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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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1/2022
vol. 17
 
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abstract:
Meta-analysis

Role of magnetic resonance-high intensity focused ultrasound (MR-HIFU) in uterine fibroids management: an updated systematic review and meta-analysis

Shilin Zheng
1
,
Yu Rong
2
,
Haiyun Zhu
3
,
Xiaoyu Zhang
4
,
Xuan Liu
1
,
Yun Wu
1
,
Meng Zhao
5

  1. Department of Interventional Medicine Ward, Wuhan Third Hospital-Tongren Hospital of Wuhan University, Wuhan, China
  2. Department of Radiology, Guizhou Provincial People’s Hospital, Guizhou Provincial Key Laboratory of Intelligent Medical Image Analysis and Precision Diagnosis, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
  3. Department of Imaging section, Linyi County People’s Hospital, Dezhou City, Shandong Province, Shandong Dezhou Linyi, China
  4. Department of Radiology, Affiliated Hospital of Chifeng University, Chifeng, China
  5. Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
Videosurgery Miniinv 2022; 17 (1): 83–94
DOI: https://doi.org/10.5114/wiitm.2021.109760
Online publish date: 2021/10/08
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Introduction
Magnetic resonance-high intensity focused ultrasound (MR-HIFU) has revolutionized the treatment of Uterine fibroids. Usually, they are associated with prolonged heavy bleeding during the menstrual period, sacral pain, and increased frequency of UTIs, secondary dysmenorrhea, constipation, and pregnancy-associated problems. It also impacts usual activities, which lead to diminished quality of life and rising healthcare costs. Generally, surgery is the only choice for uterine fibroids; however, MR-HIFU is an entirely non-invasive novel therapy, preferred in pregnancy desiring females.
Aim: To re-evaluate the efficacy of magnetic resonance-high intensity focused ultrasound (MRHIFU) therapy for uterine fibroids.

Material and methods
Randomized clinical trials (RCTs), prospective or retrospective non-randomized, and cross-over studies that considered clinically symptomatic uterine fibroid treatment were included. Meta-analysis was performed using NCSS software, and data were analyzed at a 95% confidence level with a significance level of 0.05. In addition, the non-perfused volume percentage (NPV%), transformed Symptom Severity Score percentage change (tSSS change%), and health-related quality of life (HR-QoL) were computed.

Results
The overall effect of NPV% was 67.60%, where the 95% confidence interval ranged from 55.58% to 79.62%. The overall impact of tSSS% change was approximately 50% (0.54) with 95% CI of 0.41–0.66 of 3 months, 6 months, and 12 months in the included studies. There was a significant improvement in the health-related quality of life (HR-QoL).

Conclusions
The efficacy of MR-HIFU therapy was improved as treatment protocols aimed for total ablation.

keywords:

uterine fibroids, magnetic resonance-high intensity focused ultrasound (MR-HIFU), health-related quality of life (HRQoL), meta-analysis, uterine artery embolization (UAE)
  
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