Our Doctor - Jae-Seong Lee, MD, OB-GYN | Aegis Roen HIFU Center

OBJECTIVES: This study aimed to assess the therapeutic outcomes of patients with uterine fibroid or adenomyosis treated by ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation at Incheon Christian Hospital, Korea.

METHODS: This study included 618 patients, of which 272 suffered from uterine fibroid and 346 suffered from adenomyosis. Treatment was administrated using the Model Haifu JC Focused Ultrasound Tumor Therapeutic System (Chongqing Haifu Technology, Chongqing, China) under real-time ultrasound guidance. A follow-up was conducted on volume change as well as on symptom improvement using the Symptom Severity Score (SSS) and Uterine Fibroid Symptom and Quality of Life (UFS-QOL) after treatment.

RESULT: The uterine fibroid volume reduction rates (%) were 58.08%, 66.18%, and 77.59% at 3, 6, and 12 months after treatment, respectively. The SSS reduction rates (%) were 55.58%, 52.76%, and 50.39% by 3, 6, and 12 months, respectively. The UFS-QOL score increasing rates (%) were 42.66%, 43.50%, and 43.45% by 3, 6, and 12 months, respectively. The uterine volume reduction rates (%) for adenomyosis were 43.99%, 47.01%, and 53.98% by 3, 6, and 12 months, respectively. The SSS reduction rates (%) for adenomyosis were 55.61%, 52.38%, and 57.98% by 3, 6, and 12 months, respectively. The UFS-QOL score increasing rates (%) for adenomyosis UFS-QOL score were 80.06%, 69.39%, and 85.07% by 3, 6, and 12 months, respectively.

CONCLUSION: We conclude that USgHIFU treatment for uterine fibroid and adenomyosis is an effective non-invasive therapy via the assessment of fibroid volume reduction, symptom improvement, UFS-QOL score increase, and acceptable level of side effects. Although preliminary experience of HIFU is encouraging, well-designed prospective trials and more clinical experiences are needed to ascertain the efficacy and safety of this new treatment.

Effects of High-Intensity-Focused Ultrasound Treatment on Benign Uterine Tumor. (J Korean Med Sci. 2016 Aug;31(8):1279-83. doi: 10.3346/jkms.2016.31.8.1279. Epub 2016 Jun 7.)

In this study, the effects of high-intensity-focused ultrasound (HIFU) treatment on benign uterine tumor patients were examined. A total of 333 patients diagnosed with fibroids or adenomyosis using diagnostic sonography, treated with HIFU between February 4, 2010 and December 29, 2014 at a hospital in Korea, and followed up for three or six months were selected for this study. Their benign uterine tumor volume was measured, and the effects of HIFU treatment on the volume were analyzed according to age, disease, fertility, and treatment duration. The volume of benign tumors of the uterus changed by age in all age groups after conducting HIFU treatment for 3 and 6 months, respectively. The rate of decrease in individuals' in their twenties was the largest, at 64.9%. When the decreasing volume of benign tumors of the uterus was analyzed by type of disease, the treatment efficacy for adenomyosis was the best, with a decrease of 164.83 cm(3) after 6 months. Myoma had the fastest decreasing rate, at 68.5%.

When evaluated on the basis of fertility, the volume of benign tumors of the uterus continued to decrease until 6 months after completing all procedures. The volume has continued to decrease for 6 months after all procedures. This study showed that HIFU treatments for uterine fibroid and adenomyosis is an effective non-invasive therapy via reducing the benign uterine tumor volume.

Therefore, the HIFU method might replace other conventional treatment methods.

High-intensity focused ultrasound combined with hysteroscopic resection to treat retained placenta accreta. (Obstet Gynecol Sci. 2016 Sep;59(5):421-5. doi: 10.5468/ogs.2016.59.5.421. Epub 2016 Sep 13.)

We present a case of retained placenta accreta treated by high-intensity focused ultrasound (HIFU) ablation followed by hysteroscopic resection. The patient was diagnosed as submucosal myoma based on ultrasonography in local clinic. Pathologic examination of several pieces of tumor mass from the hysteroscopic procedure revealed necrotic chorionic villi with calcification. HIFU was performed using an ultrasound-guided HIFU tumor therapeutic system. The ultrasound machine had been used for real-time monitoring of the HIFU procedure. After HIFU treatment, no additional vaginal bleeding or complications were observed. A hysteroscopic resection was performed to remove ablated placental tissue 7 days later. No abnormal vaginal bleeding or discharge was seen after the procedure. The patient was stable postoperatively. We proposed HIFU and applied additional hysteroscopic resection for a safe and effective method for treating retained placenta accreta to prevent complications from the remaining placental tissue and to improve fertility options.