Lessons learned during implementation of MR-guided High-Intensity Focused Ultrasound treatment of uterine fibroids.

Autor:	Anneveldt KJ; Department of Radiology, Isala Hospital, Zwolle, The Netherlands. k.j.anneveldt@isala.nl.; Department of Gynecology, Isala Hospital, Zwolle, The Netherlands. k.j.anneveldt@isala.nl., Verpalen IM; Department of Radiology, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands., Nijholt IM; Department of Radiology, Isala Hospital, Zwolle, The Netherlands., Dijkstra JR; Department of Gynecology, Isala Hospital, Zwolle, The Netherlands., van den Hoed RD; Department of Radiology, Isala Hospital, Zwolle, The Netherlands., Van't Veer-Ten Kate M; Department of Radiology, Isala Hospital, Zwolle, The Netherlands., de Boer E; Department of Radiology, Isala Hospital, Zwolle, The Netherlands., van Osch JAC; Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands., Heijman E; Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany.; Department of Oncology, Philips Research Eindhoven, Eindhoven, The Netherlands., Naber HR; Department of Anesthesiology, Isala Hospital, Zwolle, The Netherlands., Ista E; Department of Internal Medicine, Section of Nursing Science, Erasmus Medical Center, Rotterdam, The Netherlands., Franx A; Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands., Veersema S; Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands., Huirne JAF; Department of Gynecology, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands., Schutte JM; Department of Gynecology, Isala Hospital, Zwolle, The Netherlands., Boomsma MF; Department of Radiology, Isala Hospital, Zwolle, The Netherlands.
Jazyk:	angličtina
Zdroj:	Insights into imaging [Insights Imaging] 2021 Dec 18; Vol. 12 (1), pp. 188. Date of Electronic Publication: 2021 Dec 18.
DOI:	10.1186/s13244-021-01128-w
Abstrakt:	Background: Although promising results have been reported for Magnetic Resonance image-guided High-Intensity Focused Ultrasound (MR-HIFU) treatment of uterine fibroids, this treatment is not yet widely implemented in clinical practice. During the implementation of a new technology, lessons are learned and an institutional learning-curve often has to be completed. The primary aim of our prospective cohort study was to characterize our learning-curve based on our clinical outcomes. Secondary aims included identifying our lessons learned during implementation of MR-HIFU on a technical, patient selection, patient counseling, medical specialists and organizational level. Results: Our first seventy patients showed significant symptom reduction and improvement of quality of life at 3, 6 and 12 months after MR-HIFU treatment compared to baseline. After the first 25 cases, a clear plateau phase was reached in terms of failed treatments. The median non-perfused volume percentage of these first 25 treatments was 44.6% (range: 0-99.7), compared to a median of 74.7% (range: 0-120.6) for the subsequent treatments. Conclusions: Our findings describe the learning-curve during the implementation of MR-HIFU and include straightforward suggestions to shorten learning-curves for future users. Moreover, the lessons we learned on technique, patient selection, patient counseling, medical specialists and organization, together with the provided supplements, may be of benefit to other institutions aiming to implement MR-HIFU treatment of uterine fibroids. Trial registration ISRCTN14634593. Registered January 12, 2021-Retrospectively registered, https://www.isrctn.com/ISRCTN14634593 . (© 2021. The Author(s).)
Databáze:	MEDLINE
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