Ultrasound-Guided hifu in uterine leiomyomata: First Italian experience

Purpose: Report our three years results in treatment of uterine leiomyomata with the HIFU (high-intensity focused ultrasound) technique. Material and methods: In the period between 2009 – 2012, we treated 14 women (mean age of 47 year old; range 38 – 70 year old) affected by symptomatic uterine fibroids: 4 patients were afflicted by dysmenorrhea, 10 by metrorrhagia, 1 by urinary disturbs. Leiomyomata mean diameter before the HIFU treatment was 68.8 mm (range 55 – 140 mm). All the treatments were performed under light sedation. The equipment used was JC 200 of Haifu Chong Qing Company. The fibroids were ablated using a mean power output of 218 W, for a mean total elapse time of 2598 seconds. Results: All patients tolerated the treatment well, and no severe complications were found during follow-up (24h, 1 – 3-6 – 12 – 24 months). The efficacy of therapy was judged by a clinical evaluation, contrast-enhanced ultrasound and contrast-enhanced magnetic resonance. 12 months after the treatment no patient was still affected by dysmenorrhea and urinary disturbs, 50% had yet metrorrhagia. After treatment, non-enhanced necrotic regions were shown in all treated fibroids and the mean diameter was 49 mm (range 19 – 76 mm), with a mean decrease of 29%. Conclusion: HIFU may be a safe and effective non-invasive method to treat adenomyosis. Results are promising (symptoms reduction, volume reduction, presence of necrosis), however a larger sample is require