Percutaneous High Frequency Microwave Ablation of Uterine Fibroids: Systematic Review

Table 1

The table summarizes all reviewed series according to each variable included in review process. The following are reported specific acronyms: Pts: patients; CE-MRI: Contrast-Enhanced Magnetic Resonance Imaging; CEUS: Contrast-Enhanced Ultrasound; FUP: follow UpNA: not available; Hb: hemoglobin level; SSS: symptom severity scores. Questions regarding the severity of symptoms; scale of score was 5–40; QMAV: Quantitative Microwave Ablation Volume. The nonenhanced CEUS volume after 50 W × 300 sec or 60 W × 300 sec ablation; HRQL: Health Related Quality of Life; UFS-QOL: Uterine Fibroid Symptom and Quality Of Life.

Study

Pts

Dimension fibroids treated

Technology

Number of antennas

Median treatment time

Posttreatment

Technical; success

Clinical success

Complications

FUP

Second treatment

Surgery; yes/no

Ablation rate

CE-MRI/CEUS

Timing

Zhang et al. 2011; [13]

40 fibroids

Volume mean: 140,1 +/− 87,4 cm^3

KV2000, 2450 MHz,; 50 W 300–600 min,; antenna 15 G

1 antenna for <5 cm fibroids; Double antennas for >5 cm fibroids

490 sec

Shrinkage rate:

CE-MRI

100%

NA

Lower abdominal pain (6 pz); Small amount vaginal bloody secretions (7 pz → 6 of these recovered for 1 week)

12 m

0

NA

61,8%

3 months

78,7%

6 months

73,2%

9 months

93,1%

12 months

Xia et al. 2014; [15]

88 pts; 91 leiomyomas; (T2WI signal: 35 hypointense; 29 isointense; 27 hyperintense)

Volume: 158,09 +/− 127,28 cm^3

KV2000 tumor coagulator; Power: 50 W or 60 W; Frequency: 2450 MHz; Electrode diameter: 15 G

NA

300 sec

QMAV: Hypointense: 46,58 +/− 25,63 cm^3; Isointense: 44.46 +/− 16.72 cm^3; Hyperintense: 23,58 +/− 11,85 cm^3

CEUS

After 50 W × 300 sec; or 60 W × 300 sec’s ablation

100%

NA

NA

NA

0

NA

CE-MRI

Within 5 days after treatment

Xia et al. 2014; [16]

49 pts; 49 leiomyomas; (T2WI signal: 28 hypointense; 13 Isointense; 8 hyperintense)

Average diameter: intramural/subserous myoma 5 cm; submucous myoma 3 cm

KV2000 tumor coagulator: Power 50 W; Frequency: 2450 MHz; Electrode diameter: 15 G

1 antenna for <5 cm fibroids; Double antennas for >5 cm fibroids

NA

NA

CEUS

At the end of treatment to evaluate ablation effects

100%

NA

NA

NA

0

NA

CE-MRI

Within 7 days after treatment

Yang et al. 2014; [17]

22 pts; 22 submucosal myomas

Diameter: 4,9 cm

KY2000 MW, 2450 MHz, antenna 15 G

100% single ablation

NA

Volume reduction rate: 81,46%; 90%

CE-MRI and CEUS

3 months; 12 months

100%

Hb: from 88,64 g/l; to 123,21 g/l at 3 months and to 125,92 at 12 months; UFS-QOL: normal level at 1 year

No major complications; Lower abdominal pain (31,82%); Small amount of vaginal secretion (100%); Bloody vaginal secretion (9%)

12 m

0

NA

Zhao et al. 2015; [18]

31 pts; 40 fibroids

Average diameter: 68,6 +/− 12,7 mm

KV2100 Microwave tumor treatment device: Power 50–100 W; Frequency: 2450 MHz; Electrode diameter: 15 G

1 electrode for <5 cm fibroids; Double electrode for >5 cm fibroids

Session 46,2 min; MWA NA

Ablation rate: 79,8 +/− 14,9%

CEUS

Immediately after procedure

100%

Changes in SSS: 10.2

Lower abdomen pain; Vaginal discharge; Low grade fever; NO serious adverse events

6 m

0

NA

Regression rate: 52,4%

CE-MRI

After 6 months

Liu et al. 2016; [19]

311 pts; 405 leiomyomas

Diameter: 5,1 +/− 1,28 cm; Volume: 95,01 +/− 70,29 cm^3

KV2000 MW +; ECO-100C Microwave system

1 or 2 microwave antennas

NA

Reduction rate: 63,5%; 78,5%; 86,7%

CEUS

3 months; 6 months; 12 months

100%

Hb: from 88,84 +/− 9,31 g/l; to 107,14 +/− 13,32 at 3 months; and to 117,79 +/− 6,51 at 12 months; SSS and HRQL significantly improve post treatment

Lower abdominal pain (8,68%).; Small amount of vaginal secretion (6,11%)

12 m

2 pts

NA