Long-term outcome and risk factors of reintervention after high intensity focused ultrasound ablation for uterine fibroids: a systematic review and meta-analysis
AbstractObjectives To quantify the reintervention rate and analyze the risk factors for reintervention after high-intensity focused ultrasound (HIFU) ablation of uterine fibroids.Methods Eighteen studies were selected from the seven databases. A meta-analysis was applied to synthesize the reinterven...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | International Journal of Hyperthermia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/02656736.2023.2299479 |
| _version_ | 1797369672083963904 |
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| author | Yuya Dou Lian Zhang Yu Liu Min He Yanzhou Wang Zhibiao Wang |
| author_facet | Yuya Dou Lian Zhang Yu Liu Min He Yanzhou Wang Zhibiao Wang |
| author_sort | Yuya Dou |
| collection | DOAJ |
| description | AbstractObjectives To quantify the reintervention rate and analyze the risk factors for reintervention after high-intensity focused ultrasound (HIFU) ablation of uterine fibroids.Methods Eighteen studies were selected from the seven databases. A meta-analysis was applied to synthesize the reintervention rates for fibroids across various follow-up durations. Subgroup-analysis was conducted based on the year of surgery, sample size, guide methods, and non-perfusion volume ratio (NPVR). Signal intensity of T2-weighted imaging (T2WI) was independently evaluated for reintervention risk.Results The study enrolled 5216 patients with fibroids treated with HIFU. There were 3247, 1239, 1762, and 2535 women reaching reintervention rates of 1% (95% confidence interval (CI): 1-1), 7% (95% CI: 4-11), 19% (95% CI: 11-27), and 29% (95% CI: 14-44) at 12, 24, 36, and 60-month after HIFU. The reintervention rates of patients treated with US-guided HIFU (USgHIFU) were significantly lower than those of patients treated with MR-guided focused ultrasound surgery (MRgFUS). When the NPVR of fibroids was over 50%, the reintervention rates at 12, 36 and 60-month after HIFU were 1% (95% CI: 0.3–2), 5% (95% CI: 3–8), and 15% (95% CI: 9–20). The reintervention risk for hyper-intensity fibroids on T2WI was 3.45 times higher (95% CI: 2.7–4.39) for hypo-/iso-intensity fibroids.Conclusion This meta-analysis showed that the overall reintervention rates after HIFU were acceptable and provided consultative suggestions regarding treatment alternatives for patients with fibroids. Subgroup-analysis revealed that USgHIFU, NPVR ≥ 50%, and hypo-/iso-intensity of fibroids on T2WI were significant factors in reducing reintervention.Systematic Review Registration PROSPERO, CRD42023456094 |
| first_indexed | 2024-03-08T17:50:13Z |
| format | Article |
| id | doaj.art-901acfe3362842fc8d9c73a8a8e9fbe5 |
| institution | Directory Open Access Journal |
| issn | 0265-6736 1464-5157 |
| language | English |
| last_indexed | 2024-03-08T17:50:13Z |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | International Journal of Hyperthermia |
| spelling | doaj.art-901acfe3362842fc8d9c73a8a8e9fbe52024-01-02T08:46:18ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572024-12-0141110.1080/02656736.2023.2299479Long-term outcome and risk factors of reintervention after high intensity focused ultrasound ablation for uterine fibroids: a systematic review and meta-analysisYuya Dou0Lian Zhang1Yu Liu2Min He3Yanzhou Wang4Zhibiao Wang5State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, ChinaState Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, ChinaDepartment of Obstetrics and Gynecology, Hainan Hospital of PLA General Hospital, Sanya, ChinaState Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, ChinaDepartment of Obstetrics and Gynecology, Southwest Hospital, Army Military Medical University, Chongqing, ChinaState Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, ChinaAbstractObjectives To quantify the reintervention rate and analyze the risk factors for reintervention after high-intensity focused ultrasound (HIFU) ablation of uterine fibroids.Methods Eighteen studies were selected from the seven databases. A meta-analysis was applied to synthesize the reintervention rates for fibroids across various follow-up durations. Subgroup-analysis was conducted based on the year of surgery, sample size, guide methods, and non-perfusion volume ratio (NPVR). Signal intensity of T2-weighted imaging (T2WI) was independently evaluated for reintervention risk.Results The study enrolled 5216 patients with fibroids treated with HIFU. There were 3247, 1239, 1762, and 2535 women reaching reintervention rates of 1% (95% confidence interval (CI): 1-1), 7% (95% CI: 4-11), 19% (95% CI: 11-27), and 29% (95% CI: 14-44) at 12, 24, 36, and 60-month after HIFU. The reintervention rates of patients treated with US-guided HIFU (USgHIFU) were significantly lower than those of patients treated with MR-guided focused ultrasound surgery (MRgFUS). When the NPVR of fibroids was over 50%, the reintervention rates at 12, 36 and 60-month after HIFU were 1% (95% CI: 0.3–2), 5% (95% CI: 3–8), and 15% (95% CI: 9–20). The reintervention risk for hyper-intensity fibroids on T2WI was 3.45 times higher (95% CI: 2.7–4.39) for hypo-/iso-intensity fibroids.Conclusion This meta-analysis showed that the overall reintervention rates after HIFU were acceptable and provided consultative suggestions regarding treatment alternatives for patients with fibroids. Subgroup-analysis revealed that USgHIFU, NPVR ≥ 50%, and hypo-/iso-intensity of fibroids on T2WI were significant factors in reducing reintervention.Systematic Review Registration PROSPERO, CRD42023456094https://www.tandfonline.com/doi/10.1080/02656736.2023.2299479Uterine fibroidhigh-intensity focused ultrasoundreintervention ratemeta-analysis |
| spellingShingle | Yuya Dou Lian Zhang Yu Liu Min He Yanzhou Wang Zhibiao Wang Long-term outcome and risk factors of reintervention after high intensity focused ultrasound ablation for uterine fibroids: a systematic review and meta-analysis International Journal of Hyperthermia Uterine fibroid high-intensity focused ultrasound reintervention rate meta-analysis |
| title | Long-term outcome and risk factors of reintervention after high intensity focused ultrasound ablation for uterine fibroids: a systematic review and meta-analysis |
| title_full | Long-term outcome and risk factors of reintervention after high intensity focused ultrasound ablation for uterine fibroids: a systematic review and meta-analysis |
| title_fullStr | Long-term outcome and risk factors of reintervention after high intensity focused ultrasound ablation for uterine fibroids: a systematic review and meta-analysis |
| title_full_unstemmed | Long-term outcome and risk factors of reintervention after high intensity focused ultrasound ablation for uterine fibroids: a systematic review and meta-analysis |
| title_short | Long-term outcome and risk factors of reintervention after high intensity focused ultrasound ablation for uterine fibroids: a systematic review and meta-analysis |
| title_sort | long term outcome and risk factors of reintervention after high intensity focused ultrasound ablation for uterine fibroids a systematic review and meta analysis |
| topic | Uterine fibroid high-intensity focused ultrasound reintervention rate meta-analysis |
| url | https://www.tandfonline.com/doi/10.1080/02656736.2023.2299479 |
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