O câncer de mama é o tipo de câncer que mais acomete as mulheres no mundo, podendo ser invasivo ou não. Existem vários fatores de risco como idade, histórico familiar e obesidade, e os tratamentos incluem cirurgia, quimioterapia e hormonioterapia. As chances de cura variam de acordo com o estágio da doença.
This document discusses penile conservation for squamous cell carcinoma of the penis. It provides evidence that radiotherapy can successfully preserve the penis in over 50% of cases, with 5-year survival rates comparable to surgery. Brachytherapy is highlighted as an effective non-surgical approach, allowing for homogenous dose distribution and sparing of surrounding tissue. Complications are mostly mild to moderate, with urethral stenosis occurring in under 15% of cases. With close follow-up, radiotherapy can offer local control and penile preservation similar to surgery while maintaining patient quality of life and sexuality.
O documento discute vários tópicos relacionados à mama, incluindo: 1) histologia normal e alterações, como distúrbios do desenvolvimento, processos inflamatórios e alterações fibrocísticas; 2) manifestações clínicas usuais; e 3) neoplasias mamárias benignas e malignas, como carcinomas ductal e lobular.
O documento discute o câncer de colo de útero, explicando que é resultado de alterações celulares desordenadas e que acomete especificamente o colo do útero. Ele também descreve que é o câncer mais comum entre as mulheres no Brasil e que possui fase pré-clínica assintomática, sendo importante a detecção por meio de exames preventivos periódicos. Além disso, lista os principais fatores de risco, sintomas e formas de diagnóstico e tratamento da doença.
1. Hormone therapy is an important treatment for hormone receptor positive breast cancers, working by reducing estrogen levels or blocking estrogen receptors.
2. The document discusses various hormone therapy options for early and locally advanced breast cancer including surgical ovarian suppression, radiation ovarian suppression, medications like aromatase inhibitors, LHRH analogues, SERMs, and more.
3. Evidence shows that hormone therapy reduces the risk of recurrence and death from breast cancer in both premenopausal and postmenopausal women with hormone receptor positive early breast cancer.
Management of Early Stage Carcinoma CervixSubhash Thakur
This presentation covers the management of early stage carcinoma cervix (FIGO stage I to IIA). A brief introuduction to different surgical procedures and the radiation treatment techninques have been described.
This presentation is intended to refer while doing planning of SBRT Prostate for all practical aspects from Simulation - contouring - planning - treatment. I am sure it will be very useful presentation for any radiation oncologist who are willing to start workflow of SBRT Prostate in the department of radiation oncology
O documento descreve a história da radioterapia, desde a descoberta dos raios-X em 1895 até os avanços modernos. Aborda figuras importantes como Röntgen, Becquerel e os Curie, e conceitos como fracionamento da dose e tipos de radioterapia como teleterapia, braquiterapia e radiocirurgia.
O câncer de mama é o tipo de câncer que mais acomete as mulheres no mundo, podendo ser invasivo ou não. Existem vários fatores de risco como idade, histórico familiar e obesidade, e os tratamentos incluem cirurgia, quimioterapia e hormonioterapia. As chances de cura variam de acordo com o estágio da doença.
This document discusses penile conservation for squamous cell carcinoma of the penis. It provides evidence that radiotherapy can successfully preserve the penis in over 50% of cases, with 5-year survival rates comparable to surgery. Brachytherapy is highlighted as an effective non-surgical approach, allowing for homogenous dose distribution and sparing of surrounding tissue. Complications are mostly mild to moderate, with urethral stenosis occurring in under 15% of cases. With close follow-up, radiotherapy can offer local control and penile preservation similar to surgery while maintaining patient quality of life and sexuality.
O documento discute vários tópicos relacionados à mama, incluindo: 1) histologia normal e alterações, como distúrbios do desenvolvimento, processos inflamatórios e alterações fibrocísticas; 2) manifestações clínicas usuais; e 3) neoplasias mamárias benignas e malignas, como carcinomas ductal e lobular.
O documento discute o câncer de colo de útero, explicando que é resultado de alterações celulares desordenadas e que acomete especificamente o colo do útero. Ele também descreve que é o câncer mais comum entre as mulheres no Brasil e que possui fase pré-clínica assintomática, sendo importante a detecção por meio de exames preventivos periódicos. Além disso, lista os principais fatores de risco, sintomas e formas de diagnóstico e tratamento da doença.
1. Hormone therapy is an important treatment for hormone receptor positive breast cancers, working by reducing estrogen levels or blocking estrogen receptors.
2. The document discusses various hormone therapy options for early and locally advanced breast cancer including surgical ovarian suppression, radiation ovarian suppression, medications like aromatase inhibitors, LHRH analogues, SERMs, and more.
3. Evidence shows that hormone therapy reduces the risk of recurrence and death from breast cancer in both premenopausal and postmenopausal women with hormone receptor positive early breast cancer.
Management of Early Stage Carcinoma CervixSubhash Thakur
This presentation covers the management of early stage carcinoma cervix (FIGO stage I to IIA). A brief introuduction to different surgical procedures and the radiation treatment techninques have been described.
This presentation is intended to refer while doing planning of SBRT Prostate for all practical aspects from Simulation - contouring - planning - treatment. I am sure it will be very useful presentation for any radiation oncologist who are willing to start workflow of SBRT Prostate in the department of radiation oncology
O documento descreve a história da radioterapia, desde a descoberta dos raios-X em 1895 até os avanços modernos. Aborda figuras importantes como Röntgen, Becquerel e os Curie, e conceitos como fracionamento da dose e tipos de radioterapia como teleterapia, braquiterapia e radiocirurgia.
This document provides an overview of the approach to prostate SBRT planning. It discusses the evidence supporting SBRT, patient selection, immobilization techniques, imaging protocols, target delineation guidelines, dose selection, planning constraints, quality assurance procedures, and peri-treatment management. The key advantages of SBRT for prostate cancer are the short treatment time of 5 fractions, high biological effective dose achieved, and comparable oncologic outcomes to other EBRT techniques with side effects that are earlier but also resolve sooner. Careful planning and quality assurance throughout the process are emphasized.
This document summarizes intensity modulated radiotherapy (IMRT) and its advantages over conventional radiotherapy. IMRT allows for superior dose distribution and better sparing of normal tissues by modulating the radiation beam intensity inside each treatment field. It provides more conformal dose coverage of irregularly shaped tumor targets while further reducing dose to nearby healthy tissues and critical organs. IMRT planning requires defining treatment goals and optimizing dose constraints using computer algorithms to determine the optimal intensity patterns delivered via multileaf collimators.
Evolution of Hypofractionated Radiotherapy in Breast Cancerkoustavmajumder1986
Hypofractionated radiotherapy in breast cancer is one of the major evolution. It started few decades back. We have to know its history and radiobiological perspective. In this presentation I have tried to cover as much as possible. It would be helpful for all Radiation Oncologist specially the trainees.
O documento discute o câncer de próstata, incluindo sua definição como a segunda causa mais comum de câncer em homens. Ele destaca que o diagnóstico precoce através de exames como toque retal e dosagem de PSA aumentam as chances de cura em até 90%. O texto também lista fatores de risco como idade e raça negra e discute opções de tratamento como prostatectomia, radioterapia e bloqueio androgênico.
This document summarizes the treatment planning and quality assurance process for single fraction stereotactic radiosurgery (SRS) to treat a brain metastasis in a 70-year old female patient with breast cancer. Key steps included imaging the patient with MRI and CT, delineating the tumor and organs at risk, planning treatment with VMAT to deliver 18Gy in a single fraction, and verifying the plan meets dosimetric parameters including conformality and dose fall-off. A dry run and setup verification using CBCT were performed prior to treatment to ensure accurate dose delivery to the target while sparing surrounding healthy tissue.
This document discusses management of prostate cancer through different treatment modalities including active surveillance, radical prostatectomy, radiation therapy, and hormonal therapy. It provides treatment recommendations based on cancer stage and risk level as well as 5-year outcomes. For low risk prostate cancer, active surveillance, radical prostatectomy, or radiation therapy are recommended depending on life expectancy. Radiation therapy techniques like 3D-CRT, IMRT, and brachytherapy are covered. Dose escalation studies showing improved outcomes with higher radiation doses are also summarized.
1) Radiotherapy plays an important role in managing carcinoma of the cervix by delivering high doses through a combination of external beam radiotherapy and brachytherapy.
2) The disease has central and peripheral components - the central component confined to the cervix is best treated with brachytherapy, while the peripheral component involving surrounding tissues is treated with both external beam radiotherapy and brachytherapy.
3) External beam radiotherapy techniques include 3D conformal radiotherapy and IMRT to improve dose distribution and spare surrounding organs-at-risk.
Radiosensitivity and cell age in mitotic cycle .pptxKiran Ramakrishna
1) The document discusses cell cycle analysis techniques like autoradiography using tritium-labeled thymidine and bromodeoxyuridine staining to determine what phase of the cell cycle cells are in.
2) It describes how synchronizing cells through mitotic shake-off or hydroxyurea blocking allows studying the effects of radiation at different phases, finding sensitivity is highest in M and lowest in S phase.
3) Checkpoint genes can stop the cell cycle if DNA is damaged, preventing mitosis, and their absence leads to higher radiation and cancer risks. The oxygen effect is also less for denser ionizing radiations.
The document provides information about breast cancer, including defining cancer, listing common symptoms, discussing myths and risk factors, how breast cancer progresses, diagnosis methods, treatment options including surgery, radiation therapy and chemotherapy, prevention through screening and lifestyle changes, and concludes by thanking the reader.
Hormonal therapy plays an important role in the treatment of breast cancer. Estrogen exposure is a major risk factor for breast cancer, so therapies aim to reduce estrogen levels or block its effects. Selective estrogen receptor modulators (SERMs) like tamoxifen act as antagonists in breast tissue. Aromatase inhibitors prevent aromatization of androgens to estrogens in postmenopausal women. LHRH agonists suppress ovarian function. Oophorectomy was one of the earliest hormonal therapies used but had significant morbidity. Modern therapies like tamoxifen, aromatase inhibitors, and LHRH agonists are better tolerated and more effective, improving outcomes for breast cancer patients.
A qualidade do ponto de vista médico mamografiaGerciane Neves
O documento discute a importância da qualidade técnica da mamografia para o diagnóstico precoce do câncer de mama, com melhor prognóstico e redução da mortalidade. Uma boa mamografia depende de fatores como o equipamento, processamento e realização técnica correta do exame, com bom posicionamento e compressão da mama.
A short overview of Image Guided Radiotherapy process in Lung Cancer presented at TMC Kolkata circa 2016. Basic principles and concepts as well as examples are outlined.
Braquiterapia é um tratamento de radioterapia que envolve a colocação de fontes radioativas diretamente no tumor ou próximo a ele para irradiar o alvo de dentro para fora. Discute-se o uso da braquiterapia para tratamento de cânceres ginecológicos, de cabeça e pescoço, de mama, da próstata, do pulmão e esófago, bem como para hemangiomas da coroideia.
This document discusses prostate cancer, including that it is the most common cancer in men. It covers prostate anatomy, the importance of cancer stage and Gleason score for determining prognosis and treatment. It explains that prostate cancer is often detected through elevated PSA levels and diagnosed via biopsy. The document discusses how risk groups combine stage, PSA and Gleason score to predict outcomes and guide treatment decisions.
O documento descreve os procedimentos e testes necessários para o controle de qualidade em mamografia, incluindo o alinhamento do campo de raios-X, desempenho do controle automático de exposição, força de compressão, qualidade da imagem e periodicidade dos testes. O objetivo é assegurar a obtenção de imagens de boa qualidade para diagnóstico e detectar falhas no equipamento.
Carcinoma cervix brachytherapy- dr upasnaUpasna Saxena
Dr. Upasna Saxena presented on brachytherapy. Brachytherapy involves placing radioactive sources close to or inside the tumor. It has advantages like high localized dose and sparing of surrounding tissues. Intracavitary brachytherapy is commonly used to treat cervical cancer using applicators like tandems and ovoids. Key planning points include Point A which is 2cm lateral and 2cm superior to the cervical os. Dose to organs at risk like bladder and rectum are also important. Proper placement and geometry of applicators is important for adequate dose coverage and sparing of organs at risk.
Several institutions have studied stereotactic body radiation therapy (SBRT) for primary lung cancer. Indiana University studies showed a maximum tolerated dose of 66 Gy for T2 lesions delivered over 3 fractions, with 1-year local control rates of 98%. Other studies from Aarhus University, Kyoto University, Air Force General Hospital in Beijing, and University of Marburg demonstrated 1-2 year local control rates ranging from 85-95% using SBRT dose fractions between 30-60 Gy delivered over 1 to 10 fractions.
O documento discute a prevenção do câncer de mama e de colo do útero. Ele explica os fatores de risco para câncer de mama, como hereditariedade, idade, gravidez tardia e estilo de vida. Também descreve os métodos de rastreamento como autoexame e mamografia. Para o câncer de colo do útero, discute que é causado principalmente pelo HPV e que o exame citopatológico é importante para detecção precoce.
Aplicação da medicina nuclear - Expansion of Nuclear MedicineLídia Pavan
A medicina nuclear utiliza pequenas quantidades de substâncias radioativas para diagnosticar ou tratar doenças de forma segura e indolor. Exames como gama-câmara, SPECT e PET formam imagens dos órgãos e fornecem informações sobre a anatomia e função dos mesmos. Estes exames são úteis para diagnosticar problemas cardíacos, cerebrais e cancerígenos de forma precoce e menos invasiva.
This document provides an overview of the approach to prostate SBRT planning. It discusses the evidence supporting SBRT, patient selection, immobilization techniques, imaging protocols, target delineation guidelines, dose selection, planning constraints, quality assurance procedures, and peri-treatment management. The key advantages of SBRT for prostate cancer are the short treatment time of 5 fractions, high biological effective dose achieved, and comparable oncologic outcomes to other EBRT techniques with side effects that are earlier but also resolve sooner. Careful planning and quality assurance throughout the process are emphasized.
This document summarizes intensity modulated radiotherapy (IMRT) and its advantages over conventional radiotherapy. IMRT allows for superior dose distribution and better sparing of normal tissues by modulating the radiation beam intensity inside each treatment field. It provides more conformal dose coverage of irregularly shaped tumor targets while further reducing dose to nearby healthy tissues and critical organs. IMRT planning requires defining treatment goals and optimizing dose constraints using computer algorithms to determine the optimal intensity patterns delivered via multileaf collimators.
Evolution of Hypofractionated Radiotherapy in Breast Cancerkoustavmajumder1986
Hypofractionated radiotherapy in breast cancer is one of the major evolution. It started few decades back. We have to know its history and radiobiological perspective. In this presentation I have tried to cover as much as possible. It would be helpful for all Radiation Oncologist specially the trainees.
O documento discute o câncer de próstata, incluindo sua definição como a segunda causa mais comum de câncer em homens. Ele destaca que o diagnóstico precoce através de exames como toque retal e dosagem de PSA aumentam as chances de cura em até 90%. O texto também lista fatores de risco como idade e raça negra e discute opções de tratamento como prostatectomia, radioterapia e bloqueio androgênico.
This document summarizes the treatment planning and quality assurance process for single fraction stereotactic radiosurgery (SRS) to treat a brain metastasis in a 70-year old female patient with breast cancer. Key steps included imaging the patient with MRI and CT, delineating the tumor and organs at risk, planning treatment with VMAT to deliver 18Gy in a single fraction, and verifying the plan meets dosimetric parameters including conformality and dose fall-off. A dry run and setup verification using CBCT were performed prior to treatment to ensure accurate dose delivery to the target while sparing surrounding healthy tissue.
This document discusses management of prostate cancer through different treatment modalities including active surveillance, radical prostatectomy, radiation therapy, and hormonal therapy. It provides treatment recommendations based on cancer stage and risk level as well as 5-year outcomes. For low risk prostate cancer, active surveillance, radical prostatectomy, or radiation therapy are recommended depending on life expectancy. Radiation therapy techniques like 3D-CRT, IMRT, and brachytherapy are covered. Dose escalation studies showing improved outcomes with higher radiation doses are also summarized.
1) Radiotherapy plays an important role in managing carcinoma of the cervix by delivering high doses through a combination of external beam radiotherapy and brachytherapy.
2) The disease has central and peripheral components - the central component confined to the cervix is best treated with brachytherapy, while the peripheral component involving surrounding tissues is treated with both external beam radiotherapy and brachytherapy.
3) External beam radiotherapy techniques include 3D conformal radiotherapy and IMRT to improve dose distribution and spare surrounding organs-at-risk.
Radiosensitivity and cell age in mitotic cycle .pptxKiran Ramakrishna
1) The document discusses cell cycle analysis techniques like autoradiography using tritium-labeled thymidine and bromodeoxyuridine staining to determine what phase of the cell cycle cells are in.
2) It describes how synchronizing cells through mitotic shake-off or hydroxyurea blocking allows studying the effects of radiation at different phases, finding sensitivity is highest in M and lowest in S phase.
3) Checkpoint genes can stop the cell cycle if DNA is damaged, preventing mitosis, and their absence leads to higher radiation and cancer risks. The oxygen effect is also less for denser ionizing radiations.
The document provides information about breast cancer, including defining cancer, listing common symptoms, discussing myths and risk factors, how breast cancer progresses, diagnosis methods, treatment options including surgery, radiation therapy and chemotherapy, prevention through screening and lifestyle changes, and concludes by thanking the reader.
Hormonal therapy plays an important role in the treatment of breast cancer. Estrogen exposure is a major risk factor for breast cancer, so therapies aim to reduce estrogen levels or block its effects. Selective estrogen receptor modulators (SERMs) like tamoxifen act as antagonists in breast tissue. Aromatase inhibitors prevent aromatization of androgens to estrogens in postmenopausal women. LHRH agonists suppress ovarian function. Oophorectomy was one of the earliest hormonal therapies used but had significant morbidity. Modern therapies like tamoxifen, aromatase inhibitors, and LHRH agonists are better tolerated and more effective, improving outcomes for breast cancer patients.
A qualidade do ponto de vista médico mamografiaGerciane Neves
O documento discute a importância da qualidade técnica da mamografia para o diagnóstico precoce do câncer de mama, com melhor prognóstico e redução da mortalidade. Uma boa mamografia depende de fatores como o equipamento, processamento e realização técnica correta do exame, com bom posicionamento e compressão da mama.
A short overview of Image Guided Radiotherapy process in Lung Cancer presented at TMC Kolkata circa 2016. Basic principles and concepts as well as examples are outlined.
Braquiterapia é um tratamento de radioterapia que envolve a colocação de fontes radioativas diretamente no tumor ou próximo a ele para irradiar o alvo de dentro para fora. Discute-se o uso da braquiterapia para tratamento de cânceres ginecológicos, de cabeça e pescoço, de mama, da próstata, do pulmão e esófago, bem como para hemangiomas da coroideia.
This document discusses prostate cancer, including that it is the most common cancer in men. It covers prostate anatomy, the importance of cancer stage and Gleason score for determining prognosis and treatment. It explains that prostate cancer is often detected through elevated PSA levels and diagnosed via biopsy. The document discusses how risk groups combine stage, PSA and Gleason score to predict outcomes and guide treatment decisions.
O documento descreve os procedimentos e testes necessários para o controle de qualidade em mamografia, incluindo o alinhamento do campo de raios-X, desempenho do controle automático de exposição, força de compressão, qualidade da imagem e periodicidade dos testes. O objetivo é assegurar a obtenção de imagens de boa qualidade para diagnóstico e detectar falhas no equipamento.
Carcinoma cervix brachytherapy- dr upasnaUpasna Saxena
Dr. Upasna Saxena presented on brachytherapy. Brachytherapy involves placing radioactive sources close to or inside the tumor. It has advantages like high localized dose and sparing of surrounding tissues. Intracavitary brachytherapy is commonly used to treat cervical cancer using applicators like tandems and ovoids. Key planning points include Point A which is 2cm lateral and 2cm superior to the cervical os. Dose to organs at risk like bladder and rectum are also important. Proper placement and geometry of applicators is important for adequate dose coverage and sparing of organs at risk.
Several institutions have studied stereotactic body radiation therapy (SBRT) for primary lung cancer. Indiana University studies showed a maximum tolerated dose of 66 Gy for T2 lesions delivered over 3 fractions, with 1-year local control rates of 98%. Other studies from Aarhus University, Kyoto University, Air Force General Hospital in Beijing, and University of Marburg demonstrated 1-2 year local control rates ranging from 85-95% using SBRT dose fractions between 30-60 Gy delivered over 1 to 10 fractions.
O documento discute a prevenção do câncer de mama e de colo do útero. Ele explica os fatores de risco para câncer de mama, como hereditariedade, idade, gravidez tardia e estilo de vida. Também descreve os métodos de rastreamento como autoexame e mamografia. Para o câncer de colo do útero, discute que é causado principalmente pelo HPV e que o exame citopatológico é importante para detecção precoce.
Aplicação da medicina nuclear - Expansion of Nuclear MedicineLídia Pavan
A medicina nuclear utiliza pequenas quantidades de substâncias radioativas para diagnosticar ou tratar doenças de forma segura e indolor. Exames como gama-câmara, SPECT e PET formam imagens dos órgãos e fornecem informações sobre a anatomia e função dos mesmos. Estes exames são úteis para diagnosticar problemas cardíacos, cerebrais e cancerígenos de forma precoce e menos invasiva.
14. Diseases that harm require
therapies that harm less.
傷害人體的疾病需要
對人體傷害更小的治療方法。
—— Sir William Osler, (1849-
1919), the Father of Modern
Medicine
醫學發展趨勢
27. History
• 1956 Burov for malignant tumors in animal and humans
• 1959 Parkinsons and Neurologic Conditions
• 1964 Breast Cancer and Thyroid Cancer
• 1990s Pancreatic Cancer
• 1990s HIFU for Fibroids
• 1993 Liver Cancer
28. • 1999 Chongqing USgHIFU for Malignant Tumors
• 2000 Bone Cancer
• 2004 FDA approved MRgFUS for Fibroid Treatment
• 2005 CE approved UsgHIFU for Uterine Fibroid
• 2013 TFDA approved UsgHIFU for Uterine Fibroid
• 2018 CE approved UsgHIFU for Adenomyosis
History
33. 患者數量 10078
年齡 40.4± 5.8
每種適應症的患者數量
子宮肌瘤 7439(74%)
子宮腺肌症 2549(25%)
陰道分娩後胎盤植入 25(0%)
子宮內膜異位症 60(1%)
剖腹產後瘢痕妊娠
5(0%)
SI
R
描述
Complicatio
n Rate (%)
A 無需治療,無後續 12.7
0.45
B 觀察,無後續
C 幾乎不需治療,
住院時間短(<48小時)
0.06
0.06
D 需治療,細心照料,
長期住院(>48小時)
E 永久性反應,
需後續處理
0
F 死亡
10家中心有關HIFU治療的安全性和有效性的回顧性研究: 9988例(2006-2013)
關於FUAS臨床應用
Safety of ultrasound-guided ultrasound ablation for uterine fibroids and adenomyosis: A review of 9988 cases CrossMark
jinyun Chen a, Wenzhi Chen a,b,*, Lian Zhang b, Kequan u c, Song Penga, Min He c, Liang Hu a
Ultrasonics Sonochemistry 27 (2015) 671-676
36. Instant Ultrasound Image Monitoring
HIFU Before treatment HIFU After treatment
Immediately after HIFU treatment,
real-time ultrasound images of liver
coagulation necrosis in live pigs
41. Prospective study of multi-center
(20 Hospitals: 2011.03-2013.12)
A prospective multi-center study with a volume of 2411 patients compared the
differences between HIFU, myomectomy and hysterectomy for uterine fibroids
Dr. P Mc Culloch
Professor of Surgical Science and Practice
Chair, IDEAL Collaboration
Deputy Director, Surgical and Interventional Trials
Unit (SITU)
University of Oxford,
Nuffield Department of Surgical Sciences
John Radcliffe Hospital
Dr. Lang Jinghe
President of Chinese Obstetricians and
Gynecologists Association
45. FIGO Staging of Uterine Fibroids
Munro MG, Critchley HOD , Broder MS , et al. FIGO classification system (PALM-COEIN) for causes of abnormal
uterine bleeding in nongravid women of reproductive age[J]. Int J Gynaecol Obstet, 2011, 113(1):0-13.
✥Type 2, 3, 4, 5,
6 are indications
for HIFU
✥70-80% of
fibroids that
require surgical
interventions can
benefit from
HIFU
46. MRI-based treatment planning and post-HIFU assessment
Pre-treatment Day 14 post-HIFU 4.5 months post-HIFU 10 months post-HIFU
Pre-treatment 1-Day Post-treatment
Average annual
absorption rate:
67%
47. Effectiveness of FUS
Before treatment After treatment
Single uterine fibroid Multiple uterine fibroids
Before treatment After treatment
55. 202 patients with adenomyosis
(120 focal, 82 diffuse). MRI taken before and
after USgHIFU to evaluate the treatment
effectiveness, 18m follow-up.
March 2014
57. FUS Treatment Improves Sexual Life Quality in
Adenomyosis Patients
- 51 patients with
symptomatic
adenomyosis were
treated for HIFU,
- 2 were pregnant
- 47 were followed for
12 months with
improved symptoms
and improved sexual
quality.
62. Sigittal view of MR images from a 47-year-old woman with diffuse adenomyosis.
(A) Pre-treatment T2 weighted image shows the invading endometrium causes a
generalized expansion of the uterine walls. (B) Pre-treatment T1-weighted contrast-
enhanced MR image shows perfusion of the adenomyotic lesion. (C) Post-treatment
T1-weighted contrast-enhanced MR image shows the fractional ablation was 83.5%
A B C
FUS Treatment of Diffused Adenomyosis
A B C
63. Pre- and post-HIFU MRI images obtained from a 39 years old adenomyosis patient
Before HIFU 1-day post-HIFU 4-m post-HIFU
MRI-based treatment planning and post-HIFU assessment
75. KMUH HIFU Chongqing HIFU
SIR
Class Description
Number
of
patients
Percentage of
patients with
complications
Number of
patients
Percentage of
patients with
complications
A No therapy, no consequences
45 9.00% 1228 12.29%
B Nominal therapy, observation,
no consequences 2 0. 40% 45 0.45%
C Required therapy, minor
hospitalization(<48 h) 1 0.20% 26 0.26%
D Major therapy, unplanned
increase in level of care,
prolonged hospitalization
(>48 h)
2 0.40% 6 0.26%
E Permanent adverse sequelae 0 0 0 0
F Death 0 0 0 0
Definitions of SIR AE Class and percentage incidence
(KMUH HIFU N = 500 ; Chongqing HIFU N = 9988 )
SIR AE = Society of Interventional Radiology Adverse Event
76. Conclusion
• Uterine fibroids and adenomyosis lesion
reduction rates : 40.2% and 46.2% at 3
months after HIFU
• Patient symptoms have significant
improvement at 3 months after treatment
• Adverse effects are not often