Volume reduction rate and its influencing factors in solitary uterine fibroids classified as Funaki types I and II after ultrasonography-guided high intensity focused ultrasound ablation: a prospective cohort study

International Journal of Hyperthermia · Published 2025-12-14 · DOI 10.1080/02656736.2025.2597678

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Abstract

Background We aimed to explore the volume reduction rate (VRR) and its influencing factors in solitary uterine fibroids classified as Funaki type I and II after ultrasonography-guided high-intensity focused ultrasound (USgHIFU) ablation.Methods We enrolled 191 patients with uterine fibroids who underwent USgHIFU ablation. To calculate the VRR, fibroid dimensions were measured using ultrasonography at 3, 6 and 12 post-treatment months. The primary endpoint was the VRR at 12 post-treatment months. The secondary endpoints included the non-perfused volume ratio (NPVR) and VRR at three and six months.Results The mean VRR for all 191 patients was 29.9%, 39.6% and 44.0% at 3, 6 and 12 post-treatment months, respectively. Subgroup analysis demonstrated a significant volume reduction across groups stratified by maximum fibroid diameter, Funaki type and NPVR. Univariable logistic analysis identified the following factors significantly associated with a higher VRR at 12 months: age ≥35 years (odds ratio [OR] 3.960, 95% confidence interval [CI] 1.405–11.159), presence of menstrual abnormalities (OR 1.936, 95% CI 1.075–3.485), moderate enhancement (OR 2.340, 95% CI 1.193–4.591), anteverted uterus (OR 2.020, 95% CI 1.034–4.025) and lymphocyte count <1.8 × 109/L (OR 2.963, 95% CI 1.265–5.993). Multivariable logistic analysis revealed that age ≥35 years (OR 3.436, 95% CI 1.188–9.947) and lymphocyte count <1.8 × 109/L (OR 2.113, 95% CI 1.142–3.908) were significantly associated with high VRR.Conclusion The uterine fibroid volume progressively decreased after USgHIFU ablation. Age ≥35 years and lymphocyte count <1.8 × 109/L were significantly associated with high VRR.

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Year
2025

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