Intraprocedure contrast enhanced ultrasound: The value in assessing the effect of ultrasound-guided high intensity focused ultrasound ablation for uterine fibroids

• Intraprocedure CEUS correlated well with the post-HIFU MRI.
• No severe complications associated with the ultrasound contrast agent were observed.
• CEUS offers a less costly way to evaluate the therapeutic results of HIFU.

PurposeTo investigate the value of microbubble contrast-enhanced ultrasound (CEUS) in evaluating the treatment response of uterine fibroids to HIFU ablation.Materials and methodsSixty-eight patients with a solitary uterine fibroid from the First Affiliated Hospital of Chongqing Medical University were included and analyzed. All patients underwent pre- and post-treatment magnetic resonance imaging (MRI) with a standardized protocol, as well as pre-evaluation, intraprocedure, and immediate post-treatment CEUS. CEUS and MRI were compared by different radiologists.ResultsIn comparison with MRI, CEUS showed that the size of fibroids, volume of fibroids, size of non-perfused regions, non-perfused volume (NPV) or fractional ablation (NPV ratio) was similar to that of MRI. In terms of CEUS examination results, the median volume of fibroids was 75.2 (interquartile range, 34.2–127.3) cm3, the median non-perfused volume was 54.9 (interquartile range, 28.0–98.1) cm3, the mean fractional ablation was 83.7 ± 13.6 (range, 30.0–100.0)%. In terms of MRI examination results, the median volume of fibroids was 74.1 (interquartile range, 33.4–116.2) cm3. On the basis of contrast-enhanced T1-weighted images immediately after HIFU treatment, the median non-perfused volume was 58.5 (interquartile range, 27.7–100.0) cm3, the average fractional ablation was 84.2 ± 14.2 (range, 40.0–100.0)%.ConclusionsCEUS clearly showed the size of fibroids and the non-perfused areas of the fibroid. Results from CEUS correlated well with results obtained from MRI.