Efficacy and safety of daily repeated sonographically guided high-intensity focused ultrasound treatment of uterine fibroids: Preliminary study

Objectives: To evaluate the efficacy and safety of repeated low-dose sonographically guided high-intensity focused ultrasound (HIFU) treatment of uterine fibroids. Methods: Between April and December 2010, 24 consecutive premenopausal women with symptomatic uterine fibroids were enrolled in this study. The treatment was performed with an HIFU unit without anesthesia or sedative administration and Foley catheter insertion. The treatment was performed 40 to 70 min/d according to the tumor volume. The entire treatment was finished after 4 to 6 days of treatment. We assessed the differences in the symptom severity score, tumor volume, and contrast-enhanced volume at baseline and 1 and 3 months after treatment. The clinical success rates according to tumor volume and contrast-enhanced volume reductions and echogenicity and vascular flow changes were analyzed. The clinical success rates according to the baseline characteristics of fibroids were analyzed. We assessed adverse events during and after treatment. Results: The symptom severity score, tumor volume, and contrast-enhanced volume decreased significantly after repeated low-dose HIFU treatment (P <.05). There were significant correlations between tumor volume and contrast-enhanced volume reduction and the decrease in the symptom severity score. The clinical success rates were significantly different according to the tumor vascularity on color Doppler sonography and the degree of enhancement on magnetic resonance imaging. Skin burns and other serious adverse events did not develop. Conclusions: Although this preliminary report had several limitations, daily repeated HIFU treatment of uterine fibroids may be a useful and safe method and can be used as a different option for HIFU treatment in patients who prefer treatment without anesthesia or sedation.