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Background Focused ultrasound ablation surgery (FUAS) has been widely employed to treat patients with uterine fibroid (UF). This study aimed to estimate myometrial stiffness changes in patients who received FUAS for UFs or myomectomy (ME) and compare the recovery of surrounding myometrium between FUAS and ME groups. Our results may provide more evidence for guiding the proper conception timing in patients with UF.Methods This study enrolled 173 patients from May 2022 to August 2023. Shear wave elastography (SWE) was used to dynamically monitor myometrial elasticity changes in patients before and after surgery. Moreover, our study monitored and analyzed the stiffness changes in the targeted fibroid after FUAS, as well as in the myometrium around after FUAS or ME.Results The stiffness of the myometrium around the resected fibroid was significantly higher than at the preoperative level until 6 months. Conversely, the stiffness of the surrounding myometrium was only temporarily increased 1 day after FUAS. The comparison between FUAS and ME groups regarding the stiffness of the surrounding myometrium showed that nonsignificant differences were detected between the two groups before the treatment. The stiffness of the surrounding myometrium in the ME group was statistically significantly higher than that of the FUAS group 1 day as well as 1, 3, and 6 months after the treatment, respectively.Conclusion The FUAS had less impact on the surrounding myometrium than the ME, which may be more conducive to the recovery of myometrial elasticity in patients with UF.

Background: Focused ultrasound ablation surgery (FUAS) has been widely employed to treat patients with uterine fibroid (UF). This study aimed to estimate myometrial stiffness changes in patients who received FUAS for UFs or myomectomy (ME) and compare the recovery of surrounding myometrium between FUAS and ME groups. Our results may provide more evidence for guiding the proper conception timing in patients with UF. Methods: This study enrolled 173 patients from May 2022 to August 2023. Shear wave elastography (SWE) was used to dynamically monitor myometrial elasticity changes in patients before and after surgery. Moreover, our study monitored and analyzed the stiffness changes in the targeted fibroid after FUAS, as well as in the myometrium around after FUAS or ME. Results: The stiffness of the myometrium around the resected fibroid was significantly higher than at the preoperative level until 6 months. Conversely, the stiffness of the surrounding myometrium was only temporarily increased 1 day after FUAS. The comparison between FUAS and ME groups regarding the stiffness of the surrounding myometrium showed that nonsignificant differences were detected between the two groups before the treatment. The stiffness of the surrounding myometrium in the ME group was statistically significantly higher than that of the FUAS group 1 day as well as 1, 3, and 6 months after the treatment, respectively. Conclusion: The FUAS had less impact on the surrounding myometrium than the ME, which may be more conducive to the recovery of myometrial elasticity in patients with UF. [ABSTRACT FROM AUTHOR]

• A new FUAS monitoring approach is proposed and evaluated experimentally. • Echos from a 1 MHz-FUS transducer vary slowly with the tissue penetration depth. • Monitoring thermal ablation using the normalized echo amplitude changes. • The echo changes of the FUS transducer are 2∼3 fold greater than those of sonography. • Ex vivo thermal lesion prediction using the FUS transducer is better than sonography. B-mode sonography is commonly used to monitor focused ultrasound ablation surgery (FUAS), but has limitations in sensitivity. More accurate and reliable prediction of coagulation is required. The focused ultrasound (FUS) transducer was adapted for echo reception. Numerical simulations compared the normalized echo amplitudes from the FUS transducer and imaging probe at varying tissue depths and frequencies with a 3 mm necrosis at focus. An ex vivo experiment then evaluated echo changes from the FUS transducer and ultrasound imaging probe under different settings. Finally, coagulation prediction using FUS echo data was compared to sonography in a clinical ex vivo context. The echo amplitudes from the FUS transducer exhibit a less pronounced decline with increasing tissue penetration depth compared to the ultrasound imaging probe. In ex vivo bovine liver experiments at depths of 2 cm and 4 cm, the FUS transducer detected normalized echo amplitudes that were significantly larger (i.e., 2∼3 folds) than those received by the ultrasound imaging probe. Moreover, multi-layered ex vivo tissue experiments that replicate clinical conditions revealed that coagulation prediction utilizing the FUS transducer's echo amplitudes achieved superior accuracy (91.2% vs. 60.3 %), sensitivity (92.1% vs. 54.5 %), and negative prediction (78.9% vs. 30.6 %), but similar specificity (88.2% vs. 84.6 %) and positive prediction (95.9% vs. 93.8 %) in comparison to sonography. The echo amplitude of the FUS transducer serves as a sensitive and dependable metric for monitoring the FUAS outcomes. Its utilization may augment the procedure's safety and efficacy. [ABSTRACT FROM AUTHOR]

Background: The effectiveness and safety of focused ultrasound ablation surgery (FUAS) for primary hepatocellular carcinoma (HCC) treatment has not been fully evaluated. This study analyzed the effectiveness and safety of FUAS compared to radiofrequency ablation (RFA)., Methods: Studies published before November 1, 2020, in the following databases were analyzed: PubMed, Embase, Cochrane Library, Web of Science, Wanfang Data, CqVip, China National Knowledge Infrastructure (CNKI), and Chinese Biomedical (CBM) database. All publications were reviewed independently by two authors. Both randomized controlled trials (RCTs) and cohort studies examining the effectiveness and safety of FUAS and RFA were considered. RCTs and cohort studies' methodological quality were evaluated using the Cochrane collaboration tool and the Newcastle-Ottawa Scale, respectively., Results: A total of 6,597 records were identified, from which 3 cohort studies were selected for quantitative synthesis. All studies had relatively high methodological quality. The meta-analysis indicated that FUAS and RFA had comparable 3-month overall survival (OS) rates [risk ratio (RR): 0.99, 95% confidence interval (CI): 0.86 to 1.14], 6-month OS rates (RR: 1.03, 95% CI: 0.82 to 1.29), and 1-year OS rates (RR: 0.96, 95% CI: 0.84 to 1.11). Also, individual studies reported that the tumor response (reflected by tumor response and tumor ablation rate) and posttreatment complications were comparable between patients treated with FUAS and patients treated with RFA. Due to the limited number of studies reporting tumor response and posttreatment complications, further meta-analyses could not be conducted., Discussion: FUAS and RFA were comparable in terms of effectiveness and safety in the treatment of primary HCC. However, current evidence is limited, and more prospective RCTs are warranted to confirm these findings., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tcr-20-3458). The authors have no conflicts of interest to declare., (2021 Translational Cancer Research. All rights reserved.)