Abstract
BackgroundAbdominal scars pose a challenge in magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) therapies, limiting patient selection and increasing the risk of skin burns. Especially, scars arising from longitudinal incisions are problematic as they usually lie medially at the lower abdomen where the ultrasound beam has to go through. Volumetric sonication has been shown to efficiently enlarge the ablated volume per sonication, but they nevertheless require more thermal energy to be deposited per sonication which increases the temperature in the near-field area located between the transducer and the target region.Case presentationThe scar patch was used in three patients undergoing MR-HIFU ablation of fibroids using volumetric technique, one with transverse incision and the other two with longitudinal incision. No severe adverse effects were observed. The relative shrinkage of the fibroid of these patients at 6-month follow-up were 67, 78, and 59 %, respectively.ConclusionsOur preliminary experience suggests that the use of scar patch on MR-HIFU ablation of fibroids using volumetric technique provides an effective treatment option for patients who were previously excluded from MR-HIFU treatment due to the abdominal scars.
Highlights
Abdominal scars pose a challenge in magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) therapies, limiting patient selection and increasing the risk of skin burns
Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) which allows for 3D treatment planning and feedback of temperature deposition in the area to be treated is an emerging therapy technique which uses focused ultrasound to heat and coagulate tissue deep within the body, with minimal damage to surrounding tissues
A number of studies have shown the clinical effectiveness of MR-HIFU for uterine fibroid treatment [1,2,3,4,5,6,7,8]
Summary
Abdominal scars pose a challenge in magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) therapies, limiting patient selection and increasing the risk of skin burns. Volumetric sonication has been shown to efficiently enlarge the ablated volume per sonication, but they require more thermal energy to be deposited per sonication which increases the temperature in the near-field area located between the transducer and the target region. Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) which allows for 3D treatment planning and feedback of temperature deposition in the area to be treated is an emerging therapy technique which uses focused ultrasound to heat and coagulate tissue deep within the body, with minimal damage to surrounding tissues. The conventional approach is performed by iterative sonication of a single focal point with each sonication followed by a cooling period With this approach, a relatively large portion of the delivered energy is lost via diffusion of heat out of the small targeted region, and long treatment duration is required. Since all biological tissues absorb ultrasound energy to various extents, the increase in deposited energy might inevitably lead to higher temperature rise in the near field of the ultrasound beam path [12, 13]
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