Magnetic Resonance-High Intensity Focused Ultrasound (MR-HIFU) in
uterine fibroids management: An updated meta-analysis.
Abstract
Purpose: Magnetic Resonance-High Intensity Focused Ultrasound (MR-HIFU)
has revolutionized the treatment of Uterine fibroids. Usually, they are
associated with prolonged heavy bleeding during the menstrual period,
sacral pain, and increased frequency of UTIs, secondary dysmenorrhea,
constipation, and pregnancy-associated problems. It also impacts usual
activities, which lead to diminished quality of life and rising
healthcare costs. Generally, surgery is the only choice for uterine
fibroids; however, MR-HIFU is an entirely non-invasive novel therapy,
preferred in pregnancy desiring females. Excluding trials with stringent
treatment protocols that are no longer used, the efficacy of Magnetic
Resonance-High Intensity Focused Ultrasound (MRHIFU) therapy for uterine
fibroids is being re-evaluated. Methods: RCTs, Prospective or
Retrospective non-randomized, and cross-over studies that considered
clinically symptomatic uterine fibroid treatment were included. The
author has searched the data in Cochrane Library, PubMed/MEDLINE,
SCOPUS, EMBASE databases. Meta-Analysis was performed using NCSS
software, and data were analyzed at a 95% confidence level with a level
of precision at 0.05. The NPV%, tSSS change%, and QoL were computed.
Meta-Regression was done to evaluate the association between the
different parameters. Results: The overall effect of NPV% was 70.24,
where the 95% confidence interval ranged from 61.9% to 78.16%. The
overall impact of tSSS% change is near 50% after the follow-up of 3
months, 6 months, and 12 months in the included studies. There was a
significant improvement in the health-related quality of life (Hr-QoL).
Conclusion: The efficacy of MR-HIFU therapy was improved as treatment
protocols aimed for total ablation. On the other hand, regulated studies
are required to determine the function of MR-HIFU in the treatment of
uterine fibroids.