Journal of International Medical Research · 2022 · 20 citations · 15 references
MedicineGynecologyMedical EducationGynecologic UltrasoundUltrasonographyUltrasoundUterine UltrasonographyUterine UltrasoundAblation Of Uterine FibroidsFibroid Volume ReductionHigh-intensity Focused UltrasoundLearning Curve EvaluationOperator Learning CurveUltrasound AblationUltrasound-guided AblationUterine Fibroid Evaluation
OBJECTIVE: To evaluate the effect of different levels of physician experience on the high-intensity focused ultrasound (HIFU) ablation of uterine fibroids and to provide a reference for the use of non-perfused volume ratio (NPVR) standards during training. METHODS: This prospective multicentre study enrolled patients with uterine fibroids. The effect of the physician's level of experience on the outcomes under different NPVR standards and the learning curve of six centres without HIFU experience were analysed. The impact of patient demographic and clinical characteristics were also evaluated. RESULTS: A total of 1352 patients from 20 centres were included in the study. The median NPVRs were 92.00%, 88.10% and 92.86% in the no experience group, inexperienced group and experienced group, respectively. Posterior wall fibroids, lateral wall fibroids and fundus fibroids were inversely correlated with NPVR, while experienced physicians were positively correlated with NPVR. With NPVR ≥ 70% and NPVR ≥ 80% standards, physicians in the no experience group completed the learning curve on the 11th and 16th procedure, respectively. Physicians under a standard of an NPVR ≥ 90% did not complete the learning curve. CONCLUSIONS: NPVR ≥ 80% is a standard that is worth using for HIFU treatment of uterine fibroids.
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Kaoru Funaki, Hidenobu Fukunishi, Tsuyoshi Funaki et al. · American Journal of Obstetrics and Gynecology · 2007 · 248 citations