Abstract：
UNASSIGNED: To quantify the reintervention rate and analyze the risk factors for reintervention after high-intensity focused ultrasound (HIFU) ablation of uterine fibroids.
UNASSIGNED: Eighteen studies were selected from the seven databases. A meta-analysis was applied to synthesize the reintervention rates for fibroids across various follow-up durations. Subgroup-analysis was conducted based on the year of surgery, sample size, guide methods, and non-perfusion volume ratio (NPVR). Signal intensity of T2-weighted imaging (T2WI) was independently evaluated for reintervention risk.
UNASSIGNED: The study enrolled 5216 patients with fibroids treated with HIFU. There were 3247, 1239, 1762, and 2535 women reaching reintervention rates of 1% (95% confidence interval (CI): 1-1), 7% (95% CI: 4-11), 19% (95% CI: 11-27), and 29% (95% CI: 14-44) at 12, 24, 36, and 60-month after HIFU. The reintervention rates of patients treated with US-guided HIFU (USgHIFU) were significantly lower than those of patients treated with MR-guided focused ultrasound surgery (MRgFUS). When the NPVR of fibroids was over 50%, the reintervention rates at 12, 36 and 60-month after HIFU were 1% (95% CI: 0.3-2), 5% (95% CI: 3-8), and 15% (95% CI: 9-20). The reintervention risk for hyper-intensity fibroids on T2WI was 3.45 times higher (95% CI: 2.7-4.39) for hypo-/iso-intensity fibroids.
UNASSIGNED: This meta-analysis showed that the overall reintervention rates after HIFU were acceptable and provided consultative suggestions regarding treatment alternatives for patients with fibroids. Subgroup-analysis revealed that USgHIFU, NPVR ≥ 50%, and hypo-/iso-intensity of fibroids on T2WI were significant factors in reducing reintervention.
UNASSIGNED: PROSPERO, CRD42023456094.
UNASSIGNED: Eighteen studies were selected from the seven databases. A meta-analysis was applied to synthesize the reintervention rates for fibroids across various follow-up durations. Subgroup-analysis was conducted based on the year of surgery, sample size, guide methods, and non-perfusion volume ratio (NPVR). Signal intensity of T2-weighted imaging (T2WI) was independently evaluated for reintervention risk.
UNASSIGNED: The study enrolled 5216 patients with fibroids treated with HIFU. There were 3247, 1239, 1762, and 2535 women reaching reintervention rates of 1% (95% confidence interval (CI): 1-1), 7% (95% CI: 4-11), 19% (95% CI: 11-27), and 29% (95% CI: 14-44) at 12, 24, 36, and 60-month after HIFU. The reintervention rates of patients treated with US-guided HIFU (USgHIFU) were significantly lower than those of patients treated with MR-guided focused ultrasound surgery (MRgFUS). When the NPVR of fibroids was over 50%, the reintervention rates at 12, 36 and 60-month after HIFU were 1% (95% CI: 0.3-2), 5% (95% CI: 3-8), and 15% (95% CI: 9-20). The reintervention risk for hyper-intensity fibroids on T2WI was 3.45 times higher (95% CI: 2.7-4.39) for hypo-/iso-intensity fibroids.
UNASSIGNED: This meta-analysis showed that the overall reintervention rates after HIFU were acceptable and provided consultative suggestions regarding treatment alternatives for patients with fibroids. Subgroup-analysis revealed that USgHIFU, NPVR ≥ 50%, and hypo-/iso-intensity of fibroids on T2WI were significant factors in reducing reintervention.
UNASSIGNED: PROSPERO, CRD42023456094.
摘要：
■量化再干预率，并分析高强度聚焦超声（HIFU）消融子宫肌瘤后再干预的危险因素。
■从七个数据库中选择了18项研究。应用荟萃分析综合了不同随访时间的肌瘤再介入率。根据手术年份进行亚组分析，样本量,指导方法,和非灌注体积比(NPVR)。独立评估T2加权成像（T2WI）的信号强度以评估再干预风险。
■该研究纳入了5216例接受HIFU治疗的肌瘤患者。3247、1239、1762和2535名妇女的再干预率为1％（95％置信区间（CI）：1-1），7%（95%CI：4-11），19%（95%CI：11-27），在HIFU后12、24、36和60个月时为29%（95%CI：14-44）。US引导下HIFU（USgHIFU）治疗的患者的再干预率明显低于MR引导下聚焦超声手术（MRgFUS）治疗的患者。当肌瘤的NPVR超过50%时，HIFU后12、36和60个月的再干预率为1%(95%CI:0.3-2)，5%（95%CI：3-8），和15%（95%CI：9-20）。对于低/等强度肌瘤，T2WI高强度肌瘤的再干预风险高3.45倍（95％CI：2.7-4.39）。
■这项荟萃分析显示，HIFU后的总体再干预率是可以接受的，并为肌瘤患者的治疗方案提供了咨询建议。亚组分析显示，USgHIFU，NPVR≥50%,T2WI上肌瘤的低/等强度是减少再干预的重要因素。
■PROSPERO，CRD42023456094。
■从七个数据库中选择了18项研究。应用荟萃分析综合了不同随访时间的肌瘤再介入率。根据手术年份进行亚组分析，样本量,指导方法,和非灌注体积比(NPVR)。独立评估T2加权成像（T2WI）的信号强度以评估再干预风险。
■该研究纳入了5216例接受HIFU治疗的肌瘤患者。3247、1239、1762和2535名妇女的再干预率为1％（95％置信区间（CI）：1-1），7%（95%CI：4-11），19%（95%CI：11-27），在HIFU后12、24、36和60个月时为29%（95%CI：14-44）。US引导下HIFU（USgHIFU）治疗的患者的再干预率明显低于MR引导下聚焦超声手术（MRgFUS）治疗的患者。当肌瘤的NPVR超过50%时，HIFU后12、36和60个月的再干预率为1%(95%CI:0.3-2)，5%（95%CI：3-8），和15%（95%CI：9-20）。对于低/等强度肌瘤，T2WI高强度肌瘤的再干预风险高3.45倍（95％CI：2.7-4.39）。
■这项荟萃分析显示，HIFU后的总体再干预率是可以接受的，并为肌瘤患者的治疗方案提供了咨询建议。亚组分析显示，USgHIFU，NPVR≥50%,T2WI上肌瘤的低/等强度是减少再干预的重要因素。
■PROSPERO，CRD42023456094。
