Objectives To investigate the factors influencing the volume reduction rate (VRR) at 12 months after ultrasound (US)-guided high-intensity focused ultrasound (HIFU) for breast fibroadenoma (FA). Materials and Methods A retrospective analysis of 104 patients with 302 FAs who underwent US-guided HIFU from January 2021 to May 2023 was conducted. All patients received US assessment and contrast-enhanced US (CEUS) evaluation, and treatment information was recorded. VRR ≥ 80% was set as the dependent variable, while nineteen baseline- and treatment-related factors were considered as the independent variables. A logistic regression model was constructed to predict 12-month VRR. Results All patients successfully underwent one-session HIFU. Significant differences were observed in volume, distance from the superficial margin of FA to skin, distance from the deep margin of FA to chest wall, mean power, energy efficacy factor, type of near-field acoustic pathway, and appearance of hyperechoic changes. Multivariate analysis revealed that type of near-field acoustic pathway, distance from the deep margin of FA to chest wall, and appearance of hyperechoic changes were independent predictors of the 12-month VRR after HIFU. The area under Receiver Operating Characteristic curve was 0.688. Conclusions The type of near-field acoustic pathway, distance from the deep margin of FA to chest wall, and appearance of hyperechoic changes could serve as predictors of 12-month VRR following HIFU treatment for FA.

Introduction This preclinical study evaluated the effects of combining hypofractionated radiation (HFRT), either as X-ray photons or protons, with hyperthermia on tumor response and normal tissue damage in mice. Methods The tumors were C3H mammary carcinomas implanted in the right rear foot of male CDF1 mice, while non-tumor-bearing mice were used to assess normal foot skin. HFRT was delivered in three fractions (5, 10, or 15 Gy) at 3 to 4-day intervals. Hyperthermia (40.5–42.5 °C) was applied once for 60 min, either 30, 90, or 180 min after the final radiation dose. Endpoints included tumor growth delay and moist skin desquamation. Mechanistic studies assessed DNA damage (γ-H2AX foci) 24 h after 3 × 10 Gy, with or without hyperthermia (42.5 °C for 1 h, administered 30 min post-RT), and tumor hypoxia (pimonidazole staining) measured 1 h after the last radiation fraction. Results Animals responded similarly to X-ray photons and protons in the tumor and skin. Hyperthermia enhanced the response to X-ray photons in both tissues, with temperature and time-interval dependency, showing the greatest effects at higher temperatures and shorter intervals. Protons combined with hyperthermia showed similar results, although with less decay in time-interval effects at 42.5 °C. DNA damage assessments revealed no significant difference between radiation types, but a significant enhancement was seen when tumors were heated at 42.5 °C. Tumor hypoxia was reduced after 3 × 10 Gy irradiation with either radiation type. Conclusions Combining HFRT with hyperthermia yielded effects comparable to single-dose studies for both tumors and normal tissues. These responses were similar for both X-rays and protons.

Objective This study aimed to examine the evolution of vigilance, sleepiness and electrophysiological markers of arousal in healthy subjects exposed to moderate hyperthermia, during habitual or restricted sleep conditions. Methods Twelve healthy males (30.4 ± 7.3 yr) completed two experimental crossover sessions in a bioclimatic chamber, consisting of sequential exposure to a thermoneutral condition (TCORE = 37.0 ± 0.2 °C) then an hyperthermic condition (TCORE = 38.3 ± 0.2 °C). Sessions followed either an habitual night of sleep (>6h time in bed, TIB) or sleep restriction (<3h TIB). A 10-minute psychomotor vigilance task (PVT) and a sleepiness scale were administered under thermoneutrality and hyperthermia conditions, immediately after recording a one-minute eyes-closed resting state electroencephalogram (EEG). This allowed for the calculation of individual alpha frequency (IAF), relative spectral powers (alpha, theta and beta bands) and theta-to-alpha ratio in frontal and parieto-occipital territories. Results Moderate hyperthermia induced an increase in PVT speed and a decrease in sleepiness. This arousal response was associated with an increase of IAF, a reduction in frontal theta power and an increase in frontal alpha power, leading to a decrease in the theta/alpha ratio. In contrast, sleep restriction induced the opposite effect on PVT performances and sleepiness, as well as for EEG parameters (without influence on IAF). No significant interaction was observed for all parameters. Conclusion Sleep restriction and moderate hyperthermia induced opposite effects in our model with limited time exposure to heat. This confirms that heat can help with arousing under certain conditions, although this needs to be confirmed by further studies.

Objective: Histotripsy, an ultrasound-based technology for noninvasive tissue destruction, is FDA-approved for treating liver tumors. However, its safety profile — particularrly regarding major vascular complications — has not been well established. Method: We present two cases of arterial pseudoaneurysms following histotripsy for hepatocellular carcinoma. Clinical course, imaging findings, and associated clinical factors were reviewed. Results Of those two pseudoaneurysms patients, one developed a likely bilio-vascular fistula and one with portal vein thrombosis. Conclusions Major vascular complications may represent a rare but significant risk of histotripys in the treatment of liver tumors. Further studies are required to estimated the incidence; to clarify patient factors and treatment factors that may predispose to these complications.

Objective This study seeks to examine the role of miR-210-3p, delivered by atrial myocyte-derived exosomes, in the progression of atrial fibrosis after hyperthermia. Methods Firstly, by conducting a bioinformatics analysis on the miRDB, miRTarbase, and TargetScan databases, multiple potential target genes of miR-210-3p were identified. Further analysis with the GeneCards database pinpointed GPD1L as a crucial gene related to atrial fibrosis. Subsequently, the expression pattern of GPD1L was analyzed using The Human Protein Atlas database, which showed that GPD1L was highly expressed in myocardial cells. The GSE31821 dataset from the GEO database was further analyzed, revealing significant gene expression differences between atrial fibrillation (AF) patients and sinus rhythm controls, with enrichment analysis identifying key fibrosis-related pathways. Then, an AF cell model was established and exposed to hyperthermia to simulate the effects of insufficient radiofrequency ablation (IRFA). Results The results demonstrated that hyperthermia significantly increased the expression of miR-210-3p from exosomes of AC16 atrial myocytes. Co-culture experiments with human cardiac fibroblasts (HCFs) showed that miR-210-3p directly targeted and downregulated GPD1L, thereby activating the PI3K/AKT signaling pathway and promoting the expression of fibrosis-related markers α-SMA, collagen I, and III. Further validation revealed that inhibiting miR-210-3p or overexpressing GPD1L could reverse these fibrotic effects, while GPD1L knockdown significantly enhanced the activation of the PI3K/AKT pathway. Additionally, the PI3K/AKT inhibitor LY294002 effectively suppressed pro-fibrotic effects. Conclusion These findings underscore the crucial role of miR-210-3p in exosomes derived from cardiomyocytes in atrial fibrosis following IRFA through GPD1L, providing new potential targets and mechanisms for the treatment of AF-related fibrosis.

Background 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. Methods 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. Results 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 × 109/L (OR 2.963, 95% CI 1.265–5.993). Multivariable logistic analysis revealed that age ≥35 years (OR 3.436, 95% CI 1.188–9.947) and lymphocyte count <1.8 × 109/L (OR 2.113, 95% CI 1.142–3.908) were significantly associated with high VRR. Conclusion The uterine fibroid volume progressively decreased after USgHIFU ablation. Age ≥35 years and lymphocyte count <1.8 × 109/L were significantly associated with high VRR.

Purpose To investigate the safety and efficacy of percutaneous ultrasound-guided radiofrequency ablation (RFA) for the treatment of patients with colorectal liver metastases (CRLM) ≥5 lesions. Methods A retrospective study was conducted on 492 patients with CRLM who underwent RFA in our center from January 2018 to July 2023. The clinical baseline characteristics of the CRLM ≥ 5 group and CRLM < 5 group were balanced by propensity score matching. Survival curves were assessed using the Kaplan-Meier and log-rank test. Univariate and multivariate Cox regression analyses were used to determine prognostic factors. Results A total of 69 patients were enrolled after 1:2 matching, including 23 patients in CRLM ≥ 5 group and 46 patients in CRLM < 5 group. The 1-, 3- and 5-year overall survival (OS) rates were 87.0%, 24.9%, 24.9% in CRLM ≥5 group and 97.8%, 51.6%, 37.4% in CRLM < 5 group, respectively. The OS of CRLM ≥ 5 group was shorter than that of CRLM < 5 group (median survival 21.0 ± 3.7 months vs 44.0 ± 7.9 months, p = 0.007). The rates of intrahepatic progression-free survival (ihPFS) at 1-, 3- and 5-years were 17.4%, 0%, 0% in CRLM ≥5 group and 53.9%, 29.9%, 29.9% in CRLM < 5 group, respectively. The ihPFS was shorter in CRLM ≥5 group than in CRLM < 5 group (median time 4.0 ± 1.2 months vs 17.0 ± 6.7 months, p < 0.001). The number of CRLM and extrahepatic metastases were independent risk factors for OS. The number of CRLM and tumor size were independent risk factors for ihPFS. No major complications occurred in either group. Conclusion Radiofrequency ablation is safe and effective for the treatment of CRLM ≥5 lesions.

Background Multinodular goiter (MNG) faces the challenge of recurrence after surgery. The usefulness of thermal ablation (TA) for MNGs and its effectiveness compared to surgery are unclear. This study aimed to investigate two-year treatment outcomes of TA versus surgery for selected MNG. Methods The selection for MNG patients fulfilled over 50% normal tissue, 2–5 benign nodules and 1–3 well-defined dominant target nodules with maximum diameter ≥20 mm and/or with clinical complaints. Those who underwent complete ablation of dominant nodules in a single TA were retrospectively compared with those who underwent lobectomy or subtotal thyroidectomy after propensity score matching (PSM). Efficacy, all nodules burden changes, complications and health-related quality of life (HRQoL) were analyzed during two years. Complete relief (CR), stable disease (SD), progressive disease (PD) and retreatment rate were to assess all nodule burden changes. Results Eighty-six pairs (1:1) were identified using PSM. At 24 months, the volume reduction rate of ablated nodules was 98.32% without regrowth. No significant differences were observed in the PD (9.30% vs 6.98%, p = 0.577), retreatment (1.16% vs 2.33%, p = 0.560) and complications (1.16% vs 4.65%, p = 0.173) between the TA and surgery group. TA was superior to surgery in the cosmetic outcome, hospitalization time (3d vs 8d, p < 0.001), estimated blood loss (3 mL vs 20 mL, p < 0.001), hypothyroidism (0 vs 61.63%, p < 0.001) and HRQoL. Conclusions For selected MNG, TA did not show higher retreatment risks than surgery with better thyroid function protection and quality of life during two years after a single complete TA of all dominant nodules.

Objective To evaluate the clinical efficacy of high-intensity focused ultrasound (HIFU) in treating low-grade intraepithelial neoplasia (VaIN-1) in the vagina. Methods 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 (n = 69), interferon group (n = 43), or nonintervention group (n = 15). All the patients were followed up with TCT, human papilloma virus (HPV) testing and colposcopy to determine treatment efficacy and outcomes after 6 months. Results 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%) (p < 0.05). Conclusions 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.

Objective This study focused on determining the clearance rate of high-risk human papillomavirus (HR-HPV) with chronic cervicitis or squamous intraepithelial lesion following focused ultrasound (FUS) in premenopausal and postmenopausal women. Methods From March 2022 to December 2024, clinicopathological data of 124 women, including 67 premenopausal patients and 57 postmenopausal counterparts who received FUS treatment, were gathered. The cumulative HR-HPV clearance rate served as an evaluation metric for treatment effectiveness. By employing the logistic regression analysis model, influencing variables of HR-HPV clearance were determined. The HR-HPV clearance efficacy following FUS surgery in both premenopausal and postmenopausal groups was analyzed by the Kaplan–Meier method, with log-rank test being used for assessing heterogeneities of outcomes between two groups. Results After FUS surgery, the HR-HPV clearance rates were 70.1% and 76.1% in postmenopausal and premenopausal groups separately, with no significant difference (χ2=0.557, p = 0.455). Meanwhile, the median HR-HPV clearance time in premenopausal and postmenopausal women was 10.6 months (95% confidence interval (CI): 8.185–12.189) and 12.6 months (95% CI: 7.758-17.497), and the difference was not significant (log-rank test p = 0.455). As revealed by multivariate logistic regression, HPV16/18 genotype (OR = 4.99, p = 0.004) and cervical intraepithelial neoplasia(CIN)pathology (OR = 6.67, p = 0.045) were the independent predictors of clearance following FUS surgery, and they did not have any significant effect of menopausal status. Conclusions FUS demonstrates equivalent safety and efficacy in the treatment of HR-HPV infections in premenopausal and postmenopausal patients, with potential benefits in enhancing the clearance rates of persistent HPV16/18 infections. Yet further research is warranted for verification.