International Journal of Hyperthermia最新文献

{"title":"Prediction of clinical outcome for high-intensity focused ultrasound ablation of adenomyosis based on non-enhanced MRI radiomics.","authors":"Ziyi Liu, Ziyan Liu, Xiyao Wan, Yuan Wang, Xiaohua Huang","doi":"10.1080/02656736.2025.2468766","DOIUrl":"https://doi.org/10.1080/02656736.2025.2468766","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to develop a non-enhanced MRI-based radiomics model for the preoperative prediction of the efficacy of adenomyosis after high-intensity focused ultrasound (HIFU) treatment.</p><p><strong>Methods: </strong>The data of 130 patients with adenomyosis who underwent HIFU treatment were reviewed. Based on a non-perfused volume ratio (NPVR) of 50%, the patients were assigned to high ablation rate and low ablation rate groups. A radiomics model was constructed from the screened radiomics features and its output probability was calculated as the radiomics score (Radscore). The clinical-imaging model was constructed from the independent predictors of clinical-imaging characteristics. The combined model was constructed by integrating Radscore and clinical-imaging independent predictors. Receiver operating characteristic (ROC) curves, the Delong test, and decision curve analysis (DCA) were used to evaluate the models.</p><p><strong>Results: </strong>The combined model had the best overall performance among the three models. The AUC (95% CI), specificity, sensitivity, accuracy, and precision of the combined model were 0.860 (0.786-0.935), 0.780, 0.756, 0.769, 0.738 in the training set, and 0.878 (0.774-0.983), 0.859, 0.667, 0.769, 0.800 in the test set, respectively. The Delong test showed that the performance of both the radiomics and combined models differed significantly from the clinical-imaging model. But the performance of the combined and the radiomics model was statistically equivalent. The DCA indicated that the combined model had better clinical net benefit.</p><p><strong>Conclusion: </strong>The combined model based on non-enhanced MRI radiomics was effective in predicting the outcome of HIFU ablation of adenomyosis before surgery.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"42 1","pages":"2468766"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addition of PARP1-inhibition enhances chemoradiotherapy and thermoradiotherapy when treating cervical cancer in an <i>in vivo</i> mouse model.","authors":"Marloes IJff, Xionge Mei, Enzo M Scutigliani, Hans M Rodermond, Gregor G W van Bochove, Przemek M Krawczyk, Nicolaas A P Franken, Lukas J A Stalpers, Johannes Crezee, Arlene L Oei","doi":"10.1080/02656736.2025.2450514","DOIUrl":"https://doi.org/10.1080/02656736.2025.2450514","url":null,"abstract":"<p><p><b>Background:</b> Efficacy of current treatment options for cervical cancer require improvement. Previous <i>in vitro</i> studies have shown the enhancing effects of the addition of PARP1-inhibitors to chemoradiotherapy and thermoradiotherapy. The aim of our present study was to test efficacy of different combinations of treatment modalities radiotherapy, cisplatin, hyperthermia and PARP1-inhibitors using <i>in vitro</i> tumor models, <i>ex vivo</i> treated patient samples and <i>in vivo</i> tumor models.</p><p><p><b>Materials and Methods:</b> <i>In vitro</i> clonogenic survival curves (0-6 Gy) show that PARP1<i>-i</i> (4-5 M Olaparib) enhances both chemoradiotherapy (0.3-0.5 µM cisplatin) and thermoradiotherapy (42 °C for 1 h) in SiHa, CaSki and HeLa cells. A cervical cancer mouse model and freshly obtained in-house developed patient-derived organoids were used to examine the effects of different treatment combinations. For the <i>in vivo</i> study, human cervical cancer (SiHa) cells were injected in the right hind leg of athymic nude mice. <i>In vivo</i> mouse experiments show that PARP1<i>-i</i> enhances thermoradiotherapy or chemoradiotherapy by reduction of tumor volumes. Five cycles of treatment were applied with the following doses per cycle: irradiation 3 Gy, hyperthermia 1 h at 42 °C, cisplatin at 2 mg/kg, and twice PARP1<i>-i</i> at 50 mg/kg.</p><p><p><b>Results:</b> Quadruple treatment, combining radiotherapy, hyperthermia, cisplatin and PARP1<i>-i</i>, was very effective but also lead to severe side effects causing severe weight loss and death. In contrast, thermoradiotherapy or chemoradiotherapy with addition of PARP1-<i>i,</i> were effective without serious side effects.</p><p><p><b>Conclusion:</b> The triple combinations are promising options for potentially more effective treatment of locally advanced cervical cancer without more toxicity.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"42 1","pages":"2450514"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicted SAR/temperature changes induced by phase-amplitude steering are minimally affected by uncertainties in tissue properties: a basis for robust on-line adaptive hyperthermia treatment planning.","authors":"H P Kok, J Crezee","doi":"10.1080/02656736.2025.2483433","DOIUrl":"https://doi.org/10.1080/02656736.2025.2483433","url":null,"abstract":"<p><strong>Background: </strong>Reliability of absolute specific absorption rate (SAR)/temperature levels predicted by treatment planning is strongly affected by tissue parameter uncertainties. Therefore, regular re-optimization to suppress hot spots can accidentally induce new hot spots elsewhere. Adaptive planning methods to avoid this problem re-optimize with respect to the current predicted 3D-distribution. This strategy is robust if reliability of predicted SAR/temperature changes (i.e., increases/decreases) after phase-amplitude adjustments is minimally affected by parameter uncertainties; this work evaluated this robustness.</p><p><strong>Methods: </strong>We validated the basic concept in an inhomogeneous phantom, followed by a patient model. Uncertainties in electrical conductivity, permittivity and perfusion were mimicked by simulations using 100 random parameter samples from normal distributions. Reliability of predicted SAR/temperature increase/decrease after phase-amplitude adjustments was evaluated. Next, correlations between measured and simulated SAR and SAR changes were determined for phase settings evaluated at the treatment start for a treatment series. Finally, practical use in an adaptive workflow was illustrated.</p><p><strong>Results: </strong>Local SAR/temperature increases/decreases after phase-amplitude adjustments can be predicted accurately. For the phantom, the measured 28.5% SAR decrease was predicted accurately(28.5 ± 0.7%). In the patient model, predicted SAR/temperature changes were typically accurate within a few percent. For the treatment series, correlations between measured and simulated (relative) SAR changes were much better(R²=0.70-0.82) than for absolute SAR levels(R²=0.29). Predictions of steering effects during treatment corresponded qualitatively with measurements/observations.</p><p><strong>Conclusion: </strong>Predictions of SAR/temperature increases/decreases induced by phase-amplitude steering are hardly affected by tissue parameter uncertainties. On-line adaptive planning based on predicted changes is thus robust to effectively support clinical steering strategies.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"42 1","pages":"2483433"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A translational review of hyperthermia biology.","authors":"Mark W Dewhirst","doi":"10.1080/02656736.2024.2447952","DOIUrl":"https://doi.org/10.1080/02656736.2024.2447952","url":null,"abstract":"<p><p>This review was written to be included in the Special Collection 'Therapy Ultrasound: Medicine's Swiss Army Knife?' The purpose of this review is to provide basic presentation and interpretation of the fundamentals of hyperthermia biology, as it pertains to uses of therapeutic ultrasound. The fundamentals are presented but in the setting of a translational interpretation and a view toward the future. Subjects that require future research and development are highlighted. The effects of hyperthermia are time and temperature dependent. Because intra-tumoral temperatures are non-uniform in tumors, one has to account for differential biologic effects in different parts of a tumor that occur simultaneously during and after hyperthermia.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"42 1","pages":"2447952"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nec-1 regulates phenotypic transformation of heat stroke-induced vascular smooth muscle cells by inhibiting RIPK1.","authors":"Le Mu, Shujing Xue, Wei Tuo, Xiaomin Wu, Ling Hou, Guanghua Li","doi":"10.1080/02656736.2025.2463477","DOIUrl":"https://doi.org/10.1080/02656736.2025.2463477","url":null,"abstract":"<p><strong>Objective: </strong>Cardiovascular injury is a common complication of heat stroke (HS). However, the mechanism underlying vascular smooth muscle cells (VSMCs) following HS remains unclear.</p><p><strong>Method: </strong>A rat and VSMCs model was established by simulating high-temperature exposure. Primary VSMC was extracted <i>in vitro</i>, and CCK8 screened the concentration of Nec-1 and detected cell proliferation activity. The expression of α-smooth muscle protein (α-SMA), osteopontin (OPN), receptor-interacting protein kinase 1 (RIPK1), receptor-interacting protein kinase 3 (RIPK3), Bcl-2 and Bax were detected by immunohistochemistry and Western blot.</p><p><strong>Results: </strong>The results of <i>in vivo</i> experiments showed that with the prolongation of HS recovery time, α-SMA expression basically decreased and OPN expression increased. Meanwhile, the expression of RIPK1 and RIPK3 was increased, which promoted the occurrence of necroptosis. <i>In vitro</i> results showed that with the extension of HS recovery time, the proliferative viability of VSMCs decreased, the cell morphology changed, and the apoptotic cells increased. The fluorescence results indicate that the expression levels of RIPK1 and PIPK3 in the cells are elevated, accompanied by the typical characteristics of cell necroptosis. Nec-1 restored the decreased cell viability and the high expression of RIPK1 and RIPK3 induced by heat stroke, and improved the occurrence of cell necrotic apoptosis. Nec-1 also restored α-SMA expression, reduced OPN expression, and reversed phenotypic abnormalities of VSMC caused by heat stroke.</p><p><strong>Conclusion: </strong>HS induces abnormal phenotypic transformation and necroptosis in VSMCs. Necrostatin-1 can improve necroptosis and maintain the contractile phenotype of VSMCs. This study can provide new insights into cardiovascular damage caused by high temperatures.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"42 1","pages":"2463477"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conventional magnetic resonance imaging combined with three-dimensional ultrasound for preoperative prediction of immediate ablation rate in high-intensity focused ultrasound treatment of uterine fibroids.","authors":"Qiong Hao, Junwei Liu, Ruoying Hou, Wenxia Huang, Juan Liao, Zhenjiang Lin, Tijiang Zhang","doi":"10.1080/02656736.2024.2448545","DOIUrl":"https://doi.org/10.1080/02656736.2024.2448545","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the effectiveness of conventional magnetic resonance imaging (MRI) combined with three-dimensional (3D) ultrasound for the preoperative prediction of nonperfused volume ratio (NPVR) in uterine fibroids after high-intensity focused ultrasound (HIFU) ablation.</p><p><strong>Materials and methods: </strong>In total, 178 patients who had undergone HIFU ablation therapy for uterine fibroids between July 2021 and August 2023 were enrolled. Baseline clinical, MRI, and 3D ultrasound parameters collected before and after HIFU ablation were analyzed. Multiple linear regression models were constructed for conventional MRI parameters alone and for combined MRI-3D ultrasound parameters to predict NPVR. Paired-sample <i>t</i>-tests and Pearson's correlation were employed to assess relationships between predicted and actual NPVR values. The prediction efficacy of both models was statistically compared.</p><p><strong>Results: </strong>The combined MRI-3D ultrasound model outperformed the conventional MRI model, with adjusted <i>R</i>² values of 0.597 and 0.553, respectively, both statistically significant (<i>p</i> < 0.05). The combined model revealed that signal intensity on T₂-weighted imaging, degree of enhancement on contrast-enhanced T₁-weighted imaging, maximum distance between the fibroid's dorsal surface and the skin, uterine fibroid vascular network, and fibroid vascularization negatively affected NPVR. The predicted NPVR was significantly correlated with the actual NPVR (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>3D ultrasound provided essential information for screening fibroids and predicting NPVR before HIFU ablation, serving as a valuable supplement to MRI. The combined MRI-3D ultrasound model shows promise for the preoperative prediction of NPVR in patients with uterine fibroids treated with HIFU and may offer substantial clinical value.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"42 1","pages":"2448545"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of targeting accuracy of cone beam CT guided histotripsy in an <i>in vivo</i> porcine model.","authors":"Martin G Wagner, Grace M Minesinger, Katrina L Falk, Ayca Z Kutlu, Meridith A Kisting, Michael A Speidel, Timothy J Ziemlewicz, J Louis Hinshaw, John F Swietlik, Fred T Lee, Paul F Laeseke","doi":"10.1080/02656736.2025.2455138","DOIUrl":"10.1080/02656736.2025.2455138","url":null,"abstract":"<p><strong>Purpose: </strong>The application of histotripsy, an emerging noninvasive, non-ionizing, and non-thermal tumor treatment, is currently limited by the inherent limitations of diagnostic ultrasound as the sole targeting modality. This study evaluates the feasibility and accuracy of cone beam computed tomography (CBCT) guidance for histotripsy treatments in an <i>in vivo</i> porcine model.</p><p><strong>Materials and methods: </strong>Histotripsy treatments were performed in the liver of seven healthy swine under the guidance of a C-arm CBCT system that was calibrated to the robotic arm of the histotripsy system. For each treatment, pseudotumors (small histotripsy treatments of 15 mm) were created using conventional US guidance to serve as targets for subsequent CBCT guided treatments. A pretreatment CBCT with intravenous contrast was acquired for each swine and the center of the pseudotumor was selected as the target. The robotic arm automatically aligned the transducer to the selected target location. Ultrasound based aberration offset correction was performed when possible, and a 25 mm diameter treatment was performed. A post-treatment CBCT with intravenous contrast was then acquired to evaluate coverage, treatment size, and distance between the pseudotumor target and actual treatment zone center.</p><p><strong>Results: </strong>Treatments were technically successful and pseudotumors were completely covered in all seven treatments (7/7). The average treatment diameter was 39.3 ± 4.2 mm. The center-to-center distance between pseudotumor and actual treatments was 3.8 ± 1.3 mm.</p><p><strong>Conclusion: </strong>CBCT provides accurate targeting for histotripsy treatment <i>in vivo</i>. While future work is required to assess safety and efficacy in the presence of obstructions, the proposed approach could supplement ultrasound imaging for targeting.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"42 1","pages":"2455138"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoarthritis-related knee pain: MRI-guided focused ultrasound ablation treatment.","authors":"Christin A Tiegs-Heiden, Zaiyang Long, Aiming Lu, Krzysztof R Gorny, Gina K Hesley","doi":"10.1080/02656736.2025.2451686","DOIUrl":"https://doi.org/10.1080/02656736.2025.2451686","url":null,"abstract":"<p><p><b>Objective:</b> Osteoarthritis of the knee is a common cause of pain, functional disability, and reduced quality of life in the elderly. Despite its prevalence, there are limited currently available noninvasive treatment options. MRI-guided focused ultrasound (MRgFUS) is a noninvasive thermal ablation method which is used in a spectrum of musculoskeletal conditions. It is FDA approved for the treatment of painful bone metastases and osteoid osteoma and has been considered for the treatment of other painful conditions such as osteoarthritis. The purpose of this case report is to describe the use of MRgFUS for the treatment of osteoarthritic knee pain in an active 72-year-old male.</p><p><p><b>Method:</b> The patient suffered significant limitations due to lateral knee pain with jogging and walking down the stairs. MRgFUS ablation treatment was performed to the lateral knee, targeting the periosteum in the patients' area of pain.</p><p><p><b>Results:</b> Following treatment, the patient experienced considerable reduction in his activity limiting symptoms with a duration of at least 6 months.</p><p><p><b>Conclusions:</b> It is important for radiologists to be aware of MRgFUS as an innovative ablation modality. Similar pain reduction was observed in two small series of MRgFUS treatment of knee pain from Japan. MRgFUS appears promising as a safe, noninvasive treatment option for temporary relief of knee pain. This may be particularly valuable for patients who are unwilling or unable to undergo total knee arthroplasty. Future study is needed to assess the efficacy and safety of this treatment in a larger population.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"42 1","pages":"2451686"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid nodule rupture after thermal ablation for benign thyroid nodules: incidence, risk factors, and clinical management.","authors":"Yu-Tong Liu, Ying Wei, Zhen-Long Zhao, Jie Wu, Shi-Liang Cao, Na Yu, Yan Li, Li-Li Peng, Ming-An Yu","doi":"10.1080/02656736.2024.2439536","DOIUrl":"https://doi.org/10.1080/02656736.2024.2439536","url":null,"abstract":"<p><strong>Background: </strong>Thyroid nodule rupture (TNR) is a rare and severe complication after thermal ablation (TA), mostly from benign thyroid nodules (BTN).</p><p><strong>Objective: </strong>To summarize the incidence of TNR after TA and analyze the causes and prevention strategies.</p><p><strong>Materials and methods: </strong>This retrospective study enrolled 3971 patients who underwent TA for BTN from January 2014 to March 2024. The incidence, causes, and risk factors of TNR were analyzed. Propensity score matching (PSM) controlled for confounding factors. Multivariate regression identified risk factors for TNR. ROC curves determined the optimal cutoff value for the maximum diameter (MD) for TNR.</p><p><strong>Results: </strong>TNR occurred in 8 cases [0.2% (8/3971)]. The mean time from TA to TNR was 29.6 ± 13.0 days (range, 20-60 days). After PSM, MD was larger in the TNR group than in the non-TNR group [mean 4.1 ± 1.6 cm vs. mean 1.8 ± 1.2 cm; <i>p</i> < 0.001]<u>.</u> The optimal cutoff value of MD for TNR was 2.75 cm. After PSM, the incidence of pressure on the ablation zone was significantly higher in the TNR group than in the non-TNR group [100% (8/8) vs. 0 (0/32); <i>p</i> < 0.001], which has been suspected as a case of TNR. Antibiotic drugs, aspiration, or incision drainage could successfully manage all TNR cases.</p><p><strong>Conclusion: </strong>TNR could be encountered in case of pressure on the BTN after TA. Protecting the ablation site from pressure might be crucial in preventing TNR, especially within two months. TNR is more likely to occur if the MD of BTN exceeds 2.75 cm under pressure. Observation, antibiotics, and aspiration could successfully manage all TNR cases.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"42 1","pages":"2439536"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of focused ultrasound ablation surgery in patients with adenomyosis and coexisting pelvic adhesions.","authors":"Jinfeng Lin, Zhiyun Yang, Lu Wang, Zhibo Xiao, Tao Tan, Jinyun Chen","doi":"10.1080/02656736.2025.2461456","DOIUrl":"https://doi.org/10.1080/02656736.2025.2461456","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to assess the efficacy of focused ultrasound ablation surgery (FUAS) in treating patients with adenomyosis and coexisting pelvic adhesions.</p><p><strong>Materials and methods: </strong>A total of 396 patients diagnosed with adenomyosis and who underwent FUAS between January 2014 and December 2022 were enrolled. Pelvic adhesions were evaluated using magnetic resonance imaging (MRI), and the patients were categorized into either adhesive group or non-adhesive group. The aim was to investigate the comparative efficacy between the two groups.</p><p><strong>Results: </strong>Among the 396 patients, pelvic adhesions were detected in 123 (31.06%) women. Compared to the non-adhesive group, patients in the adhesive group exhibited a higher preoperative dysmenorrhea score (7 <i>vs.</i> 6, <i>p</i>  < 0.001), a lower short-term clinical success rate (74.80% <i>vs.</i> 84.62%, <i>p</i> = 0.025), and a higher long-term cumulative recurrence rate (log-rank <i>p</i> = 0.009). The adhesive group exhibited a high incidence of anal discomfort during the procedure compared to the non-adhesive group (18.70% <i>vs.</i> 7.69%, <i>p</i> = 0.002). Additionally, patients with severe adhesion demonstrated a lower ratio of non-perfused volume ratio (NPVR) (38.81% <i>vs.</i> 46.58%, <i>p</i> = 0.009). Multivariate binary logistic regression analysis revealed that pelvic adhesion independently increased the risk of dysmenorrhea (OR = 4.730, 95%CI: 2.026-11.044, <i>p</i> < 0.001), while severe pelvic adhesion was identified as an independent risk factor for NPVR (OR = 2.226, 95%CI: 1.181-4.196, <i>p</i> = 0.013).</p><p><strong>Conclusion: </strong>The preoperative assessment of pelvic adhesions plays a crucial role in predicting intraoperative adverse events of FUAS in patients with adenomyosis, as well as determining both short-term and long-term efficacy, thereby providing valuable guidance for the development of comprehensive treatment.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"42 1","pages":"2461456"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}