International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group最新文献

{"title":"Dielectric properties, thermal properties, blood perfusion rate: which biophysical parameter is the leading source of variability of microwave ablation models in lung?","authors":"Anna Bottiglieri, Punit Prakash","doi":"10.1080/02656736.2026.2685124","DOIUrl":"10.1080/02656736.2026.2685124","url":null,"abstract":"<p><strong>Background: </strong>The large variability in outcomes following microwave ablation (MWA) of pulmonary tumors highlights a need for quantitative methods to assess 3D temperature profiles accounting for tissue-specific biophysical characteristics. The goal of this study is to identify the least and most influential biophysical parameters on the ablation zone.</p><p><strong>Methods: </strong>A computational bioheat transfer model was built to simulate a 2.45 GHz microwave applicator positioned within a 2 cm diameter tumor. Simulations were conducted using 60 W - 10 min energy settings and considering low and high values of: 1) relative permittivity, 28.3-50.4 and effective conductivity, 1.0-1.9 (Sm^-1); 2) volumetric heat capacity, 1.3-3.5 (MJm^-3K^-1) and thermal conductivity 0.2-0.4 (Wm^-1K^-1); 3) blood perfusion rate of tumor periphery-parenchyma, 5-9 (kgm^-3s^-1). Length (L₆₀) and diameter (D₆₀) of the 60 °C isotherm, volumetric thermal coverage of the tumor without (TM0) and with 5 mm margin (TM5) were quantified.</p><p><strong>Results: </strong>The variabilities in the volumetric heat capacity and blood perfusion rate at the tumor-lung parenchyma boundary yield differences between 5.7 - 11.4% (TM5), 3.1-4.6 mm (D₆₀), 3.0-4.4 mm (L₆₀). Variabilities in baseline values of dielectric properties yield 3% (TM5) and 1.2 mm (D₆₀ and L₆₀) differences.</p><p><strong>Conclusion: </strong>Thermal properties and blood perfusion between tumor and surrounding tissue are the most impactful parameters on achieving adequate treatment margin following lung MWA. This quantitative analysis provides insight on the tissue biophysical properties that warrant deeper experimental assessment in order to inform treatment planning of lung MWA.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2685124"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of focused ultrasound in the treatment of cervical squamous intraepithelial lesion on vaginal microbiota and cervical immune microenvironment: a prospective observational study.","authors":"Yan Peng, Linlin Xiao, Qing Feng, Jing Liang, Xuerui Zhang, Shufang Chang","doi":"10.1080/02656736.2026.2732518","DOIUrl":"10.1080/02656736.2026.2732518","url":null,"abstract":"<p><strong>Purpose: </strong>To observe the changes in the vaginal microbiota and cervical immune microenvironment following focused ultrasound treatment of cervical squamous intraepithelial lesions, with clinical efficacy assessed for contextual validation.</p><p><strong>Methods: </strong>The case group comprised 50 patients with cervical squamous intraepithelial lesions who underwent focused ultrasound treatment and completed longitudinal collection of cervical secretions at pretreatment, 1-2 weeks, and (14 ± 2) weeks post-treatment. According to the treatment response at (14 ± 2) weeks, the case group was further classified into cure (histopathologically confirmed absence of SIL, or normal cytology and colposcopy) and improvement (decreased SIL level on histopathology or cytology with corresponding colposcopy) subgroups. These patients were compared with 17 healthy individuals (the control group). Changes in the levels of DEFB1, IFN-γ, IL-1β, IL-8, IL-10, SIgA, SLPI, and the Th1/Th2 ratio were measured in cervical secretions. Meanwhile, vaginal microbiota was examined in both groups at baseline and (14 ± 2) weeks post-treatment.</p><p><strong>Results: </strong>(1) Following focused ultrasound treatment, levels of DEFB1, IL-1β, IL-8, SIgA, and SLPI in cervical secretions were significantly decreased at (14 ± 2) weeks post-treatment in the cure group compared with pretreatment levels (<i>p</i> < 0.05). (2) Compared with pretreatment levels in the cure group, vaginal microbiota indicators-including pH, Nugent score, bacterial diversity, bacterial density, and Lactobacillus abundance-were significantly normalized at (14 ± 2) weeks post-treatment (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Focused ultrasound treatment may contribute to regression of cervical squamous intraepithelial lesions and may be associated with restoration of vaginal microbiota and cervical immune microenvironment.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2732518"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative thyroglobulin antibody positivity is associated with delayed absorption after microwave ablation for papillary thyroid carcinoma.","authors":"Qingqing Tang, Qiushuang Li, Xuexin Liang, Guicai Luo, Yanghui Wei","doi":"10.1080/02656736.2026.2688995","DOIUrl":"https://doi.org/10.1080/02656736.2026.2688995","url":null,"abstract":"<p><strong>Background: </strong>Microwave ablation (MWA) has emerged as a minimally invasive alternative to surgery for selected patients with low-risk papillary thyroid carcinoma (PTC). While thyroid autoimmunity is frequently observed in PTC, the impact of preoperative thyroid autoantibodies (TAb) on post-ablation absorption kinetics remains unclear.</p><p><strong>Methods: </strong>This retrospective study included 150 patients with PTC who underwent MWA between December 2019 and December 2024 with a median follow-up of 18 months (range: 6-54 months). Patients were categorized according to preoperative thyroid autoantibody status. Volume reduction rate, complete absorption rate, tumor recurrence rate, incidence of new nodules, and thyroid function were evaluated during follow-up. Kaplan-Meier analysis and Cox proportional hazards regression were used to assess factors associated with time to complete absorption.</p><p><strong>Results: </strong>During follow-up, ablation zone volume gradually decreased in all patients, but absorption was significantly slower in TAb-positive patients. The TAb-positive group exhibited a longer median time to complete absorption than the TAb-negative group (median: 30 vs. 19 months; log-rank <i>p</i> = 0.01). Subgroup analyses demonstrated that preoperative thyroglobulin antibody (TgAb) positivity, but not thyroid peroxidase antibody (TPOAb) positivity, was significantly associated with delayed absorption. TgAb positivity remained independently associated in multivariate Cox analysis (adjusted hazard ratio = 0.27; 95% confidence interval: 0.09-0.78; <i>p</i> = 0.015). No malignant recurrence occurred. TPOAb-positive patients showed a higher incidence of newly detected benign nodules. Thyroid function remained stable throughout follow-up.</p><p><strong>Conclusions: </strong>Preoperative TgAb positivity is associated with delayed absorption of the ablation zone after MWA for PTC without compromising treatment completeness.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2688995"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic characteristic changes in local tissues after high-intensity focused ultrasound treatment for uterine fibroids.","authors":"Yan Mu, Tong Zhu, Xue Ming, Xi Yang, Kun He, Guohua Huang, Xiaofang Liu, Qiuling Shi","doi":"10.1080/02656736.2026.2639437","DOIUrl":"10.1080/02656736.2026.2639437","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the changes in the metabolome of fibroid tissue after high-intensity focused ultrasound (HIFU) treatment, providing insights into its potential mechanisms of action.</p><p><strong>Materials and methods: </strong>Thirty patients with uterine fibroids who scheduled for hysterectomy were included. Among them, 15 patients had HIFU previously (HIFU group), and 15 patients did not receive HIFU (Control group). The tissues of treated fibroid, myometrium, endometrium, and new-emerging fibroids were collected. Gas chromatography-mass spectrometry (GC-MS) was applied for metabolomic analysis.</p><p><strong>Results: </strong>GC-MS metabolomics analysis identified 94 metabolites. There was no significant difference in metabolite profile between the newly emerged fibroid tissue in the HIFU group and fibroid tissue in the Control group, and also no significant difference in the myometrial tissue and endometrial tissue between the two groups. In contrast, a significant difference was observed in metabolites between the treated fibroid tissue and the myometrial tissue in HIFU group. The levels of malus pumila acid, dimethyl fumarate, fumaric acid, methylphenylacetic acid, benzoic acid, and phosphoenolpyruvic acid were significantly higher (<i>p</i> < 0.05), and acetophenone, hexanoic acid, and idketoglutaric acid monoamide exhibited significantly decreased levels in the HIFU group (<i>p</i> < 0.05). Biomarker analysis revealed that malus pumila acid and nicotinic acid were elevated in the HIFU group, whereas erketoglutaric acid monoamide, hexanoic acid, and acetophenone were significantly reduced (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>HIFU ablation may have a reprogramming effect on energy metabolism in the treated fibroids. The findings of this study provide a new direction for exploring the future development of biomarkers for combined metabolic regulation therapy.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2639437"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of capacitive hyperthermia as an adjunct treatment in oncology: a systematic review of randomized phase III trials.","authors":"Paul Krahl, Kagayaki Kuroda, Jorge Contreras, Hans Crezee, Udo S Gaipl, H Petra Kok, Carrie Minnaar, Felix Navarro, Daniel Zips, Pirus Ghadjar, Takayuki Ohguri","doi":"10.1080/02656736.2026.2678876","DOIUrl":"10.1080/02656736.2026.2678876","url":null,"abstract":"<p><strong>Introduction: </strong>Capacitive hyperthermia (cHT) has been established for superficial tumors but the efficacy of cHT for intermediate or deep-seated tumors remains a subject of debate. This review is an evaluation of the current clinical evidence on the effectiveness of cHT in the treatment of tumors that are located deeper within the body.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with the PRISMA guidelines of Phase III randomized controlled trials that included cancer patients of all ages and sexes with confirmed malignant tumors undergoing radiotherapy (RT) and/or chemotherapy (CT), with or without additional cHT. The literature search was conducted in PubMed and the Cochrane Register of Controlled Trials (CENTRAL). The primary endpoints included overall survival (OS), tumor response (TR; encompassing complete response (CR)), local control (LC), and cHT treatment-related toxicity (TRT).</p><p><strong>Results: </strong>A total of nine randomized phase III trials were included in the study. The combination of cHT with RT and/or CT was found to improve both LC and OS in three out of five trials conducted in patients with cervical cancer. The analysis of both head and neck cancer trials demonstrated a marked increase in TR rates in cases where cHT was employed. Conversely, no such benefit was observed in non-small cell lung cancers and in a large multicenter cervical cancer trial. The treatment was well tolerated, with mild to moderate adverse events being the most common.</p><p><strong>Conclusion: </strong>It has been demonstrated that the combination of cHT with either RT or CT may improve TR and LC and, in certain cases, OS when compared with RT with or without CT alone. The occurrence of significant side effects is rare.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2678876"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review with network meta-analysis: efficacy and safety of minimally invasive interventions for symptomatic uterine fibroids.","authors":"Yue Li, Xing-Yi Wang, Ying Guo, Ying Shen, Fang-Yuan Liu, Dan-Ni Ding, Fang Shen, Chan Li, Feng-Juan Han","doi":"10.1080/02656736.2026.2670499","DOIUrl":"10.1080/02656736.2026.2670499","url":null,"abstract":"<p><strong>Background: </strong>Uterine fibroids (UFs) substantially affect the health of women of reproductive age. Minimally invasive and noninvasive therapies have become the main alternatives to traditional surgery; however, evidence on their comparative efficacy remains fragmented. This network meta-analysis compared high-intensity focused ultrasound (HIFU), radiofrequency ablation (RFA), microwave ablation (MWA), and uterine artery embolization (UAE) with myomectomy (Myo) for symptomatic UFs.</p><p><strong>Methods: </strong>Eight databases were searched (Jan 2016-Dec 2025) for randomized controlled trials (RCTs). ROB 2.0 and Stata 15.1 were used to analyze fibroid volume, recurrence counts, luteinizing hormone [LH], follicle-stimulating hormone [FSH], estradiol [E₂], and adverse events using surface under the cumulative ranking curve (SUCRA) values, weighted mean differences (WMDs), and 95% confidence intervals (95% CIs).</p><p><strong>Results: </strong>Thirty-one RCTs (2622 patients) were included. HIFU ranked highest for fibroid volume reduction (SUCRA = 96.7%; vs UAE: WMD = 10.31, 95% CIs: 3.52-17.10; vs RFA: WMD = 3.66, 95% CIs: 1.71-5.61) and recurrence prevention (SUCRA = 70.1%). Fluctuations in ovarian function indicators across therapies were clinically acceptable. HIFU ranked first for stabilizing LH (SUCRA = 58.4%) and FSH (SUCRA = 68.4%), whereas UAE ranked first for E₂ stability (SUCRA = 77.0%). For safety, MWA (SUCRA = 78.8%) and HIFU (SUCRA = 69.7%) had the lowest incidence of adverse events.</p><p><strong>Conclusion: </strong>HIFU showed overall efficacy advantages, MWA showed a safety advantage, and UAE may suit specific patient populations. This study provides evidence-based support for individualized treatment decisions for UFs. However, these findings require cautious interpretation due to limited evidence.</p><p><strong>Systematic review registration: </strong>PROSPERO (CRD420251273503).</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2670499"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148255500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of thermal dose painting during magnetic nanoparticle thermal therapy: a computational analysis.","authors":"Shreeniket Pawar, Yash Sharad Lad, Nageshwar Arepally, Hayden Carlton, Ma'Moun Abu-Ayyad, Robert Ivkov, Anilchandra Attaluri","doi":"10.1080/02656736.2026.2635293","DOIUrl":"10.1080/02656736.2026.2635293","url":null,"abstract":"<p><strong>Background: </strong>Spatially confined magnetic nanoparticle thermal therapy (SC-MNTT) can improve the tumor coverage index (CI) when the magnetic field-free region (FFR) is manually steered. However, static steering demands significant time and expertise from experienced control engineers during treatment planning.</p><p><strong>Objective: </strong>This study presents a computational framework for automated, dynamic FFR steering combined with real-time tumor boundary temperature control to enhance magnetic nanoparticle thermal therapy (MNTT) for cancer therapy. The framework also supports controlled MNTT treatment planning.</p><p><strong>Method: </strong>We integrated the Pennes bioheat transfer equation with a proportional-integral-derivative (PID) controller to maintain the maximum tumor boundary temperature at 46 °C. The magnetic nanoparticle (MNP) heat source was divided into four subdomains to simulate SC-MNTT. A fuzzy logic controller automatically selected the FFR based on four-point temperature measurements and corresponding thermal dose, aiming to maximize CI. We examined the influence of key treatment parameters: maximum treatment temperature (60 or 80 °C), MNP distribution (uniform or Gaussian), sensor noise, and MNP position relative to the tumor center.</p><p><strong>Results: </strong>Automated dynamic FFR steering increased CI by ∼25-35%, depending on these parameters. The highest CI occurred at a maximum treatment temperature of 80 °C with a uniform MNP distribution. Sensor noise had minimal effect, while minimal offset between the MNP position and tumor center was essential for maximizing CI.</p><p><strong>Conclusion: </strong>The proposed fuzzy logic-based dynamic FFR steering may reduce reliance on expert control engineers for SC-MNTT treatment planning. Future work will focus on pre-clinical implementation and experimental validation of the control system.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2635293"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perfusion response to treatment outcome: CEUS links oxytocin to HIFU efficacy prediction for uterine fibroids.","authors":"Dan-Ling Zhang, Songsong Wu, Guisheng Ding, Xin Wei Chen, Mengqi Chen, Sheng Chen","doi":"10.1080/02656736.2026.2706038","DOIUrl":"https://doi.org/10.1080/02656736.2026.2706038","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate oxytocin-induced perfusion changes in uterine fibroids using contrast-enhanced ultrasound(CEUS) and determine their predictive value for high-intensity focused ultrasound (HIFU) ablation efficacy.</p><p><strong>Methods: </strong>Fifty-five patients (mean age 42.15 ± 5.34 years). with 78 uterine fibroids underwent oxytocin-enhanced HIFU therapy. CEUS was performed before and after intravenous oxytocin infusion (0.10 U/ml over 10 min). Perfusion changes were assessed using two parameters:(1) Arterial-phase Perfusion Delay Time difference (APDTΔt), defined as the time difference in enhancement onset of fibroids before and after oxytocin exposure; (2) Visual Perfusion Grading (VPG), based on relative contrast perfuse reduction of fibroids at the end of the arterial phase(Grade1:≤30%;Grade2:30-70%;Grade3:≥70%). Post-treatment contrast-enhanced pelvic MRI was used to calculate fibroid volume and non-perfused volume(NPV),from which ablation ratio was derived. Fibroids were dichotomized by ablation efficacy (≥70%vs < 70%), and correlation analyses and ROC curves were used to evaluate predictive performance.</p><p><strong>Results: </strong>Fibroids in the <70% ablation group showed a mean APDT(Δt) of 8.32 ± 5.61s and 52.2%(12/23) VPG as Grade1. In the ≥70% group, APDT(Δt) was significantly longer (16.76 ± 12.12 s), and 54.5%(30/55) VPG were Grade3. Both APDT(Δt) and VPG differed significantly between groups (<i>p</i> < 0.05), Showing strong correlations with ablation ratio (<i>r</i> = 0.577 and <i>r</i> = 0.585; both <i>p</i> < 0.001). Thresholds of APDT(Δt) >3.5 s and VPG >1.5 yielded sensitivities of 83.6% and 87.3%, specificity of 65.2% and 52.3%, with AUCs of 0.791 and 0.725, respectively.</p><p><strong>Conclusion: </strong>CEUS can effectively detect oxytocin-mediated perfusion changes in uterine fibroids. These changes are strongly associated with HIFU ablation outcomes, and in particular, Arterial-phase Perfusion Delay Time demonstrates robust predictive value for treatment efficacy.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2706038"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polidocanol augments high-intensity focused ultrasound efficacy for hyperintense fibroids on T2WI: a retrospective cohort study.","authors":"Ming-Tao Yang, Ling Tian, Yu Xia, Hong-Ni He, Chuan Lin, Tian-Wen He, Ying Tang, Hui-Quan Hu, Jun Li","doi":"10.1080/02656736.2025.2612543","DOIUrl":"10.1080/02656736.2025.2612543","url":null,"abstract":"<p><strong>Objective: </strong>To compare the immediate efficacy and safety of high-intensity focused ultrasound (HIFU) monotherapy with the combination of ultrasound-guided intratumoral polidocanol injection and HIFU for the treatment of uterine fibroids with high T2-weighted imaging (T2WI) signal intensity.</p><p><strong>Methods: </strong>In this retrospective study, 116 patients with T2-hyperintense uterine fibroids treated between January 2024 and May 2025 were enrolled. Patients were allocated to either HIFU monotherapy (the H group, <i>n</i> = 63) or combined polidocanol and HIFU therapy (the H + P group, <i>n</i> = 53). Thereafter, therapeutic parameters, the non-perfused volume ratio (NPVR), and adverse events were compared between the two groups after propensity score matching.</p><p><strong>Results: </strong>The matched cohort comprised 53 patients per group. The median NPVR was significantly higher in the H + P group than in the H group (92.57% vs. 77.81%, <i>p</i> < 0.001). Additionally, a significantly greater proportion of patients in the H + P group achieved an NPVR ≥ 80% (87% vs. 43%, <i>p</i> < 0.001) and an NPVR ≥ 90% (60% vs. 9%, <i>p</i> < 0.001). The H + P group also required significantly less sonication time and lower total energy delivery (both <i>p</i> < 0.05). Furthermore, the overall incidence of adverse events was similar between the two groups (73.6% vs. 69.8%, <i>p</i> = 0.506). However, the H + P group exhibited a markedly lower incidence of sacrococcygeal pain (5.7% vs. 45.3%, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Pretreatment with ultrasound-guided intratumoral polidocanol injection may improve the immediate ablation efficacy of HIFU in T2-hyperintense uterine fibroids, reducing energy requirements and mitigating procedure-related sacrococcygeal pain. These findings highlight the potential of this combined therapy and underscore the need for prospective studies to confirm its long-term clinical benefits.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2612543"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subharmonics are not an infallible safety metric for cavitation dynamics.","authors":"Qiang Wu, Michael D Gray, Cameron A B Smith, Luca Bau, Constantin C Coussios, Robin O Cleveland, Eleanor P J Stride","doi":"10.1080/02656736.2026.2620728","DOIUrl":"10.1080/02656736.2026.2620728","url":null,"abstract":"<p><strong>Objective: </strong>There has been a substantial increase in the range of applications for focused ultrasound in recent years with multiple clinical trials reporting promising results. Reliable treatment monitoring protocols will be essential for future clinical development of these therapies. Acoustic emissions provide a valuable source of data for real time monitoring, especially for procedures in which cavitation plays an important role. Currently, however, there is a lack of consensus as to whether specific frequency components (e.g., broadband noise or subharmonics) are more or less valuable as indicators of cavitation. Our aim in this study was to investigate the relationship between cavitation bubble dynamics and corresponding acoustic emissions from single bubbles, with a specific focus on the conditions producing subharmonic emissions.</p><p><strong>Method: </strong>We used a combination of acoustic measurements and ultra-high speed imaging captured simultaneously from single phosphoplipid-coated microbubbles generated using a microfluidic device to control their size and separation.</p><p><strong>Results: </strong>Contrary to much of the literature, we found that there were no well-defined thresholds in any of the frequency components commonly used in cavitation monitoring (harmonics, subharmonics, ultraharmonics or broadband noise) at a driving frequency of 0.5 MHz within a therapeutically relevant range of pressures (0.12-1.2 MPa), nor was there any clear relationship between changes in the vigor of cavitation bubble dynamics and the corresponding subharmonic emissions. In addition, the magnitude of the subharmonic signal power was typically an order of magnitude lower than the local broadband noise, even after compensating for receiver sensitivity.</p><p><strong>Conclusion: </strong>These results suggest that caution is needed in utilizing simple metrics such as the presence or absence of a subharmonic signal as an indicator of cavitation; especially in applications where off-target cavitation represents a safety concern.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"43 1","pages":"2620728"},"PeriodicalIF":3.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}