{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:40:08Z","timestamp":1787071208455,"version":"build-2736575974"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The objective of this study was to evaluate the safety and efficacy of intratumoral ethanol injection followed by high-intensity focused ultrasound (HIFU) for hyperintense uterine fibroids on T2-weighted magnetic resonance images (T2WI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Patients with hyperintense uterine fibroids who received intratumoral ethanol injection followed by HIFU in our hospital from January 2022 to February 2024 were retrospectively reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 195 patients with 209 fibroids were pretreated with intratumoral ethanol injection before HIFU. The median volume of anhydrous ethanol injected in each patient was 10.0 (interquartile range: 5.0, 13.0) ml. During the procedure of intratumoral ethanol injection, 1 patient experienced facial flushing and 7 patients experienced coughing. The median sonication time of HIFU was 800.0 (interquartile range: 499.5, 1300) s. Significant grayscale change was observed in 133 (63.6%) fibroids, and homogeneous grayscale change was observed in 76 (36.4%) fibroids. The average nonperfused volume ratio (NPVR) of fibroids was 81.2% \u00b113.0%. No significant difference was observed in NPVR between fibroids using different volumes of ethanol (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). The frequent adverse effects during HIFU were lower abdominal pain and sacrococcygeal region pain, with a median pain score of 3.0 (interquartile range: 2.0, 3.0) points. The frequent adverse effects after HIFU included vaginal discharge, lower abdominal pain, or sacrococcygeal pain. All adverse effects were minor. No severe adverse effects occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Intratumoral ethanol injection followed by HIFU treatment is safe and effective for hyperintense uterine fibroids. This strategy offers a new option for patients with hyperintense uterine fibroids who want to avoid surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/gmit.gmit-d-24-00013","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T11:00:09Z","timestamp":1758884409000},"page":"36-43","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Safety and Efficacy of Intratumoral Ethanol Injection Followed by High-intensity Focused Ultrasound Ablation for Hyperintense Uterine Fibroids on T2-weighted Magnetic Resonance Images"],"prefix":"10.4103","volume":"15","author":[{"given":"Kaiyin","family":"Qu","sequence":"first","affiliation":[{"name":"Department of Gynecology, Chongqing Haifu Hospital, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Chongqing Haifu Hospital, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Chongqing Haifu Hospital, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Chongqing Haifu Hospital, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Chongqing Haifu Hospital, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Chongqing Haifu Hospital, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"R1-20260209","first-page":"424","article-title":"Epidemiology of uterine myomas: A review","volume":"9","author":"Sparic","year":"2016","journal-title":"Int J Fertil Steril"},{"key":"R2-20260209","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/ijgo.13102","article-title":"Epidemiology and management of uterine fibroids","volume":"149","author":"Giuliani","year":"2020","journal-title":"Int J Gynaecol Obstet"},{"key":"R3-20260209","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1185\/03007995.2014.982246","article-title":"Contemporary management of uterine fibroids: Focus on emerging medical treatments","volume":"31","author":"Singh","year":"2015","journal-title":"Curr Med Res Opin"},{"key":"R4-20260209","doi-asserted-by":"crossref","first-page":"e14566","DOI":"10.1097\/MD.0000000000014566","article-title":"Ultrasound-guided high-intensity focused ultrasound in the treatment of uterine fibroids","volume":"98","author":"Fan","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"R5-20260209","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.ultsonch.2015.05.031","article-title":"Safety of ultrasound-guided ultrasound ablation for uterine fibroids and adenomyosis: A review of 9988 cases","volume":"27","author":"Chen","year":"2015","journal-title":"Ultrason Sonochem"},{"key":"R6-20260209","first-page":"e44680","article-title":"High-intensity focused ultrasound ablation of uterine fibroids: A review","volume":"15","author":"Patel","year":"2023","journal-title":"Cureus"},{"key":"R7-20260209","doi-asserted-by":"crossref","first-page":"104","DOI":"10.4103\/GMIT.GMIT_36_19","article-title":"Magnetic resonance imaging-guided volumetric high-intensity focused ultrasound surgery for pedunculated subserosal uterine leiomyoma","volume":"9","author":"Nguyen","year":"2020","journal-title":"Gynecol Minim Invasive Ther"},{"key":"R8-20260209","doi-asserted-by":"crossref","first-page":"79","DOI":"10.4103\/gmit.gmit_23_23","article-title":"High-intensity focused ultrasound is a better choice for women with fertility desire: A systematic review and meta-analysis of the comparison between high-intensity focused ultrasound and laparoscopic treatment of uterine fibroids","volume":"13","author":"Hu","year":"2024","journal-title":"Gynecol Minim Invasive Ther"},{"key":"R9-20260209","doi-asserted-by":"crossref","first-page":"109","DOI":"10.4103\/gmit.gmit_95_22","article-title":"Segmentation of in vitro fertilization with high-intensity focused ultrasound in repeated implantation failure with adenomyosis","volume":"12","author":"Yu","year":"2023","journal-title":"Gynecol Minim Invasive Ther"},{"key":"R10-20260209","doi-asserted-by":"crossref","first-page":"15","DOI":"10.4103\/gmit.gmit_102_22","article-title":"High-intensity focused ultrasound for the treatment of fibroids: A single-center experience in Singapore","volume":"12","author":"Jindal","year":"2023","journal-title":"Gynecol Minim Invasive Ther"},{"key":"R11-20260209","doi-asserted-by":"crossref","first-page":"272","DOI":"10.4103\/GMIT.GMIT_18_21","article-title":"Noninvasive high-intensity focused ultrasound surgeries for fibroids and adenomyosis during COVID-19 pandemic in Hong Kong: A gynecologist's viewpoint","volume":"10","author":"Shun","year":"2021","journal-title":"Gynecol Minim Invasive Ther"},{"key":"R12-20260209","doi-asserted-by":"crossref","first-page":"71","DOI":"10.4103\/GMIT.GMIT_23_21","article-title":"A journey from learning a noninvasive high-intensity focused ultrasound surgical treatment for gynecological diseases to providing high-intensity focused ultrasound services in Hong Kong","volume":"10","author":"Wong","year":"2021","journal-title":"Gynecol Minim Invasive Ther"},{"key":"R13-20260209","doi-asserted-by":"crossref","first-page":"61","DOI":"10.4103\/gmit.gmit_20_23","article-title":"An alternative treatment for uterine fibroids and adenomyosis: High-intensity focused ultrasound","volume":"12","author":"Lee","year":"2023","journal-title":"Gynecol Minim Invasive Ther"},{"key":"R14-20260209","doi-asserted-by":"crossref","first-page":"2194594","DOI":"10.1080\/02656736.2023.2194594","article-title":"Therapeutic dose and long-term efficacy of high-intensity focused ultrasound ablation for different types of uterine fibroids based on signal intensity on T2-weighted MR images","volume":"40","author":"Wang","year":"2023","journal-title":"Int J Hyperthermia"},{"key":"R15-20260209","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1080\/02656736.2021.1973585","article-title":"Ultrasound-guided high intensity focused ultrasound ablation for uterine fibroids: Long-term outcomes and factors affecting local recurrence","volume":"38","author":"Liu","year":"2021","journal-title":"Int J Hyperthermia"},{"key":"R16-20260209","doi-asserted-by":"crossref","first-page":"184.e1","DOI":"10.1016\/j.ajog.2006.08.030","article-title":"Magnetic resonance-guided focused ultrasound surgery for uterine fibroids: Relationship between the therapeutic effects and signal intensity of preexisting T2-weighted magnetic resonance images","volume":"196","author":"Funaki","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"R17-20260209","doi-asserted-by":"crossref","first-page":"S245","DOI":"10.1016\/S1051-0443(07)61792-8","article-title":"Chemical ablation of hepatocellular carcinoma","volume":"13","author":"Clark","year":"2002","journal-title":"J Vasc Interv Radiol"},{"key":"R18-20260209","doi-asserted-by":"crossref","first-page":"105","DOI":"10.2214\/AJR.07.2145","article-title":"CT-guided percutaneous chemical ablation of adrenal neoplasms","volume":"190","author":"Xiao","year":"2008","journal-title":"Am J Roentgenol"},{"key":"R19-20260209","doi-asserted-by":"crossref","first-page":"3651","DOI":"10.1007\/s00330-018-5371-9","article-title":"Combined percutaneous radiofrequency ablation and ethanol injection versus hepatic resection for 2.1-5.0 cm solitary hepatocellular carcinoma: A retrospective comparative multicentre study","volume":"28","author":"Chen","year":"2018","journal-title":"Eur Radiol"},{"key":"R20-20260209","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1080\/02656736.2021.1977857","article-title":"Percutaneous ethanol injection enhanced the efficacy of radiofrequency ablation in the treatment of HCC: An insight into the mechanism of ethanol action","volume":"38","author":"Tan","year":"2021","journal-title":"Int J Hyperthermia"},{"key":"R21-20260209","doi-asserted-by":"crossref","first-page":"20160760","DOI":"10.1259\/bjr.20160760","article-title":"Ultrasound guided high-intensity focused ultrasound combined with gonadotropin releasing hormone analogue (GnRHa) ablating uterine leiomyoma with homogeneous hyperintensity on T(2) weighted MR imaging","volume":"90","author":"Yang","year":"2017","journal-title":"Br J Radiol"},{"key":"R22-20260209","doi-asserted-by":"crossref","first-page":"10812","DOI":"10.1038\/s41598-017-11486-5","article-title":"A clinical investigation treating different types of fibroids identified by MRI-T2WI imaging with ultrasound guided high intensity focused ultrasound","volume":"7","author":"Zhao","year":"2017","journal-title":"Sci Rep"},{"key":"R23-20260209","doi-asserted-by":"crossref","first-page":"7360","DOI":"10.1007\/s00330-023-09984-4","article-title":"What predicts durable symptom relief of uterine fibroids treated with MRI-guided focused ultrasound? A multicenter trial in 8 academic centers","volume":"33","author":"Bitton","year":"2023","journal-title":"Eur Radiol"},{"key":"R24-20260209","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.ejogrb.2014.09.039","article-title":"Safety and five-year re-intervention following magnetic resonance-guided focused ultrasound (MRgFUS) for uterine fibroids","volume":"182","author":"Quinn","year":"2014","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"R25-20260209","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.ejogrb.2014.05.029","article-title":"Long-term risk of fibroid recurrence after laparoscopic myomectomy","volume":"180","author":"Radosa","year":"2014","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"R26-20260209","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1089\/jwh.2017.6752","article-title":"Reintervention rates after myomectomy, endometrial ablation, and uterine artery embolization for patients with uterine fibroids","volume":"27","author":"Davis","year":"2018","journal-title":"J Womens Health (Larchmt)"},{"key":"R27-20260209","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1080\/02656736.2020.1807617","article-title":"Long-term follow-up outcome and reintervention analysis of ultrasound-guided high intensity focused ultrasound treatment for uterine fibroids","volume":"37","author":"Li","year":"2020","journal-title":"Int J Hyperthermia"},{"key":"R28-20260209","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1080\/02656736.2018.1511837","article-title":"Factors affecting effects of ultrasound guided high intensity focused ultrasound for single uterine fibroids: A retrospective analysis","volume":"35","author":"Fan","year":"2018","journal-title":"Int J Hyperthermia"},{"key":"R29-20260209","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1080\/02656736.2021.1904152","article-title":"Magnetic resonance imaging parameters in predicting the ablative efficiency of high-intensity focused ultrasound for uterine fibroids","volume":"38","author":"Gong","year":"2021","journal-title":"Int J Hyperthermia"},{"key":"R30-20260209","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.crad.2022.09.112","article-title":"MRI parameters for predicting the effect of ultrasound-guided high-intensity focused ultrasound in the ablation of uterine fibroids","volume":"78","author":"Liao","year":"2023","journal-title":"Clin Radiol"},{"key":"R31-20260209","doi-asserted-by":"crossref","first-page":"725193","DOI":"10.3389\/fonc.2021.725193","article-title":"Comparison of dose and effectiveness of a single-session ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroids with different sizes","volume":"11","author":"Yang","year":"2021","journal-title":"Front Oncol"},{"key":"R32-20260209","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.ultrasmedbio.2014.09.022","article-title":"Effect of biological characteristics of different types of uterine fibroids, as assessed with T2-weighted magnetic resonance imaging, on ultrasound-guided high-intensity focused ultrasound ablation","volume":"41","author":"Zhao","year":"2015","journal-title":"Ultrasound Med Biol"},{"key":"R33-20260209","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1080\/02656736.2019.1592242","article-title":"Reasons for different therapeutic effects of high-intensity focused ultrasound ablation on excised uterine fibroids with different signal intensities on T2-weighted MRI: A study of histopathological characteristics","volume":"36","author":"Huang","year":"2019","journal-title":"Int J Hyperthermia"},{"key":"R34-20260209","doi-asserted-by":"crossref","first-page":"923","DOI":"10.3171\/jns.1998.88.5.0923","article-title":"Tumor devascularization by intratumoral ethanol injection during surgery. Technical note","volume":"88","author":"Lonser","year":"1998","journal-title":"J Neurosurg"},{"key":"R35-20260209","doi-asserted-by":"crossref","first-page":"657","DOI":"10.7863\/ultra.33.4.657","article-title":"A case-control study of high-intensity focused ultrasound combined with sonographically guided intratumoral ethanol injection in the treatment of uterine fibroids","volume":"33","author":"Yang","year":"2014","journal-title":"J Ultrasound Med"},{"key":"R36-20260209","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1080\/02656736.2018.1473894","article-title":"Adverse effect analysis of high-intensity focused ultrasound in the treatment of benign uterine diseases","volume":"35","author":"Liu","year":"2018","journal-title":"Int J Hyperthermia"}],"container-title":["Gynecology and Minimally Invasive Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/gmit.GMIT-D-24-00013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:43:06Z","timestamp":1787067786000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/gmit.GMIT-D-24-00013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,26]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/gmit.gmit-d-24-00013","relation":{},"ISSN":["2213-3070","2213-3089"],"issn-type":[{"value":"2213-3070","type":"print"},{"value":"2213-3089","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,26]]},"assertion":[{"value":"2024-08-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-25","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}