State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.
Department of Ultrasound Medicine, Mianyang Central Hospital, Mianyang, Sichuan Province, China.
J Int Med Res. 2022 May;50(5):3000605221102087. doi: 10.1177/03000605221102087.
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.
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.
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.
NPVR ≥ 80% is a standard that is worth using for HIFU treatment of uterine fibroids.
评估不同经验水平的医生对高强度聚焦超声（HIFU）治疗子宫肌瘤的效果，为培训期间非灌注体积比（NPVR）标准的使用提供参考。
这是一项前瞻性多中心研究，纳入了子宫肌瘤患者。分析了医生经验水平对不同 NPVR 标准下的治疗效果以及 6 家无 HIFU 经验中心的学习曲线的影响，并评估了患者人口统计学和临床特征的影响。
共纳入来自 20 家中心的 1352 名患者。无经验组、经验不足组和经验丰富组的中位 NPVR 分别为 92.00%、88.10%和 92.86%。后壁肌瘤、侧壁肌瘤和底壁肌瘤与 NPVR 呈负相关，而经验丰富的医生与 NPVR 呈正相关。以 NPVR≥70%和 NPVR≥80%为标准，无经验组的医生分别在第 11 次和第 16 次手术时完成了学习曲线，而 NPVR≥90%的标准下，医生未完成学习曲线。
NPVR≥80%是高强度聚焦超声治疗子宫肌瘤值得使用的标准。
