Real-time assessment of high-intensity focused ultrasound treatment of uterine fibroids with SonoVue: a case report with literature review

Real-time assessment of high-intensity focused ultrasound treatment of uterine fibroids with SonoVue: a case report with literature review

Uterine fibroids, which affect 30%-40% of women of reproductive age, are traditionally treated with medication or surgery. High-Intensity Focused Ultrasound (HIFU) has emerged as a noninvasive alternative. However, an immediate evaluation of the efficacy of treatment is challenging with standard magnetic resonance imaging (MRI). A 35-year-old woman with a history of uterine myomas underwent HIFU treatment, experiencing persistent anemia symptoms. Contrast-Enhanced Ultrasound (CEUS) using SonoVue was used for real-time assessment during HIFU. Grayscale changes and measurements of the non-perfused area were observed immediately post-ablation. Follow-up MRI revealed a substantial reduction in the size of the treated myoma. HIFU, known for its noninvasiveness and cost-effectiveness, lacks real-time monitoring capabilities. Traditional post-treatment evaluation involves magnetic resonance imaging, which does not provide immediate insight. CEUS with SonoVue is increasingly used during HIFU due to its ability to assess treatment responses in real time. The study reviewed the existing literature supporting SonoVue's effectiveness in detecting residual fibroid tissue during HIFU procedures. SonoVue-enhanced CEUS proves to be a valuable real-time diagnostic tool during HIFU treatment for uterine fibroids. This approach allows an immediate assessment of treatment effects, especially in challenging cases such as submucosal myomas. The safety profile of SonoVue appears favorable and the obtained results correlate well with the MRI findings, presenting a promising avenue to improve the efficiency and safety of HIFU procedures.