Ablation of leiomyomas using a combination of HIFU and iodized oil in vitro.

This study investigates the enhancement effects of iodized oil and the features of hyperechoic focus changes in a target region of high-intensity focused ultrasound (HIFU) ablated uterine fibroids. Leiomyomas in the experimental group of 20 randomly assigned patients were ablated by HIFU under certain parameters 30 min after 1 mL of iodized oil was injected into the center of the myomas. The value of the gray scale and its area were observed by B-mode ultrasound in the target region and were carefully recorded at 0, 2, 4, and 5 min, respectively, after HIFU ablation. The samples were sectioned successively in a thickness of 1∼2 mm and stained by 2,3,5-triphenyltetrazolium chloride solution within 1 h after HIFU ablation. The TTC non-staining volumes were measured afterwards. All procedures in the control group of the other 20 randomly assigned patients were the same except that iodized oil was replaced by physiologic saline. The hyperechoic areas in the target region were observed in all fibroids of both groups. Compared with the control group, the gray scale values in the target region of the experimental group were higher 4 min after HIFU ablation. The enhanced gray scale area in the target region and the 2,3,5-triphenyltetrazolium chloride non-staining volumes in the experimental group were bigger. Based on our experience, HIFU sonication of leiomyomas injected with iodized oil produces hyperechoic foci that are greater than areas injected with saline. More studies are required to understand the clinical implications of these observations.

[High intensity focused ultrasound therapy combined with transcatheter arterial chemoembolization for advanced hepatocellular carcinoma].

OBJECTIVE: To study high intensity focused ultrasound (HIFU) therapy combined with transcatheter arterial chemoembolization (TACE) in the treatment of patients with advanced hepatocellular carcinoma (HCC). METHODS: Fifty patients with unresectable HCC (TNM stage IV) were randomized into a TACE (T) group and a TACE plus HIFU (T + H) group. Twenty-six patients underwent TACE alone, and 24 HIFU ablation 2 - 3 weeks after TACE. The mean follow-up time for all patients was 8.16 +/- 2.79 months (range 3 to 24 months). The median survival, 6-month-, 1-year survival rates and average survival of patients who died were calculated by Kaplan-Meier method and Fisher exact test. RESULTS: The median survival time, 6-month and 1-year survival rates were 11.3 months, 80.4 - 85.4% and 42.9% in T + H group, in contrast to 4 months, 13.2% and 0% in T group with significant differences (P < 0.01). The average survival time of patients who died was 10.21 +/- 4.12 months in T + H group, as compared with 4.35 +/- 2.39 months in T group also with significant differences (P < 0.01). CONCLUSION: High intensity focused ultrasound therapy (HIFU) combined with transcatheter arterial chemoembolization (TACE), being better than TACE alone, may become one of the most effective treatments for patients with unresectable HCC.