, women who underwent USgHIFU or myomectomy between January 2012 and December 2019 and subsequently conceived were enrolled. Propensity-score matching (PSM) was applied to balance baseline characteristics. After PSM, the Group A (patients underwent single USgHIFU ablation) and Group MY (patients underwent myomectomy) were designated as Group A Reproductive outcomes after USgHIFU were comparable to those after myomectomy. USgHIFU is a viable option for patients with fertility requirements and may also serve as a means to control the progression of UFs in patients without immediate pregnancy plans.

Machine learning models for prediction of NPVR ≥80% with HIFU ablation for uterine fibroids

Currently high-intensity focused ultrasound (HIFU) is widely used to treat uterine fibroids (UFs). The aim of this study is to develop a machine learning model that can accurately predict the efficacy of HIFU ablation for UFs, assisting the preoperative selection of suitable patients with UFs. This study collected data from 1,000 patients with UFs who underwent ultrasound-guided high-intensity focused ultrasound. The least absolute shrinkage and selection operator (LASSO) regression was used for multidimensional feature screening. Five machine learning algorithms such as logistic regression, random forest, extreme gradient boosting (XGBoost), artificial neural network, and gradient boosting decision tree were utilized to predict ablation efficacy. The efficacy was quantified by the non-perfused volume ratio (NPVR), which was classified into two categories: NPVR <80% and NPVR ≥80%. The XGBoost model proved to be the most effective, showing the highest AUC of 0.692 (95% CI: 0.622-0.762) in the testing data set. The four key predictors were T2 weighted image, the distance from ventral side of UFs to skin, platelet count, and contrast-enhanced T1 weighted image. The machine learning prediction model in this study showed significant potential for accurately predicting the preoperative efficacy of HIFU ablation for UFs. These insights were important for clinicians in the preoperative assessment and selection of patients, which could enhance the precision of treatment planning.

Targetability of cervical cancer by magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU)-mediated hyperthermia (HT) for patients receiving radiation therapy

To evaluate the targetability of late-stage cervical cancer by magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU)-induced hyperthermia (HT) as an adjuvant to radiation therapy (RT). Seventy-nine cervical cancer patients (stage IIIB-IVA) who received RT with lesions visible on positron emission tomography-computed tomography (PET-CT) were retrospectively analyzed for targetability using a commercially-available HT-capable MRgHIFU system. Targetability was assessed for both primary targets and/or any metastatic lymph nodes using both posterior (supine) and anterior (prone) patient setups relative to the transducer. Thirty-four different angles of rotation along subjects' longitudinal axis were analyzed. Targetability was categorized as: (1) Targetable with/without minimal intervention; (2) Not targetable. To determine if any factors could be used for prospective screening of patients, potential associations between demographic/anatomical factors and targetability were analyzed. 72.15% primary tumors and 33.96% metastatic lymph nodes were targetable from at least one angle. 49.37% and 39.24% of primary tumors could be targeted with patient laying in supine and prone positions, respectively. 25°-30° rotation and 0° rotation had the highest rate of the posterior and anterior targetability, respectively. The ventral depth of the tumor and its distance to the coccyx were statistically correlated with the anterior and posterior targetability, respectively. Most late-stage cervical cancer primaries were targetable by MRgHIFU HT requiring either no/minimal intervention. A rotation of 0° or 25°-30° relative to the transducer might benefit anterior and posterior targetability, respectively. Certain demographic/anatomic parameters might be useful in screening patients for treatability.

Metabolic characteristic changes in local tissues after high-intensity focused ultrasound treatment for uterine fibroids

To investigate the changes in the metabolome of fibroid tissue after high-intensity focused ultrasound (HIFU) treatment, providing insights into its potential mechanisms of action. Thirty patients with uterine fibroids who scheduled for hysterectomy were included. Among them, 15 patients had HIFU previously (HIFU group), and 15 patients did not receive HIFU (Control group). The tissues of treated fibroid, myometrium, endometrium, and new-emerging fibroids were collected. Gas chromatography-mass spectrometry (GC-MS) was applied for metabolomic analysis. GC-MS metabolomics analysis identified 94 metabolites. There was no significant difference in metabolite profile between the newly emerged fibroid tissue in the HIFU group and fibroid tissue in the Control group, and also no significant difference in the myometrial tissue and endometrial tissue between the two groups. In contrast, a significant difference was observed in metabolites between the treated fibroid tissue and the myometrial tissue in HIFU group. The levels of malus pumila acid, dimethyl fumarate, fumaric acid, methylphenylacetic acid, benzoic acid, and phosphoenolpyruvic acid were significantly higher ( HIFU ablation may have a reprogramming effect on energy metabolism in the treated fibroids. The findings of this study provide a new direction for exploring the future development of biomarkers for combined metabolic regulation therapy.

Nomogram for predicting HIFU efficacy in uterine fibroids: based on oxytocin-induced arterial-phase perfusion delay and ultrasound features

This study aimed to develop and validate a nomogram for predicting high-intensity focused ultrasound (HIFU) ablation efficacy in uterine fibroids, based on the Oxytocin-Induced Arterial-phase Perfusion Delay Time(APDT) on contrast-enhanced ultrasound (CEUS), combined with ultrasound features. A retrospective analysis was performed on 53 patients (76 fibroids) who underwent oxytocin-assisted HIFU treatment. All patients underwent abdominal ultrasound before HIFU, with APDT on CEUS recorded pre- and post-oxytocin challenge. Predictive factors were identified via univariate and multivariate logistic regression analyses. A clinical efficacy prediction model for HIFU treatment was established using R software and visualized as a nomogram. Its discriminative ability, calibration performance, and clinical utility were evaluated. The final predictive factors included the number of intratumoral attenuation bands, oxytocin-induced APDT, peripheral blood flow grade, and location/type of fibroids. The nomogram's calibration curve demonstrated excellent agreement between observed and predicted values (absolute error = 0.034). The discriminative ability, assessed by the area under the receiver operating characteristic curve (AUC), was 0.884 (95% CI: 0.803-0.965). The model achieved a sensitivity of 92.7% and specificity of 76.2%, indicating strong predictive value for ablation outcomes. Decision curve analysis revealed high clinical utility with a maximum net benefit threshold probability range of 0%-97%. The HIFU ablation efficacy prediction model, integrating oxytocin-induced Arterial-phase Perfusion Delay Time and ultrasound features, demonstrated robust predictive performance and may assist clinicians in selecting suitable candidates for HIFU treatment.

Value of multi-modal MRI in predicting the effect of high-intensity focused ultrasound for uterine fibroids

To explore the value of advanced MRI techniques in predicting the effect of high-intensity focused ultrasound (HIFU) on uterine fibroids and to establish a prediction model. This study enrolled 40 patients with 52 uterine fibroids who underwent HIFU at our hospital. All patients were scanned using multiple MRI sequences before HIFU therapy, including non-contrast enhanced MRI, contrast-enhanced MRI, diffusion weighted imaging (DWI), arterial spin labeling (ASL), and T1 mapping. MRI sequences that could predict the HIFU effect were identified, and the predictive performance was evaluated using ROC curves. Univariate and multivariate logistic analyses were employed to investigate independent predictors and establish a prediction model. In addition, we assessed and verified the performance of the model. Hyperintense on T2 weighted imaging (T2WI), large apparent diffusion coefficient (ADC) values derived from DWI, and high perfusion index derived from ASL were associated with a poor HIFU effect. Univariate and multivariate logistic analyses suggested that uterine position, ADC value and perfusion index were independent predictors for establishing the prediction model. The AUC of the prediction model was 0.939. Both the Hosmer-Lemeshow test and the calibration curve indicated good calibration. The decision curve analysis (DCA) curve showed good clinical benefits, and the leave-one-out cross-validation (LOOCV) revealed that the model had good predictive performance and generalization ability. ADC values and perfusion index are predictors of the effect of HIFU on uterine fibroids. The prediction model including uterine position, ADC value, and perfusion index as predictors has good predictive performance.

Risk factors affecting long-term efficacy of ultrasound-guided high-intensity focused ultrasound treatment for multiple uterine fibroids

To investigate the long-term efficacy of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for multiple uterine fibroids and the factors associated with recurrence. Five hundred and forty-nine patients with multiple uterine fibroids treated with USgHIFU from June 2017 to June 2019 were retrospectively analyzed. The Pictorial Blood Loss Assessment Chart (PBAC) was used to assess menstrual blood loss. The patients were asked to undergo pre- and post-USgHIFU magnetic resonance imaging (MRI) and complete routine follow-up after USgHIFU. Cox regression analysis was used to investigate the risk factors associated with recurrence. The median number of fibroids per patient was 3 (interquartile range: 3-4), and a total of 1371 fibroids were treated. Among them, 446 patients completed 3 years follow-up. Recurrence, defined as PBAC score above or equal to 100 and/or the residual fibroid volume increased by 10%, was detected in 90 patients within 3 years after USgHIFU, with a cumulative recurrence rate of 20.2% (90/446). The multi-factor Cox analysis showed that age was a protective factor for recurrence. Younger patients have a greater chance of recurrence than older patients. Mixed hyperintensity of fibroids on T2WI and treatment intensity were risk factors for recurrence. Patients with hyperintense uterine fibroids and treated with lower treatment intensity were more likely to experience recurrence than other patients after USgHIFU. No major adverse effects occurred. USgHIFU can be used to treat multiple uterine fibroids safely and effectively. The age, T2WI signal intensity and treatment intensity are factors related to recurrence.

Feasibility, safety and efficacy of high intensity focused ultrasound ablation as a preoperative treatment for challenging hysteroscopic myomectomy

To investigate the feasibility, safety and efficacy of high intensity focused ultrasound ablation (HIFU) as a preoperative treatment for challenging hysteroscopic myomectomies. A total of 75 patients diagnosed with types 0-III of uterine fibroids were enrolled. Based on the Size, Topography, Extension of the base, Penetration and lateral Wall position (STEPW) classification scoring system, 25 cases with a score ≥ 5 points were treated with HIFU followed by hysteroscopic myomectomy (HIFU + HM group), whereas 50 cases with a score < 5 points were treated with hysteroscopic myomectomy (HM group). The median preoperative STEPW score was 7 in the HIFU + HM group and 2 in the HM group. The average non-perfused volume (NPV) ratio achieved in fibroids after HIFU was 86.87%. Patients in the HIFU + HM group underwent hysteroscopic myomectomy one to four days after HIFU, and downgrading was observed in 81.81% of fibroids. The operation time for patients in the HIFU + HM group was 73 min and the success rate of myomectomy in a single attempt was 60%. The volume of distention medium used during the operation was greater in the HIFU + HM group than in the HM group (15,500 ml vs. 7500 ml). No significant difference was observed between the two groups in terms of intraoperative blood loss, the incidence of intraoperative and postoperative complications, menstrual volume score, or uterine fibroid quality of life score. HIFU can be utilized as a preoperative treatment for large submucosal fibroids prior to hysteroscopic myomectomy. HIFU offers a novel approach in the management of this subset of patients.

Possible new application of high-intensity focused ultrasound: degradation of uterine myoma classification

Hysteroscopic myomectomy is widely used to treat submucosal myomas. However, performing hysteroscopic surgery on certain type II (and even type III) or large myomas remains challenging. High-intensity focused ultrasound (HIFU) has recently emerged as a promising alternative for treating various gynecologic conditions. Studies have shown that following HIFU ablation, not only is the myoma volume reduced, but the intramural portion of the myoma may also protrude into the uterine cavity. This reclassification or 'degradation' of the myoma could facilitate the resection of difficult type II and III myomas during hysteroscopy, ultimately reducing the complexity of the procedure and improving surgical safety.

Study on the safety and efficacy of HIFU in the treatment of VaIN

This study aimed to investigate the safety and efficacy of High-Intensity Focused Ultrasound (HIFU) treatment for vaginal intraepithelial neoplasia(VaIN). Retrospective analysis was conducted on clinical, pathological, and follow-up data of 43 patients who underwent HIFU treatment for VaIN at Xiangya Third Hospital of Central South University between January 2018 and December 2022. The preliminary efficacy and safety of HIFU in treating VaIN were discussed. The 36 patients were analyzed, and the average age was 50.09 ± 12.06 years, including 24 patients with VaIN I and 12 patients with VaIN II. Five cases had a history of hysterectomy (4 due to cervical lesions, 1 due to hysteromyoma), and 2 cases had conization of cervical intraepithelial lesions (CIN). All 36 cases were complicated by human papillomavirus (HPV) infection, with 3 cases also having grade I-II CIN and undergoing cervical HIFU treatment. All patients successfully completed the HIFU treatment, with an average treatment time of 5.99 ± 1.25 min, treatment power of 3.5 W, and average total treatment dose of 1118.99 ± 316.20 J. Patients tolerated the treatment well, experiencing only slight pain with VAS score of 3. There was a mild postoperative burning sensation, which resolved within approximately 10-20 min. After 6 follow-up visits, 33 patients (91.66%) achieved cure, 1 patient (2.77%) showed persistence, 2 patients (5.55%) exhibited progression, and 27 patients (75%) tested negative for HPV. At 12 months of follow-up, the results were consistent with those of 6 months. No complications occurred during the procedure and the follow-up period. HIFU is a safe and effective treatment for VaIN. However, this study had a small sample size, a relatively short follow-up period, and lacked a control group, requiring further investigation.

Volume reduction rate and its influencing factors in solitary uterine fibroids classified as Funaki types I and II after ultrasonography-guided high intensity focused ultrasound ablation: a prospective cohort study

We aimed to explore the volume reduction rate (VRR) and its influencing factors in solitary uterine fibroids classified as Funaki type I and II after ultrasonography-guided high-intensity focused ultrasound (USgHIFU) ablation. We enrolled 191 patients with uterine fibroids who underwent USgHIFU ablation. To calculate the VRR, fibroid dimensions were measured using ultrasonography at 3, 6 and 12 post-treatment months. The primary endpoint was the VRR at 12 post-treatment months. The secondary endpoints included the non-perfused volume ratio (NPVR) and VRR at three and six months. The mean VRR for all 191 patients was 29.9%, 39.6% and 44.0% at 3, 6 and 12 post-treatment months, respectively. Subgroup analysis demonstrated a significant volume reduction across groups stratified by maximum fibroid diameter, Funaki type and NPVR. Univariable logistic analysis identified the following factors significantly associated with a higher VRR at 12 months: age ≥35 years (odds ratio [OR] 3.960, 95% confidence interval [CI] 1.405-11.159), presence of menstrual abnormalities (OR 1.936, 95% CI 1.075-3.485), moderate enhancement (OR 2.340, 95% CI 1.193-4.591), anteverted uterus (OR 2.020, 95% CI 1.034-4.025) and lymphocyte count <1.8 × 10 The uterine fibroid volume progressively decreased after USgHIFU ablation. Age ≥35 years and lymphocyte count <1.8 × 10

Comparison of high-intensity focused ultrasound ablation for uterine fibroids with different blood flow grading based on Alder classification

This study aimed to evaluate the efficacy of ultrasound-guided high-intensity focused ultrasound ablation (USgHIFU) for uterine fibroids with different blood flow grading based on Alder classification. A total of 353 patients with solitary uterine fibroid who underwent USgHIFU from July 2014 to July 2019 were enrolled. The patients were classified as four groups based on blood flow grading in fibroids. The relevant factors influencing the therapeutic effect were analyzed. Significant differences were observed in treatment time, irradiation time, irradiation intensity, nonperfusion volume (NPV), NPV ratio and energy efficiency factor (EEF) among the four groups ( Our results suggested that the difficulty of USgHIFU treatment for uterine fibroids could be evaluated using Alder classification. The fibroids with more blood flow were more difficulty to treat. However, satisfactory NPV ratio could be achieved even fibroids with abundant blood supply, and the long-term intervention rate was not increased.

Prognostic value and adverse events of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in primary advanced and platinum-sensitive recurrent epithelial ovarian cancer: a systematic review and meta-analysis

The original meta-analysis of hyperthermic intraperitoneal chemotherapy (HIPEC) is already outdated, owing to the latest trial results. This study aimed to clarify the efficacy and adverse events of cytoreductive surgery with HIPEC compared to conventional therapy for advanced and platinum-sensitive recurrent epithelial ovarian cancer (OC). In this meta-analysis, phase II/III controlled trials regarding 'HIPEC' and 'ovarian cancer' were searched for in electronic databases from inception to March 2022. Twenty-one studies were included in the quantitative synthesis. The pooled hazard ratio [HR] in the HIPEC group for progression-free survival (PFS) (HR = 0.61, 95% confidence interval [CI]: 0.45-0.83, HIPEC-based regimens improved the clinical prognosis for primary advanced OC, whereas no significant value was elicited for recurrent OC.

High-intensity focused ultrasound ablation in the treatment of fumarate hydratase-deficient uterine leiomyoma

This study aimed to explore the efficacy and safety of high-intensity focused ultrasound (HIFU) ablation for treating fumarate hydratase (FH)-deficient uterine leiomyomas. Ten patients with FH-deficient uterine leiomyomas treated with HIFU ablation at the Third Xiangya Hospital from July 2017 to January 2023 were enrolled in this study. The effectiveness and adverse effects of HIFU were analyzed. The median age of the patients who received HIFU was 32.0 years (range: 28-41 years). Only 2 patients had solitary uterine leiomyomas, whereas the remaining 8 patients had multiple uterine leiomyomas. The median diameter of the largest myoma was 56 mm (range: 41-99 mm). Magnetic resonance imaging showed that the FH-deficient uterine leiomyomas of 8 patients presented as mixed intensity on T2WI, that of one patient was hypointense, and that of another patient was hyperintense on T2WI. All patients successfully underwent HIFU ablation in one session without severe adverse effects. The median nonperfusion volume ratio (NPVR) was 40% (30.0%-78.0%) after HIFU treatment. Four patients had NPVR ≥70%. At 3-month follow-up after HIFU ablation, the clinical symptoms of 5 of the 8 patients with symptoms before treatment were relieved. Six months after treatment, 4 of the 8 patients with symptoms were still in remission. All patients received reintervention by March 2024. The reintervention rates were 20%, 70%, and 90% at 12, 24, and 36 months, respectively, after HIFU ablation. HIFU is a safe and feasible treatment for FH-deficient uterine leiomyomas, and most patients show effective results in the short term after treatment. However, the reintervention rates are high, and the long-term effects are limited.

Clinical treatment of intra-epithelia cervical neoplasia with photodynamic therapy

This clinical study was developed to primarily evaluate the Complete Cytopathological Response Rate of Cervical Intraepithelial Neoplasms to PDT using chitosan nanocapsules containing Chlorocyan-aluminum phthalocyanine as a photoactive agent. Analyses of the Free Recurrence Interval, toxicity profile (immediate and late), and complications (immediate and late), were secondarily analyzed. This study was previously approved by the National Council of Ethics in Research of Brazil (CONEP), on May 28, 2014, under case number 19182113.4.0000.5009. On the surface of the cervix of each selected patient was applied one mL of the formulated gel, and after 30 min, the light was applied. Reports or the identification of adverse effects and/or complications were observed in follow-up visits, in addition to the collection of cervical oncotic cytology. Out of the total group, 11 (91.7%) primarily treated patients evolved with negative cervical oncotic cytology as soon as in the first evaluation following treatment, and one did not achieve any therapeutic benefit, even after reapplication. Two patients with initially positive response presented cytological recurrence determined by histopathology. A new round of PDT was developed, and both evolved with cytological remission three weeks later, remaining negative until the last follow-up. No important side effects were observed in all the patients. Our trial demonstrates that treatment of CIN 1 and 2 lesions using our PDT formulation is feasible and safe. Large randomized clinical trials are required to establish efficacy.

Focused ultrasound: a novel therapy for improving vaginal microecology in patients with high-risk HPV infection

To investigate changes in vaginal microecology in women with high-risk human papillomavirus (HR-HPV) infection after focused ultrasound (FU) treatment. We collected vaginal secretions at the time of admission and 3 months after FU treatment from 169 women who received FU treatment for cervical HR-HPV infection between July 2020 and September 2022. Among them, there were 101 patients with cute vaginitis, we also collected their vaginal secretions after one week of drug treatment. These samples were evaluated for vaginal microecology and HPV-DNA examination. Of the 169 patients, 101 (59.7%) suffered from acute vaginitis at the time of admission. After one week of targeted antibiotics drug treatment, there were no pathogens or pus cells on the field of microscopic vision, but there was no significant difference( FU is an effective treatment for patients with cervical HR-HPV infection. FU does not interfere with the vaginal microecology of HR-HPV positive patients with normal vaginal microecology.FU followed by antibiotic drug therapy for pathogens is beneficial to restore the function of Lactobacillus vaginalis in HR-HPV positive patients with acute vaginitis,so as to improve the vaginal microecology of HR-HPV positive patients with abnormal vaginal microecology.

The value of susceptibility weighted imaging for immediate assessing the hyperacute outcome of MRgFUS ablation for uterine fibroids: a preliminary study

To investigate the value of susceptibility weighted imaging (SWI) for assessing the hyperacute outcome of ablation of uterine fibroids immediately after magnetic resonance-guided focused ultrasound (MRgFUS) treatment. This retrospective imaging study included patients who underwent SWI and contrast-enhanced (CE) MR within 15 min of MRgFUS ablation for uterine fibroids. Two readers independently assessed the SWI features of ablative lesions and their association with the non-perfused volume (NPV) ratio. The intraclass correlation coefficient (ICC) and diagnostic value of SWI findings were calculated. A total of 27 uterine fibroids from 21 participants (mean age 40.1 ± 7.2 years) were analyzed. 51.9% (14/27) leiomyomas had NPV ratio ≥90%. In post-ablation SWI images, the interobserver ICC for the relative signal intensity and hypointense peripheral rim were 0.613 and 0.843, respectively (both Identifying a complete hypointense peripheral rim on SWI may be a potential imaging marker for assessing the hyperacute outcome of uterine fibroids ablation by MRgFUS, specifically in determining whether the NPV ratio is ≥90%.

Percutaneous microwave ablation versus surgical resection for ovarian cancer liver metastasis

Analysis of the clinical efficacy of HIFU in the treatment of low-grade vaginal intraepithelial neoplasia

To evaluate the clinical efficacy of high-intensity focused ultrasound (HIFU) in treating low-grade intraepithelial neoplasia (VaIN-1) in the vagina. Between June 2020 and December 2024, 135 patients with pathologically confirmed VaIN-1 were initially enrolled. After excluding 8 cases lost to follow-up, 127 patients were assigned to the HIFU group ( In the HIFU group, twenty-six patients (37.7%) were cured, 36 patients (50.7%) were effectively treated, and 8 patients (11.6%) were ineffectively treated, resulting in an efficacy rate of 88.4%. In the interferon group, three patients (7.0%) were cured, 8 patients (18.6%) were effectively treated, 31 patients (72.1%) were ineffectively treated, and 1 patient (2.3%) experienced worsening of the disease, resulting in an efficacy rate of 25.6%. In the nonintervention group, 3 patients (20.0%) recovered, 10 patients (66.7%) experienced no change, and 2 patients (13.3%) experienced worsening of the disease, resulting in a clinical self-healing rate of 20.0%. The total efficacy rate was significantly greater in the HIFU group (88.4%) than in the interferon group (25.6%) and the nonintervention group (20.0%) ( This study suggests that HIFU is a safe, minimally invasive, and potentially effective approach for VaIN-1. These findings should be confirmed by larger, long-term randomized controlled trials before the treatment is adopted into routine practice.

Multimodal MRI radiomics for predicting HIFU ablation efficacy in uterine fibroids: a machine learning study

To explore the predictive value of machine learning-based multimodal MRI radiomics combined with clinical features in the efficacy of high-intensity focused ultrasound (HIFU) ablation of uterine fibroids. This study included 390 patients with uterine fibroids who underwent HIFU ablation. Patients were stratified into high and low ablation groups based on an 80% non-perfused volume ratio (NPVR) and randomly divided into training (70%) and test (30%) sets. Radiomics features were extracted from T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), and diffusion-weighted imaging (DWI). The most predictive features were selected via Recursive Feature Elimination (RFE) and the Least Absolute Shrinkage and Selection Operator (LASSO), and combined with clinical characteristics. Logistic Regression (LR), Random Forest (RF) and eXtreme Gradient Boosting (XGBoost), were constructed to predict ablation efficacy, with performance assessed using the area under the receiver operating characteristic curve (AUC). The results indicated that age, uterine fibroid location, and T2WI signal intensity were independent predictive factors ( The XGBoost model based on multimodal MRI and clinical features may serve as a reference for predicting HIFU ablation efficacy and optimizing treatment strategies.

Revolutionizing cervical cancer care: the synergistic effects of hyperthermia and machine learning

This study aimed to examine the impact of hyperthermia in conjunction with concurrent chemoradiotherapy (CCRT) on peripheral immune markers in patients with locally advanced cervical cancer (LACC). Additionally, we sought to predict the associations between these validated immune markers and the efficacy of hyperthermia by employing a developed and optimized machine learning model. Sixty LACC patients were enrolled, with 30 in the observation group receiving CCRT plus hyperthermia and 30 in the control group receiving CCRT alone. Data on complete blood counts; T lymphocyte subsets (CD3 The study showed that there was no statistical difference in 2-years PFS ( The combination of hyperthermia with CCRT alleviates the suppression of peripheral immune indicators, modulates immune function, and improves the systemic immune microenvironment in LACC patients. The RF and MLP models, which are based on dynamic peripheral immune indicators, exhibit robust performance in predicting hyperthermia efficacy.

Cervical morphology and elasticity following treatment of cervical squamous intraepithelial lesions with focused ultrasound vs . loop electrosurgical excision procedure: a prospective non-randomized controlled study

To compare the effects of focused ultrasound (FUS) and loop electrosurgical excision procedure (LEEP) on cervical morphology and elasticity after treatment of cervical squamous intraepithelial lesions (SILs). Eighty-one patients with histologically confirmed SILs (42 FUS At 3-6 months after surgery, the high-risk human papilloma virus (HR-HPV) clearance rate and high-grade SIL cure rate were similar in the FUS and LEEP groups ( FUS and LEEP demonstrate comparable efficacy in treating HR-HPV-associated SILs. Initial observations suggest that FUS impacts cervical morphology and elasticity less than does LEEP, implying an advantage of FUS for fertility preservation, although the long-term fertility outcomes require further investigation.

Carboprost tromethamine injection enhanced the efficacy of focused ultrasound ablation surgery for hyperintense uterine fibroids: a retrospective study

To investigate whether carboprost tromethamine injection enhances the efficacy of focused ultrasound ablation surgery (FUAS) for hyperintense uterine fibroids (UFs) on T2-weighted MR imaging (MRI). In this single-center study, 112 patients with symptomatic UF In the carboprost tromethamine group, the non-perfused volume (NPV) ratio was 98.38% (IQR: 91.65 - 104.35%), the energy-efficiency factor (EEF) was 2.44 J/mm³ (IQR: 1.38 - 4.83 J/mm³), and the sonication time was 400.00 s (IQR: 205.00 - 605.00 s). However, in the oxytocin group, the NPV ratio was 81.76% (IQR: 59.67 - 89.66%), the EEF was 6.98 J/mm³ (IQR: 3.92 - 14.05 J/mm³), and the sonication time was 733.50 s (295.00 - 1127.50 s). Statistically significant differences in NPV ratio, EEF, and sonication time between the two groups were observed. When FUAS was performed on UFs with 3 - 4 levels of blood flow, there were significant differences between the two groups ( Compared with oxytocin, carboprost tromethamine injection significantly reduced the energy for ablating UFS with FUAS, thereby enhancing treatment efficiency. this strategy provides a new option for patients with hyperintense fibroids and grade 3-4 blood flow in fibroids.

Development and validation of sonographic feature-based prediction models for ultrasound-guided HIFU ablation of uterine fibroids

To develop a nomogram for predicting the efficacy of high-intensity focused ultrasound (HIFU) ablation in patients with uterine fibroids. A retrospective analysis was conducted on 153 patients (39.84 ± 6.37 years old, 224 fibroids) who underwent HIFU. Patients were randomly divided into training group ( The Lasso regression model identified uterine fibroid type, peripheral blood flow grading, fibroid location, and maximum fibroid diameter as potential predictive factors. The nomogram showed good predictive performance with AUCs of 0.819 (95% CI 0.789-0.822) in the training set and 0.900 (95% CI 0.840-0.901) in the validation set. Its sensitivity and specificity were 0.750/0.732 in the training set and 0.759/0.818 in the validation set, respectively. The calibration curve showed good agreement between observed and predicted outcomes, and DCA confirmed the clinical utility and broad applicability of the nomogram model. The prediction model comprising ultrasonic characteristics of uterine fibroids had good performance in patients undergoing HIFU ablation and hence can improve clinical decision-making.

Addition of PARP1-inhibition enhances chemoradiotherapy and thermoradiotherapy when treating cervical cancer in an in vivo mouse model

Conventional magnetic resonance imaging combined with three-dimensional ultrasound for preoperative prediction of immediate ablation rate in high-intensity focused ultrasound treatment of uterine fibroids

This study aimed to assess the effectiveness of conventional magnetic resonance imaging (MRI) combined with three-dimensional (3D) ultrasound for the preoperative prediction of nonperfused volume ratio (NPVR) in uterine fibroids after high-intensity focused ultrasound (HIFU) ablation. In total, 178 patients who had undergone HIFU ablation therapy for uterine fibroids between July 2021 and August 2023 were enrolled. Baseline clinical, MRI, and 3D ultrasound parameters collected before and after HIFU ablation were analyzed. Multiple linear regression models were constructed for conventional MRI parameters alone and for combined MRI-3D ultrasound parameters to predict NPVR. Paired-sample The combined MRI-3D ultrasound model outperformed the conventional MRI model, with adjusted 3D ultrasound provided essential information for screening fibroids and predicting NPVR before HIFU ablation, serving as a valuable supplement to MRI. The combined MRI-3D ultrasound model shows promise for the preoperative prediction of NPVR in patients with uterine fibroids treated with HIFU and may offer substantial clinical value.

A novel scoring system based on magnetic resonance imaging for the prediction of the difficulty of ultrasound-guided high-intensity focused ultrasound ablation for uterine fibroids

To develop a novel scoring system based on magnetic resonance imaging (MRI) for predicting the difficulty of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation for uterine fibroids. A total of 637 patients with uterine fibroids were enrolled. Sonication time, non-perfused volume ratio (NPVR), and ultrasound energy delivered for ablating 1 mm Signal intensity on T2WI, fibroid location index, largest diameter of fibroids, abdominal wall thickness, homogeneity of the signal of fibroids, and uterine position were independent influencing factors for the difficulty of USgHIFU for uterine fibroids. A prediction equation was obtained: difficulty score = 17 × uterine position (anteverted =0, retroverted =1)+71 × signal intensity (hypointense = 0, isointense/hyperintense = 1) +8 × enhancement (homogenous = 0, heterogeneous = 1)+25×(largest diameter of fibroids-20) +35 × (fibroid location index -0.2) +1×(abdominal wall thickness -5). This scoring system established based on MRI findings can be used to reliably predict the difficulty level of USgHIFU treatment of uterine fibroids.

Risk assessment and prediction of occult uterine sarcoma in patients with presumed uterine fibroids before high-intensity focused ultrasound treatment

To develop a diagnostic model for predicting occult uterine sarcoma in patients with presumed uterine fibroids. We retrospectively reviewed 41631 patients with presumed uterine fibroids who presented for HIFU treatment in 13 hospitals between November 2008 and October 2023. Of these patients, 27 with occult uterine sarcoma and 54 with uterine fibroids were enrolled. Univariate analysis and multivariate logistics regression analysis were used to determine the independent risk factors for the diagnosis of occult uterine sarcoma. A prediction model was constructed based on the coefficients of the risk factors. The multivariate analysis revealed abnormal vaginal bleeding, ill-defined boundary of tumor, hyperintensity on T2WI, and central unenhanced areas as independent risk factors. A scoring system was created to assess for occult uterine sarcoma risk. The score for abnormal vaginal bleeding was 56. The score for ill-defined lesion boundary was 90. The scores for lesions with hypointensity, isointensity signal/heterogeneous signal intensity, and hyperintensity on T2WI were 0, 42, and 93, respectively. The scores for lesions without enhancement on the mass margin, uniform enhancement of tumor, and no enhancement in the center of tumor were 0, 20, and 100, respectively. Patients with a higher total score implied a higher likelihood of a diagnosis of occult uterine sarcoma than that of patients with a lower score. The established model showed good predictive efficacy. Our results demonstrated that the diagnostic prediction model can be used to evaluate the risk of uterine sarcoma in patients with presumed uterine fibroids.

Prediction of prognosis and immune landscape in cervical cancer based on heat shock protein-related genes

Effectiveness of focused ultrasound for high risk human papillomavirus infection-related cervical lesions

The purpose of this study was to compare the efficacy of focused ultrasound (FU) and interferon drug therapy for cervical intraepithelial neoplasia 1 (CIN1) and chronic cervicitis associated with high risk human papillomavirus (HR-HPV) infection, as well as analyze the influencing factors. A retrospective cohort study was performed from January 2017 to December 2019. A total of 592 patients were enrolled, of which 300 patients were treated with FU and 292 patients were treated with interferon drugs. Kaplan-Meier curves and a COX regression model were used to compare the curative effects of the two therapeutic methods using HR-HPV clearance as the main outcome. The relationship between age, HR-HPV infection type, pathological type, preoperative HR-HPV status and HR-HPV clearance were also analyzed. The median time for HR-HPV clearance was 6.00 months (95% CI: 5.24-6.76) in the FU group and 26.00 months (95% CI: 22.32-29.68) in the medication group. A significant difference was observed between the two groups (χ FU therapy can eliminate HR-HPV infections in a short period of time. Moreover, the treatment efficacy of FU was significantly superior to that of interferon drugs.

Molecular imaging-monitored radiofrequency hyperthermia-enhanced intratumoral herpes simplex virus-thymidine kinase gene therapy for rat orthotopic ovarian cancer

High-intensity focused ultrasound ablation in the treatment of recurrent ovary cancer and metastatic pelvic tumors: a feasibility study

To explore the feasibility of high-intensity focused ultrasound (HIFU) ablation for treating metastatic pelvic tumors and recurrent ovary cancer. Eight patients with metastatic pelvic tumors or recurrent ovary cancer were enrolled in this study. Among them, 5 patients had ovarian cancer, 1 had cervical cancer, 1 had endometrial cancer, and 1 had rectal cancer. Six of them received abdominal surgical operation for their primary cancer, no one received radiotherapy. HIFU treatment was performed under conscious sedation. Vital signs were monitored during the procedure, and adverse effects were recorded. Postoperative follow-up was performed to observe pain relief and the improvement of the patient's quality of life. The median age of the patients was 54 (range: 33-76) years, with a total of 12 lesions. The average volume of the lesions was 238.0 cm HIFU is feasible for the treatment of metastatic pelvic tumors or recurrent ovary cancer without serious complications. Therefore, HIFU seems a promising treatment for recurrent ovary cancer, metastatic pelvic tumors from cervical cancer, endometrial cancer, and rectal cancer.

Ultrasound-guided high-intensity focused ultrasound ablation for uterine arteriovenous fistula: a case series

To evaluate the efficacy and safety of high-intensity focused ultrasound (HIFU) ablation in the treatment of uterine arteriovenous fistula (UAVF). This case series included three patients diagnosed with acquired UAVF. All patients underwent routine laboratory tests, electrocardiography (ECG), chest X-ray, ultrasound, and pelvic contrast-enhanced magnetic resonance imaging (MRI). HIFU treatment was performed under sedation and analgesia using a Model JC Focused Ultrasound Tumor Therapeutic System (made by Chongqing Haifu Medical Technology Co. Ltd., China) with a B mode ultrasound device for treatment guidance. The treatment time, sonication power, sonication time, and complications were recorded. Follow-up evaluations were scheduled at 1-, 3-, 6-, and 12-month to assess symptom improvement and evaluate the post-treatment imaging. All patients completed HIFU treatment in a single session without any major complication. All patients complained of mild lower abdominal and sacrococcygeal pain. Typically, no special treatment is required. Following HIFU treatment, there was a significant relief in clinical symptoms, particularly abnormal uterine bleeding. Ultrasound examinations conducted one month after the treatment revealed a notable reduction in the volume of the lesion, ranging from 57% to 100%. Moreover, the efficacy and safety of HIFU treatment remained consistent during the 12-month follow-up period. HIFU ablation appears to be an effective and safe treatment modality for UAVF. It provides a noninvasive approach with favorable clinical outcomes.

Theoretical evaluation of the impact of diverse treatment conditions by calculation of the tumor control probability (TCP) of simulated cervical cancer Hyperthermia-Radiotherapy (HT-RT) treatments in-silico

Hyperthermia (HT) induces various cellular biological processes, such as repair impairment and direct HT cell killing. In this context, An extended linear-quadratic model calibrated for SiHa and HeLa cell lines (cervical cancer) was used to theoretically study the impact of varying HT treatment conditions on radiosensitization and direct HT cell killing effect. Simulated patients were generated to compute the Tumor Control Probability (TCP) under different HT conditions (number of HT sessions, temperature and time interval), which were randomly selected within margins based on reported patient data. Under the studied conditions, model-based simulations suggested a treatment improvement with a total CEM43 thermal dose of approximately 10 min. Additionally, for a given thermal dose, TCP increased with the number of HT sessions. Furthermore, in the simulations, we showed that the TCP dependence on the temperature/time interval is more correlated with the mean value than with the minimum/maximum value and that comparing the treatment outcome with the mean temperature can be an excellent strategy for studying the time interval effect. The use of thermoradiobiological models allows us to theoretically study the impact of varying thermal conditions on HT + RT treatment outcomes. This approach can be used to optimize HT treatments, design clinical trials, and interpret patient data.

Hyperthermic intraperitoneal chemotherapy enhances antitumor effects on ovarian cancer through immune-mediated cancer stem cell targeting

We aimed to determine the effects and possible mechanisms of hyperthermic intraperitoneal chemotherapy (HIPEC) in targeting ovarian cancer stem-like cells (CSCs). Murine ovarian cancer cell lines presenting CSC surface markers were grown intraperitoneally in both immunocompetent and immunodeficient mice, which were then treated by intraperitoneal hyperthermia with the chemotherapeutic agents: paclitaxel and cisplatin. Tumor growth was measured by non-invasive luminescent imaging. Intraperitoneal immune cells, such as CD4 Combined hyperthermia and chemotherapy exhibited an efficient therapeutic effect in the immunocompetent mice. However, a similar effect was not observed in the immunodeficient mice. Intraperitoneal hyperthermia increased the number of Intraperitoneal macrophages and dendritic cells that were lost due to chemotherapy. Compared with ovarian cancer bulk cells, CSCs were more susceptible to phagocytosis by macrophages. We demonstrated that the superior therapeutic efficacy and reduced proportion of CSCs associated with intraperitoneal hyperthermic chemotherapy were immune-related. Hyperthermia recruits the phagocytes that target surviving CSCs after chemotherapy. These results provide a novel mechanism for the efficacy of HIPEC in treating ovarian cancer.

Advanced patient-specific hyperthermia treatment planning

Hyperthermia treatment planning (HTP) is valuable to optimize tumor heating during thermal therapy delivery. Yet, clinical hyperthermia treatment plans lack quantitative accuracy due to uncertainties in tissue properties and modeling, and report tumor absorbed power and temperature distributions which cannot be linked directly to treatment outcome. Over the last decade, considerable progress has been made to address these inaccuracies and therefore improve the reliability of hyperthermia treatment planning. Patient-specific electrical tissue conductivity derived from MR measurements has been introduced to accurately model the power deposition in the patient. Thermodynamic fluid modeling has been developed to account for the convective heat transport in fluids such as urine in the bladder. Moreover, discrete vasculature trees have been included in thermal models to account for the impact of thermally significant large blood vessels. Computationally efficient optimization strategies based on SAR and temperature distributions have been established to calculate the phase-amplitude settings that provide the best tumor thermal dose while avoiding hot spots in normal tissue. Finally, biological modeling has been developed to quantify the hyperthermic radiosensitization effect in terms of equivalent radiation dose of the combined radiotherapy and hyperthermia treatment. In this paper, we review the present status of these developments and illustrate the most relevant advanced elements within a single treatment planning example of a cervical cancer patient. The resulting advanced HTP workflow paves the way for a clinically feasible and more reliable patient-specific hyperthermia treatment planning.

Analysis of the effects of mEHT on the treatment-related toxicity and quality of life of HIV-positive cervical cancer patients

Feasibility study of focused ultrasound in the treatment of vulvar low-grade squamous intraepithelial lesions with persistent symptoms

This study aimed to investigate the feasibility, efficacy, and safety of focused ultrasound (FUS) for the treatment of vulvar low-grade squamous intraepithelial lesions (VLSIL) with persistent symptoms. This retrospective analysis included 24 VLSIL patients who underwent FUS treatment. At each follow-up visit, the clinical response was assessed including changes in symptoms and signs. In addition, the histological response was assessed based on the vulvar biopsy results of the 3rd follow-up. Clinical and histological response were assessed to elucidate the efficacy. A total of 22 patients completed follow-up and post-treatment pathological biopsies. After treatment, the clinical scores of itching decreased from 2.55 ± 0.51 to 0.77 ± 0.81 ( This study revealed that FUS is feasible, effective, and safe for treating VLSIL patients with persistent symptoms, providing a new solution for the noninvasive treatment of symptomatic VLSIL.

Therapeutic effects of focused ultrasound on vulvar squamous intraepithelial lesions in rat

In this study, we established a Sprague-Dawley rat model of vulvar squamous intraepithelial lesions and investigated the impact of focused ultrasound on the expression of hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) and mutant type p53 (mtp53) in the vulvar skin of rats with low-grade squamous intraepithelial lesions (LSIL). The vulvar skin of 60 rats was treated with dimethylbenzanthracene (DMBA) and mechanical irritation three times a week for 14 weeks. Rats with LSIL were randomly allocated into the experimental group or the control group. The experimental group was treated with focused ultrasound, while the control group received sham treatment. After 14 weeks treatment of DMBA combined with mechanical irritation, LSIL were observed in 44 (73.33%) rats, and high-grade squamous intraepithelial lesions (HSIL) were observed in 14 (23.33%) rats. 90.91% (20/22) of rats showed normal pathology and 9.09% (2/22) of rats exhibited LSIL in the experimental group at four weeks after focused ultrasound treatment. 22.73% (5/22) of rats exhibited LSIL, 77.27% (17/22) of rats progressed to HSIL in the control group. Compared with the control-group rats, the levels of HIF-1α, VEGF and mtp53 were significantly decreased in experimental-group rats ( These results indicate that DMBA combined with mechanical irritation can induce vulvar squamous intraepithelial lesion in SD rats. Focused ultrasound can treat LSIL safely and effectively, prevent the progression of vulvar lesions, and improve the microenvironment of vulvar tissues by decreasing the localized expression of HIF-1α, VEGF, and mtp53 in rats.

Chemoradiotherapy with hyperthermia versus chemoradiotherapy alone in locally advanced cervical cancer: a systematic review and meta-analysis

Concurrent chemoradiotherapy (CCRT) is recommended as the standard treatment for locally advanced cervical cancer (LACC). However, the synergistic effect of hyperthermia (HT) with CCRT remains unclear. Therefore, we performed a meta-analysis to evaluate the effect of HT with CCRT on LACC patients. A systematic literature search was conducted on the MEDLINE, PubMed, Embase, Cochrane library and SCOPUS databases for articles that compared CCRT with HT and CCRT alone as treatments for LACC. Hazard ratios (HRs) and risk ratios (RRs) were used to compare five-year overall survival (OS), local relapse-free survival (LRFS) and incidence of acute and chronic toxicity between the two treatments. Two articles out of 2860 were finally selected for analysis. A total of 536 patients were evaluated (CCRT with HT group: 268, CCRT group: 268). FIGO stages I-II and III-IV were found in 295 (55.0%) and 241 patients (45.0%), respectively. The CCRT with HT group had significantly better five-year OS than the CCRT group (HR 0.67, 95% confidence interval [CI] 0.47-0.96, This systematic review and meta-analysis showed that CCRT with HT significantly improved OS in LACC patients without increasing acute and chronic toxicity. Therefore, tri-modality treatment could be a feasible approach for patients with LACC.

Acute and long-term toxicity in patients undergoing induction chemotherapy followed by thermoradiotherapy for advanced cervical cancer

To determine rates of vascular toxicity, acute kidney injury (AKI), chronic kidney disease (CKD) and survival in high-risk cervical cancer patients treated with platinum-based induction chemotherapy followed by thermoradiotherapy. Between January 1999 and April 2017, patients with large primary tumors (>6cm) and/or para-aortic lymph node (LN) metastases >1 cm and/or para-iliac LN >2 cm were included. Patient and tumor characteristics, Common Toxicity Criteria v4.03 scores, laboratory tests and treatment data were retrieved from patient records. CT scans were reviewed for the presence of thrombo-embolic events (TEE). The study protocol was approved by the Medical Ethics Review Committee of Erasmus MC, Rotterdam (MEC2017-133). The 105 included patients had a mean age of 47.9 years (range 22-79) and a median follow-up time of 43 months (IQR 14-72). Median tumor size was 6.0 cm (range 2.6-11.5), 30% had a clinical FIGO stage ≥ IIIB and 42% had enlarged para-aortic LN. Cisplatin-based therapy was started in 86 patients (82%), of whom 30 (35%) switched to carboplatin and 47% of patients completed six cycles of platinum-based chemotherapy. All patients received external beam radiotherapy as planned, 98 patients (93%) underwent brachytherapy as planned or received an external boost, and 95 patients (90%) completed all five planned hyperthermia treatments. During cisplatin chemotherapy, 34 patients experienced AKI (39%). At last follow-up, 35% of patients had chronic renal toxicity (GFR 59 - 15/min/1.73 m Achieving a five-year overall survival of 58%, platinum-based induction chemotherapy followed by thermoradiotherapy is an effective treatment for advanced-stage high-risk cervical cancer. However, treatment is accompanied by an unacceptably high prevalence of chemotherapy-associated TEE and acute kidney injury, as well as chronic kidney disease. Future studies should investigate the role of carboplatin in reducing toxicity and the effect of thromboprophylaxis in high-risk patients.

Comparison of the clinical performance of a hybrid Alba 4D and the AMC-4 locoregional hyperthermia systems

The in-house developed 70 MHz AMC-4 locoregional hyperthermia system has been in clinical use since 1984. This device was recently commercialized as the Alba 4D (Medlogix During one year after clinical acceptance of the hybrid Alba 4D, both devices were used for treatment delivery in patients scheduled for locoregional hyperthermia. Each patient started with the AMC-4, next sessions were allocated to either device. Possible differences between Alba 4D and AMC-4 sessions in power, achieved temperature T0, T10, T50, T90, T100, treatment time and complaints per session, were evaluated using linear mixed models (LMMs) for repeated measures with patient as random effect. From March 2018 to April 2019, eleven patients with cervical, pancreatic, vaginal carcinoma and uterine leiomyosarcoma received 27 locoregional hyperthermia sessions with the Alba 4D and 34 sessions with the AMC-4. Median number of sessions per patient was 5 (range 3-13). Treatment results for both devices were not significantly different: T50 was 40.5 ± 1.0 °C Results of the first patients treated with the hybrid Alba 4D demonstrated comparable clinical performance of the Alba 4D and AMC-4 locoregional hyperthermia systems, and both devices are expected to yield similar favorable clinical results.

Focused ultrasound for high-risk human papillomavirus infection-related low-grade cervical lesions: a prospective cohort study

To assess the efficacy and safety of focused ultrasound (FU) for high-risk human papillomavirus (HR-HPV) infection-related cervical low-grade squamous intraepithelial lesions (LSIL). Of 185 patients who met the inclusion criteria for this prospective study from October 2020 to November 2021, 95 received FU and 90 were followed up only. At the six-month follow-up, the HR-HPV clearance and LSIL regression rates of the groups were compared and factors affecting HR-HPV clearance were analyzed. The safety and side effects of FU were evaluated. No significant difference was found in the baseline clinical data between the two groups ( For patients with HR-HPV infection-related histological LSIL, FU can eliminate HR-HPV infection and cause lesions to regress in a short time, with few adverse effects and good tolerance.

A retrospective study of focused ultrasound versus cryotherapy in treatment of cervical squamous intraepithelial lesions

To compare the efficacy and safety of focused ultrasound (FUS) therapy and cryotherapy for cervical squamous intraepithelial lesion (SIL). In this retrospective study, data pertaining to women treated for cervical SIL with FUS therapy or cryotherapy at the Second Affiliated Hospital of Chongqing Medical University between 21 April 2018 and 31 August 2020 were obtained. The patients were followed up after 3-6 and 6-12 months. The proportions of women with no evidence of disease, recurrent disease, clearance of the human papillomavirus (HPV) and adverse effects or complications were determined. Of the 250 women with complete data who were included in the study, 144 and 106 received FUS therapy and cryotherapy, respectively. Overall, FUS therapy was observed to be more effective than cryotherapy (91.7 vs. 79.2%, The results of this study suggest that FUS therapy is superior to cryotherapy in the treatment of cervical LSIL.

Comparing the effect of FUAS and myomectomy on the elasticity of myometrium around targeted uterine fibroid

Focused ultrasound ablation surgery (FUAS) has been widely employed to treat patients with uterine fibroid (UF). This study aimed to estimate myometrial stiffness changes in patients who received FUAS for UFs or myomectomy (ME) and compare the recovery of surrounding myometrium between FUAS and ME groups. Our results may provide more evidence for guiding the proper conception timing in patients with UF. This study enrolled 173 patients from May 2022 to August 2023. Shear wave elastography (SWE) was used to dynamically monitor myometrial elasticity changes in patients before and after surgery. Moreover, our study monitored and analyzed the stiffness changes in the targeted fibroid after FUAS, as well as in the myometrium around after FUAS or ME. The stiffness of the myometrium around the resected fibroid was significantly higher than at the preoperative level until 6 months. Conversely, the stiffness of the surrounding myometrium was only temporarily increased 1 day after FUAS. The comparison between FUAS and ME groups regarding the stiffness of the surrounding myometrium showed that nonsignificant differences were detected between the two groups before the treatment. The stiffness of the surrounding myometrium in the ME group was statistically significantly higher than that of the FUAS group 1 day as well as 1, 3, and 6 months after the treatment, respectively. The FUAS had less impact on the surrounding myometrium than the ME, which may be more conducive to the recovery of myometrial elasticity in patients with UF.

Effectiveness and immune responses of focused ultrasound ablation for cervical intraepithelial neoplasia

To investigate the safety, efficacy, and the immune responses of focused ultrasound in cervical intraepithelial neoplasia (CIN). Patients with biopsy-confirmed CIN were recruited for focused ultrasound treatment and asked to return during 3-6 and 6-12 months post-treatment to receive cervical cytology, high-risk human papilloma virus (HPV) detection, and colposcopy. The effective rate was evaluated within 3-6 months, whereas the recurrence rate was evaluated within 6-12 months. Cervicovaginal lavage and cervical tissue were sampled before and 3-6 months after treatment. The expression of interferon gamma (IFN-γ), endoplasmic reticulum aminopeptidase 1 (ERAP1), human leucocyte antigen I (HLA-I), cluster of differentiation 4 (CD4), and cluster of differentiation 8 (CD8) in the cervical tissue were observed by immunohistochemistry. Immunoglobulin A (IgA) and interleukin 10 (IL-10) levels in the cervicovaginal lavage were detected by enzyme-linked immunosorbent assay. Comparisons were made in immune analyte levels before and after treatment. We analyzed the results of 154 patients. The effective rate at 3-6 months was 96.8%. The recurrence rate at 6-12 months was 2.0%. The eradication rate of HPV was 72.4% at 3-6 months and 81.0% at 6-12 months. No serious adverse reactions and complications were observed. After treatment, a higher expression of ERAP1 was observed ( Focused ultrasound is an effective and safe therapy for treating CIN, which could improve the local immune milieu of the cervix to some extent.

Clearance of HR-HPV within one year after focused ultrasound or loop electrosurgical excision procedure in patients with HSIL under 30

To compare the clearance rate of high-risk human papillomavirus (HR-HPV) in patients with a high-grade squamous intraepithelial lesion (HSIL) 12 months after focused ultrasound (FUS) or loop electrosurgical excision procedure (LEEP), and analyze the influencing factors. A retrospective cohort was established in HSIL patients with HR-HPV infection treated with FUS or LEEP from 2015 to 2019. The cohort consisted of 321 patients under 30 years of age, of which 119 patients received FUS and 202 patients received LEEP. The Cox regression model was used to identify the influencing factors for HR-HPV clearance. Kaplan-Meier method was applied to estimate the efficacy of FUS and LEEP in HR-HPV clearance, and the log-rank test was used to compare the efficacy difference between FUS and LEEP. Multivariate Cox regression analysis showed that both FUS and LEEP were independent influencing factors for HR-HPV clearance. HR-HPV cleared faster in the FUS group than in the LEEP group [the median time to HR-HPV clearance: 6 months in the FUS group (95% CI: 5.492-6.508) and 6 months in the LEEP group (95% CI: 5.734-6.266), For HPV-positive HSIL patients under 30, FUS had a better HR-HPV clearance effect than LEEP 1 year after treatment. FUS may be a viable modality for the treatment of young HSIL patients.