Skip to main content
Erschienen in:

29.05.2024 | Short Communication

Radiofrequency Ablation: A Promising Treatment Method for Abdominal Wall Endometriosis

verfasst von: Ali Mahdavi, Seyed Ali Forouzannia, Ehsan Goudarzi, Seyed Mohammad Forouzannia, Romina Rafiei, Fateme Yousefimoghaddam, Niloufar Rafiei, Roya Padmehr

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 7/2024

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the application of radiofrequency ablation (RFA) as a treatment method for abdominal wall endometriosis (AWE).

Materials and Methods

The characteristics of the AWE lesions in the patients were obtained using ultrasound (US). The patients received general and local anesthesia, and then, AWE lesions were divided into 1 cm3 sections visually, and each of these sections underwent US-guided RFA using the moving shot technique. Follow-up included outpatient appointments, including a US examination 1, 3, and 6 months after the treatment to assess the volume of the lesions. In addition, the level of pain experienced by the patients was measured using a visual analogue scale (VAS) before and the day after the procedure, as well as at each follow-up appointment.

Results

Ten patients were treated with RFA. The procedural success was achieved in all of the patients. The median volume of the lesions decreased from 7.3 cm3 (IQR = 4.39,23.75) to 2.95 cm3 (IQR = 1.65,9.09) (P = 0.005). All patients reported reduced pain levels, and the median of their VAS score decreased from 9 (IQR = 8,9) to 0 (IQR = 0,1.25) (P = 0.004) at the end of the follow-up period. None of the patients experienced complications related to RFA treatment.

Conclusion

Based on the study's findings, RFA appears to be a promising minimally invasive treatment for AWE. However, larger studies with longer follow-up periods are required for a more comprehensive understanding of its efficacy and safety.

Level of Evidence

Level 4, Case Series.

Graphical Abstract

Literatur
1.
2.
Zurück zum Zitat Horton JD, DeZee KJ, Ahnfeldt EP, Wagner M. Abdominal wall endometriosis: a surgeon’s perspective and review of 445 cases. The American Journal of Surgery. 2008;196(2):207–12.CrossRefPubMed Horton JD, DeZee KJ, Ahnfeldt EP, Wagner M. Abdominal wall endometriosis: a surgeon’s perspective and review of 445 cases. The American Journal of Surgery. 2008;196(2):207–12.CrossRefPubMed
3.
Zurück zum Zitat Kang J, Baek JH, Lee WS, Cho TH, Lee JN, Lee WK, et al. Clinical manifestations of abdominal wall endometriosis: a single center experience. Arch Gynecol Obstet. 2013;287(2):301–5.CrossRefPubMed Kang J, Baek JH, Lee WS, Cho TH, Lee JN, Lee WK, et al. Clinical manifestations of abdominal wall endometriosis: a single center experience. Arch Gynecol Obstet. 2013;287(2):301–5.CrossRefPubMed
4.
Zurück zum Zitat Maillot J, Brun JL, Dubuisson V, Bazot M, Grenier N, Cornelis FH. Mid-term outcomes after percutaneous cryoablation of symptomatic abdominal wall endometriosis: comparison with surgery alone in a single institution. Eur Radiol. 2017;27(10):4298–306.CrossRefPubMed Maillot J, Brun JL, Dubuisson V, Bazot M, Grenier N, Cornelis FH. Mid-term outcomes after percutaneous cryoablation of symptomatic abdominal wall endometriosis: comparison with surgery alone in a single institution. Eur Radiol. 2017;27(10):4298–306.CrossRefPubMed
6.
Zurück zum Zitat Welch BT, Ehman EC, VanBuren WM, Cope AG, Welch TL, Woodrum DA, et al. Percutaneous cryoablation of abdominal wall endometriosis: the Mayo Clinic approach. Abdominal Radiology. 2020;45(6):1813–7.CrossRefPubMed Welch BT, Ehman EC, VanBuren WM, Cope AG, Welch TL, Woodrum DA, et al. Percutaneous cryoablation of abdominal wall endometriosis: the Mayo Clinic approach. Abdominal Radiology. 2020;45(6):1813–7.CrossRefPubMed
7.
Zurück zum Zitat Smith KA, Welch BT, Kurup AN, Schmitz JJ, VanBuren WM, Ehman EC, et al. Feasibility and safety of percutaneous image-guided cryoablation of abdominal wall endometriosis. Abdominal Radiology. 2022;47(8):2669–73.CrossRefPubMed Smith KA, Welch BT, Kurup AN, Schmitz JJ, VanBuren WM, Ehman EC, et al. Feasibility and safety of percutaneous image-guided cryoablation of abdominal wall endometriosis. Abdominal Radiology. 2022;47(8):2669–73.CrossRefPubMed
8.
Zurück zum Zitat Wang Y, Wang W, Wang L, Wang J, Tang J. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: Preliminary results. Eur J Radiol. 2011;79(1):56–9.CrossRefPubMed Wang Y, Wang W, Wang L, Wang J, Tang J. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: Preliminary results. Eur J Radiol. 2011;79(1):56–9.CrossRefPubMed
9.
Zurück zum Zitat Zhu X, Chen L, Deng X, Xiao S, Ye M, Xue M. A comparison between high-intensity focused ultrasound and surgical treatment for the management of abdominal wall endometriosis. BJOG. 2017;124:53–8.CrossRefPubMed Zhu X, Chen L, Deng X, Xiao S, Ye M, Xue M. A comparison between high-intensity focused ultrasound and surgical treatment for the management of abdominal wall endometriosis. BJOG. 2017;124:53–8.CrossRefPubMed
10.
Zurück zum Zitat Xiao-Ying Z, Hua D, Jin-Juan W, Ying-Shu G, Jiu-Mei C, Hong Y, et al. Clinical analysis of high-intensity focussed ultrasound ablation for abdominal wall endometriosis: a 4-year experience at a specialty gynecological institution. Int J Hyperth. 2019;36(1):87–94.CrossRef Xiao-Ying Z, Hua D, Jin-Juan W, Ying-Shu G, Jiu-Mei C, Hong Y, et al. Clinical analysis of high-intensity focussed ultrasound ablation for abdominal wall endometriosis: a 4-year experience at a specialty gynecological institution. Int J Hyperth. 2019;36(1):87–94.CrossRef
11.
12.
Zurück zum Zitat Carrafiello G, Fontana F, Pellegrino C, Mangini M, Cabrini L, Mariani D, et al. Radiofrequency Ablation of Abdominal Wall Endometrioma. Cardiovasc Intervent Radiol. 2009;32(6):1300–3.CrossRefPubMed Carrafiello G, Fontana F, Pellegrino C, Mangini M, Cabrini L, Mariani D, et al. Radiofrequency Ablation of Abdominal Wall Endometrioma. Cardiovasc Intervent Radiol. 2009;32(6):1300–3.CrossRefPubMed
13.
Zurück zum Zitat Luo S, Zhang C, Huang J, Huang G, He J. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: a retrospective study. BJOG. 2017;124:59–63.CrossRefPubMed Luo S, Zhang C, Huang J, Huang G, He J. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: a retrospective study. BJOG. 2017;124:59–63.CrossRefPubMed
14.
Zurück zum Zitat Nirula R, Greaney GC. Incisional endometriosis: an underappreciated diagnosis in general surgery1. J Am Coll Surg. 2000;190(4):404–7.CrossRefPubMed Nirula R, Greaney GC. Incisional endometriosis: an underappreciated diagnosis in general surgery1. J Am Coll Surg. 2000;190(4):404–7.CrossRefPubMed
15.
Zurück zum Zitat Khan Z, Zanfagnin V, El-Nashar SA, Famuyide AO, Daftary GS, Hopkins MR. Risk Factors, Clinical Presentation, and Outcomes for Abdominal Wall Endometriosis. J Minim Invasive Gynecol. 2017;24(3):478–84.CrossRefPubMed Khan Z, Zanfagnin V, El-Nashar SA, Famuyide AO, Daftary GS, Hopkins MR. Risk Factors, Clinical Presentation, and Outcomes for Abdominal Wall Endometriosis. J Minim Invasive Gynecol. 2017;24(3):478–84.CrossRefPubMed
16.
Zurück zum Zitat Savelli L, Manuzzi L, Di Donato N, Salfi N, Trivella G, Ceccaroni M, et al. Endometriosis of the abdominal wall: ultrasonographic and Doppler characteristics. Ultrasound Obstet Gynecol. 2012;39(3):336–40.CrossRefPubMed Savelli L, Manuzzi L, Di Donato N, Salfi N, Trivella G, Ceccaroni M, et al. Endometriosis of the abdominal wall: ultrasonographic and Doppler characteristics. Ultrasound Obstet Gynecol. 2012;39(3):336–40.CrossRefPubMed
17.
Zurück zum Zitat Purvis RS, Tyring SK. Cutaneous and Subcutaneous Endometriosis. J Dermatol Surg Oncol. 1994;20(10):693–5.CrossRefPubMed Purvis RS, Tyring SK. Cutaneous and Subcutaneous Endometriosis. J Dermatol Surg Oncol. 1994;20(10):693–5.CrossRefPubMed
18.
Zurück zum Zitat Fitzpatrick D, Pirie K, Reeves G, Green J, Beral V. Combined and progestagen-only hormonal contraceptives and breast cancer risk: A UK nested case–control study and meta-analysis. PLoS Med. 2023;20(3): e1004188.CrossRefPubMedPubMedCentral Fitzpatrick D, Pirie K, Reeves G, Green J, Beral V. Combined and progestagen-only hormonal contraceptives and breast cancer risk: A UK nested case–control study and meta-analysis. PLoS Med. 2023;20(3): e1004188.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Li JX, Li XL, Zhu JE, Zhang HL, Yu SY, Xu HX. Ultrasound-guided microwave ablation for symptomatic abdominal wall endometriosis and treatment response evaluation with contrast-enhanced imaging: The first experience. Clin Hemorheol Microcirc. 2022;82(1):63–73.CrossRefPubMed Li JX, Li XL, Zhu JE, Zhang HL, Yu SY, Xu HX. Ultrasound-guided microwave ablation for symptomatic abdominal wall endometriosis and treatment response evaluation with contrast-enhanced imaging: The first experience. Clin Hemorheol Microcirc. 2022;82(1):63–73.CrossRefPubMed
21.
Zurück zum Zitat Jouffrieau C, Cazzato RL, Gabriele V, Faller E, Weiss J, Host A, et al. Percutaneous Imaging-guided Cryoablation of Endometriosis Scars of the Anterior Abdominal Wall. J Minim Invasive Gynecol. 2023;30(11):890–6.CrossRefPubMed Jouffrieau C, Cazzato RL, Gabriele V, Faller E, Weiss J, Host A, et al. Percutaneous Imaging-guided Cryoablation of Endometriosis Scars of the Anterior Abdominal Wall. J Minim Invasive Gynecol. 2023;30(11):890–6.CrossRefPubMed
22.
Zurück zum Zitat Zhang X, Duan H. One-time high-intensity focused ultrasound ablation of abdominal wall endometriosis with concurrent uterine fibroids or adenomyosis: two cases and literature review. Quant Imaging Med Surg. 2020;10(2):511–7.CrossRefPubMedPubMedCentral Zhang X, Duan H. One-time high-intensity focused ultrasound ablation of abdominal wall endometriosis with concurrent uterine fibroids or adenomyosis: two cases and literature review. Quant Imaging Med Surg. 2020;10(2):511–7.CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Izadifar Z, Izadifar Z, Chapman D, Babyn P. An Introduction to High Intensity Focused Ultrasound: Systematic Review on Principles, Devices, and Clinical Applications. J Clin Med. 2020;9(2):460.CrossRefPubMedPubMedCentral Izadifar Z, Izadifar Z, Chapman D, Babyn P. An Introduction to High Intensity Focused Ultrasound: Systematic Review on Principles, Devices, and Clinical Applications. J Clin Med. 2020;9(2):460.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Hocquelet A, Balageas P, Laurent C, Blanc JF, Frulio N, Salut C, et al. Radiofrequency ablation versus surgical resection for hepatocellular carcinoma within the Milan criteria: A study of 281 Western patients. Int J Hyperth. 2015;31(7):749–57.CrossRef Hocquelet A, Balageas P, Laurent C, Blanc JF, Frulio N, Salut C, et al. Radiofrequency ablation versus surgical resection for hepatocellular carcinoma within the Milan criteria: A study of 281 Western patients. Int J Hyperth. 2015;31(7):749–57.CrossRef
25.
Zurück zum Zitat Yin G, Zhu T, Li J, Chen M, Yang S, Zhao X. Decreased expression of survivin, estrogen and progesterone receptors in endometrial tissues after radiofrequency treatment of dysfunctional uterine bleeding. World J Surg Oncol. 2012;10(1):100.CrossRefPubMedPubMedCentral Yin G, Zhu T, Li J, Chen M, Yang S, Zhao X. Decreased expression of survivin, estrogen and progesterone receptors in endometrial tissues after radiofrequency treatment of dysfunctional uterine bleeding. World J Surg Oncol. 2012;10(1):100.CrossRefPubMedPubMedCentral
Metadaten
Titel
Radiofrequency Ablation: A Promising Treatment Method for Abdominal Wall Endometriosis
verfasst von
Ali Mahdavi
Seyed Ali Forouzannia
Ehsan Goudarzi
Seyed Mohammad Forouzannia
Romina Rafiei
Fateme Yousefimoghaddam
Niloufar Rafiei
Roya Padmehr
Publikationsdatum
29.05.2024
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 7/2024
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-024-03755-4

Neu im Fachgebiet Radiologie

Ab sofort gelten die neuen Verordnungsausnahmen für Lipidsenker

Freie Fahrt für Lipidsenker? Das nicht, doch mit niedrigerem Schwellenwert fürs Infarktrisiko und neuen Indikationen hat der G-BA die Verordnungs-Handbremse ein gutes Stück weit gelockert.

Abdominale CT bei Kindern: 40% mit Zufallsbefunden

Wird bei Kindern mit stumpfem Trauma eine CT des Bauchraums veranlasst, sind in rund 40% der Fälle Auffälligkeiten zu sehen, die nichts mit dem Trauma zu tun haben. Die allerwenigsten davon sind klinisch relevant.

Genügt die biparametrische MRT für die Prostatadiagnostik?

Die multiparametrische Magnetresonanztomografie hat einen festen Platz im Screening auf klinisch signifikante Prostatakarzinome. Ob auch ein biparametrisches Vorgehen ausreicht, ist in einer Metaanalyse untersucht worden.

Höhere Trefferquoten bei Brustkrebsscreening dank KI?

Künstliche Intelligenz unterstützt bei der Auswertung von Mammografie-Screenings und senkt somit den Arbeitsaufwand für Radiologen. Wie wirken sich diese Technologien auf die Trefferquote und die Falsch-positiv-Rate aus? Das hat jetzt eine Studie aus Schweden untersucht.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.