Focused Ultrasound Therapy
Focused ultrasound is a rapidly evolving, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with adenomyosis. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue.
How it Works
Where the beams converge, focused ultrasound produces precise ablation (thermal destruction of tissue) enabling adenomyosis to be treated without surgery.
Advantages
The primary options for treatment of adenomyosis include medication and surgery.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost and with a shorter recovery time. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary. The treatment has the potential to preserve fertility, because the uterus is not removed. Case studies have reported that women have conceived and had healthy babies after focused ultrasound.
Clinical Trials
A clinical trial is underway in Finland that is assessing focused ultrasound to treat adenomyosis as well as the impact for fertility after the procedure.
A clinical trial is underway in China that is treating adenomyosis in patients with refractory infertility with the goal of enhancing fertility.
See a full list of adenomyosis clinical trials >
See a list of treatment sites >
See a list of clinical trials sites >
See a list of laboratory research sites >
Regulatory Approval and Reimbursement
Several companies have approval to treat adenomyosis in Europe, Russia, China, Korea, the Middle East, and Taiwan.
To the best of our knowledge, focused ultrasound treatment of adenomyosis is not universally reimbursed by medical insurers in the US.
Notable Papers
Zhang Q, Chen Y, Lai M, Li Y, Li Q, Fu C, Yao Z, Zhang J. Magnetic Resonance Imaging-guided Focused Ultrasound Surgery in a Swine Adenomyosis Model. Acad Radiol. 2023 Jan 7:S1076-6332(22)00639-0. doi: 10.1016/j.acra.2022.11.034.
Zhu H, Ma Q, Dong G, Yang L, Li Y, Song S, Mu Y. Clinical evaluation of high-intensity focused ultrasound ablation combined with mifepristone and levonorgestrel-releasing intrauterine system to treat symptomatic adenomyosis. Int J Hyperthermia. 2023;40(1):2161641. doi: 10.1080/02656736.2022.2161641.
Zhong Q, Yang MJ, Hu Y, Jiang L, Yu JW, Chen JY, Chen WZ. Factors influencing treatment decisions in HIFU treatment of adenomyosis: A retrospective study. Front Surg. 2022 Oct 12;9:941368. doi: 10.3389/fsurg.2022.941368. eCollection 2022.
Zhao TT, Pang LL, Yang LL, Li RN, Fan LX, Wen Y. Efficacy of high-intensity focused ultrasound combined with LNG-IUS for adenomyosis: a systematic review and meta-analysis. Arch Gynecol Obstet. 2022 Aug 10. doi: 10.1007/s00404-022-06720-z.
Chen H, Tan X, Xiong W, Xie Y, Wang X. Expulsion of adenomyotic lesion into uterine cavity after high-intensity focused ultrasound ablation. J Minim Invasive Gynecol. 2022 Jul 24:S1553-4650(22)00295-3. doi: 10.1016/j.jmig.2022.07.009.
Xiao X, Gong CM, Zhang R, Zhang L, Wang ZB. Clinical efficacy of focused ultrasound ablation surgery in the treatment of internal adenomyosis. Zhonghua Fu Chan Ke Za Zhi. 2022 Apr 25;57(4):259-264. doi: 10.3760/cma.j.cn112141-20210915-00521.
Lai THT, Seto MTY, Cheung VYT. Uterine rupture following ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroids and adenomyosis. Ultrasound Obstet Gynecol. 2022 Jun 24. doi: 10.1002/uog.24983.
Lai M, Chen Y, Li H, Li Y, Wu S, Li Z, Zhang Q. A Modified Bowel Displacement Technique for Magnetic Resonance Imaging-Guided Focused Ultrasound Surgery in the Treatment of Uterine Fibroids and Adenomyosis. J Comput Assist Tomogr. 2022 Apr 8. doi: 10.1097/RCT.0000000000001301.
Shun Wong FW, Li TK. Noninvasive High-intensity Focused Ultrasound Surgeries for Fibroids and Adenomyosis during COVID-19 Pandemic in Hong Kong: A Gynecologist’s Viewpoint. Gynecol Minim Invasive Ther. 2021 Nov 5;10(4):272-273. doi: 10.4103/GMIT.GMIT_18_21. eCollection 2021 Oct-Dec.
Cui Y, Yao L, Feng M, Zhang J, Zhang D. [Diffusion-weighted magnetic resonance imaging instead of contrast-enhanced imaging for evaluating immediate therapeutic efficacy of high-intensity focused ultrasound ablation of adenomyosis]. Nan Fang Yi Ke Da Xue Xue Bao. 2021 Oct 20;41(10):1583-1587. doi: 10.12122/j.issn.1673-4254.2021.10.19.
Huang Y, Zhou S, Wang J, Pang Z. Efficacy and safety of magnetic resonance-guided focused ultrasound surgery (MRgFUS) ablation in the management of abnormal uterine bleeding due to uterine leiomyoma or adenomyosis. Am J Transl Res. 2022 Jan 15;14(1):656-663. eCollection 2022.
Wong WSF, Lee MHM, Wong PH. A Journey from Learning a Noninvasive High-intensity Focused Ultrasound Surgical Treatment for Gynecological Diseases to Providing High-intensity Focused Ultrasound Services in Hong Kong. Gynecol Minim Invasive Ther. 2021 Apr 30;10(2):71-74. doi: 10.4103/GMIT.GMIT_23_21. eCollection 2021 Apr-Jun.
Gong C, Wang Y, Lv F, Zhang L, Wang Z. Evaluation of high intensity focused ultrasound treatment for different types of adenomyosis based on magnetic resonance imaging classification. Int J Hyperthermia. 2022;39(1):530-538. doi: 10.1080/02656736.2022.2052366.
Click here for additional references from PubMed.
Video courtesy of Insightec.
