Carboprost tromethamine injection enhanced the efficacy of focused ultrasound ablation surgery for hyperintense uterine fibroids: a retrospective study.

Objective: To investigate whether carboprost tromethamine injection enhances the efficacy of focused ultrasound ablation surgery (FUAS) for hyperintense uterine fibroids (UFs) on T2-weighted MR imaging (MRI).

Materials and methods: In this single-center study, 112 patients with symptomatic UF_S were randomly assigned to either the carboprost trimethylamine injection group (n = 56) or oxytocin group (n = 56) during FUAS ablation conducted between February 1, 2023, and February 28, 2025. Treatment tolerance was assessed using the International Society of Interventional Radiotherapy (SIR) complication grading system. Treatment outcomes and adverse events were compared between groups.

Results: In the carboprost tromethamine group, the non-perfused volume (NPV) ratio was 98.38% (IQR: 91.65 - 104.35%), the energy-efficiency factor (EEF) was 2.44 J/mm³ (IQR: 1.38 - 4.83 J/mm³), and the sonication time was 400.00 s (IQR: 205.00 - 605.00 s). However, in the oxytocin group, the NPV ratio was 81.76% (IQR: 59.67 - 89.66%), the EEF was 6.98 J/mm³ (IQR: 3.92 - 14.05 J/mm³), and the sonication time was 733.50 s (295.00 - 1127.50 s). Statistically significant differences in NPV ratio, EEF, and sonication time between the two groups were observed. When FUAS was performed on UFs with 3 - 4 levels of blood flow, there were significant differences between the two groups (p < 0.05). No serious complications were observed during FUAS.

Conclusion: Compared with oxytocin, carboprost tromethamine injection significantly reduced the energy for ablating UFS with FUAS, thereby enhancing treatment efficiency. this strategy provides a new option for patients with hyperintense fibroids and grade 3-4 blood flow in fibroids.