International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group · 2026
Polidocanol augments high-intensity focused ultrasound efficacy for hyperintense fibroids on T2WI: a retrospective cohort study.
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Yang Ming-Tao, Tian Ling, Xia Yu, He Hong-Ni, Lin Chuan, He Tian-Wen, Tang Ying, Hu Hui-Quan, Li Jun
Аннотация
OBJECTIVE: To compare the immediate efficacy and safety of high-intensity focused ultrasound (HIFU) monotherapy with the combination of ultrasound-guided intratumoral polidocanol injection and HIFU for the treatment of uterine fibroids with high T2-weighted imaging (T2WI) signal intensity.
METHODS: In this retrospective study, 116 patients with T2-hyperintense uterine fibroids treated between January 2024 and May 2025 were enrolled. Patients were allocated to either HIFU monotherapy (the H group, n = 63) or combined polidocanol and HIFU therapy (the H + P group, n = 53). Thereafter, therapeutic parameters, the non-perfused volume ratio (NPVR), and adverse events were compared between the two groups after propensity score matching.
RESULTS: The matched cohort comprised 53 patients per group. The median NPVR was significantly higher in the H + P group than in the H group (92.57% vs. 77.81%, p < 0.001). Additionally, a significantly greater proportion of patients in the H + P group achieved an NPVR ≥ 80% (87% vs. 43%, p < 0.001) and an NPVR ≥ 90% (60% vs. 9%, p < 0.001). The H + P group also required significantly less sonication time and lower total energy delivery (both p < 0.05). Furthermore, the overall incidence of adverse events was similar between the two groups (73.6% vs. 69.8%, p = 0.506). However, the H + P group exhibited a markedly lower incidence of sacrococcygeal pain (5.7% vs. 45.3%, p < 0.001).
CONCLUSION: Pretreatment with ultrasound-guided intratumoral polidocanol injection may improve the immediate ablation efficacy of HIFU in T2-hyperintense uterine fibroids, reducing energy requirements and mitigating procedure-related sacrococcygeal pain. These findings highlight the potential of this combined therapy and underscore the need for prospective studies to confirm its long-term clinical benefits.
METHODS: In this retrospective study, 116 patients with T2-hyperintense uterine fibroids treated between January 2024 and May 2025 were enrolled. Patients were allocated to either HIFU monotherapy (the H group, n = 63) or combined polidocanol and HIFU therapy (the H + P group, n = 53). Thereafter, therapeutic parameters, the non-perfused volume ratio (NPVR), and adverse events were compared between the two groups after propensity score matching.
RESULTS: The matched cohort comprised 53 patients per group. The median NPVR was significantly higher in the H + P group than in the H group (92.57% vs. 77.81%, p < 0.001). Additionally, a significantly greater proportion of patients in the H + P group achieved an NPVR ≥ 80% (87% vs. 43%, p < 0.001) and an NPVR ≥ 90% (60% vs. 9%, p < 0.001). The H + P group also required significantly less sonication time and lower total energy delivery (both p < 0.05). Furthermore, the overall incidence of adverse events was similar between the two groups (73.6% vs. 69.8%, p = 0.506). However, the H + P group exhibited a markedly lower incidence of sacrococcygeal pain (5.7% vs. 45.3%, p < 0.001).
CONCLUSION: Pretreatment with ultrasound-guided intratumoral polidocanol injection may improve the immediate ablation efficacy of HIFU in T2-hyperintense uterine fibroids, reducing energy requirements and mitigating procedure-related sacrococcygeal pain. These findings highlight the potential of this combined therapy and underscore the need for prospective studies to confirm its long-term clinical benefits.