Use of Focused Ultrasound (Sonication) for the Diagnosis of Infections in Neurosurgical Operations: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 136 ◽  
pp. 364-373.e2
Author(s):  
Sotirios Apostolakis
Keyword(s):  
Systematic Review ◽  
Focused Ultrasound ◽  
Meta Analysis ◽  
Ultrasound Sonication

scholarly journals Functional lesional neurosurgery for tremor: a systematic review and meta-analysis

2018 ◽  
Vol 89 (7) ◽  
pp. 717-726 ◽  
Author(s):  
Sebastian R Schreglmann ◽  
Joachim K Krauss ◽  
Jin Woo Chang ◽  
Kailash P Bhatia ◽  
Georg Kägi
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Radiofrequency Ablation ◽  
Side Effects ◽  
Focused Ultrasound ◽  
Meta Analysis ◽  
Consistency Effect ◽  
Rubral Tremor ◽  
Ventral Intermediate Nucleus ◽  
Mri Guided

BackgroundThis work evaluates the consistency, effect size and incidence of persistent side effects of lesional neurosurgical interventions in the treatment of tremor due to Parkinson’s disease (PD), essential tremor (ET), multiple sclerosis (MS) and midbrain lesions.MethodsSystematic review and meta-analysis according to PRISMA-P guidelines. Random effects meta-analysis of standardised mean difference based on a peer-reviewed protocol (PROSPERO no. CRD42016048049).ResultsFrom 1249 abstracts screened, 86 peer-reviewed studies reporting 102 cohorts homogeneous for tremor aetiology, surgical target and technique were included.Effect on PD tremor was better when targeted at the ventral intermediate nucleus (V.im.) by radiofrequency ablation (RF) (Hedge’s g: −4.15;) over V.im. by Gamma Knife (GK) (−2.2), subthalamic nucleus (STN) by RF (−1.12) and globus pallidus internus (GPi) by RF (−0.89). For ET MRI-guided focused ultrasound (MRIgFUS) ablation of the cerebellothalamic tract (CTT) (−2.35) and V.im. (−2.08) showed similar mean tremor reductions to V.im. ablation by RF (−2.42) or GK (−2.13). In MS V.im. ablation by GK (−1.96) and RF (−1.63) were similarly effective.Mean rates of persistent side effects after unilateral lesions in PD were 12.8% (RF V.im.), 13.6% (RF STN), 9.2% (RF GPi), 0.7% (GK V.im.) and 7.0% (MRIgFUS V.im.). For ET, rates were 9.3% (RF V.im.), 1.8% (GK V.im.), 18.7% (MRIgFUS V.im.) and 0.0% (MRIgFUS CTT), for MS 37.7% (RF V.im.) and for rubral tremor 30.3% (RF V.im.).ConclusionThis meta-analysis quantifies safety, consistency and efficacy of lesional neurosurgical interventions for tremor by target, technique and aetiology.

Efficacy and safety of high-intensity focused ultrasound (HIFU) for treating benign thyroid nodules: a systematic review and meta-analysis

2020 ◽  
Vol 61 (12) ◽  
pp. 1636-1643 ◽  
Author(s):  
Sae Rom Chung ◽  
Jung Hwan Baek ◽  
Chong Hyun Suh ◽  
Young Jun Choi ◽  
Jeong Hyun Lee
Keyword(s):  
Systematic Review ◽  
High Intensity ◽  
Focused Ultrasound ◽  
Thyroid Nodules ◽  
Meta Analysis ◽  
High Intensity Focused Ultrasound ◽  
Efficacy And Safety ◽  
Inconsistency Index ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Background High-intensity focused ultrasound (HIFU) is an emerging thermal ablation technique that has been successfully applied to various benign thyroid nodules. Purpose To evaluate the efficacy and safety of HIFU for the treatment of benign thyroid nodules. Material and Methods The Ovid-MEDLINE and EMBASE databases were searched up to 9 July 2018 for studies describing the use of HIFU to treat benign thyroid nodules. We included studies that have outcomes with sufficient detail to evaluate the volume reduction rate (VRR). The pooled proportions of VRR ≥50% and pooled VRR at one, three, and six months after HIFU were assessed using random-effects modeling. Heterogeneity among studies was determined using Chi-square statistics for pooled estimates and the inconsistency index I2. Results Seven studies were included in the systematic review and four in the meta-analysis. The pooled VRR at one, three, and six months after HIFU were 17.59 (95% confidence interval [CI] 12.56–22.62), 48.93 (95% CI 42.20–55.66), and 60.43 (95% CI 51.88–68.98). The pooled proportions of VRR ≥50% at six months after HIFU were 75% (95% CI 53–89; I2=73.6%). There were no major complications of HIFU. Conclusion HIFU may be a safe and effective treatment modality for benign thyroid nodules, especially for small nodules.

scholarly journals Efficacy and safety of magnetic resonance-guided focused ultrasound for the treatment of painful bone metastases: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Joe D. Baal ◽  
William C. Chen ◽  
Ulysis Baal ◽  
Sagar Wagle ◽  
Jed H. Baal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Magnetic Resonance ◽  
Adverse Events ◽  
Bone Metastases ◽  
Pain Score ◽  
Focused Ultrasound ◽  
Meta Analysis ◽  
Post Treatment ◽  
Pain Scores ◽  
Painful Bone Metastases

Abstract Objective To report the safety and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) in the treatment of painful bone metastases through a systematic review and meta-analysis of pain scores before and after MRgFUS treatment and post-treatment adverse events. Materials and methods A comprehensive literature search of PubMed and Embase databases was performed for studies evaluating the efficacy and/or safety of MRgFUS. The mean difference of pain scores (10-point visual analogue scale or numerical rating scale) between baseline and 1-month/3-month pain scores was collected and analyzed in a pooled meta-analysis. Post-treatment adverse events based on the Common Terminology Criteria for Adverse Events (CTCAE) grading were recorded and the pooled prevalence was calculated. Results A total of 33 studies published between 2007 and 2019 were collected, resulting in a total sample size of 1082 patients. The majority of the studies were prospective with a reported follow-up period of 3 months. The pooled proportion of patients that achieved pain relief from MRgFUS (complete response or partial response [≥ 2-point improvement of pain score]) was 79% (95% CI 73–83%). The pooled 1-month and 3-month mean difference in pain score were − 3.8 (95% CI − 4.3; − 3.3) and − 4.4 (95% CI − 5.0; − 3.7), respectively. The overall rate of high-grade (CTCAE grade 3 or higher) and low-grade (CTCAE grade 2 or lower) MRgFUS-related adverse events were 0.9% and 5.9%, respectively. Conclusion MRgFUS is an effective procedure that is able to provide significant pain palliation for patients with symptomatic bone metastases with a favorable safety profile.

scholarly journals Efficacy of High-Intensity Focused Ultrasound Combined With GnRH-a for Adenomyosis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 9 ◽  
Author(s):  
Li-Li Pang ◽  
Jin Mei ◽  
Ling-Xiu Fan ◽  
Ting-Ting Zhao ◽  
Ruo-Nan Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Recurrence Rate ◽  
High Intensity ◽  
Focused Ultrasound ◽  
Meta Analysis ◽  
High Intensity Focused Ultrasound ◽  
Cochrane Library ◽  
Lesion Volume ◽  
Non Invasive ◽  
Serum Ca125

Objective: High-intensity focused ultrasound (HIFU) is an innovative non-invasive technology used for adenomyosis. Gonadotropin-releasing hormone agonist (GnRH-a) is a hormone commonly used for adenomyosis. We investigated and assessed the efficacy of HIFU combined with GnRH-a for adenomyosis.Methods: For this systematic review and meta-analysis, we searched Pubmed, Cochrane Library, Web of Science, Embase, CNKI, WanFang, and VIP databases for relevant articles published in Chinese or English that compared HIFU combined with GnRH-a vs. HIFU alone in patients with adenomyosis. The last literature search was completed on January 31, 2021. Two reviewers independently assessed study eligibility and assessed risk of bias. Another two reviewers extracted the data. The RevMan5.3 software was used for the data analysis. Changes in volume of the uterine and adenomyotic lesion were defined as the primary outcomes. The secondary outcomes were visual analog scale (VAS) scores for dysmenorrhea, menstrual volume scores, serum CA125 levels, and recurrence rate. This study is registered with PROSPERO (CRD42021234301).Results: Three hundred and ninety potentially relevant articles were screened. Nine studies with data for 766 patients were finally included. Compared with the HIFU alone group, the HIFU combined with GnRH-a group had a higher rate of uterine volume reduction (MD 7.51, 95% CI 5.84–9.17, p < 0.00001), smaller adenomyotic lesion volume (MD 4.11, 95% CI 2.93–5.30, p < 0.00001), lower VAS score for dysmenorrhea (MD 1.27, 95% CI 0.54–2.01, p = 0.0007) and menstrual volume score (MD 0.88, 95% CI 0.73–1.04, p < 0.00001), and lower CA125 level (SMD 0.31, 95% CI 0.05–0.56, p = 0.02) after the procedure. The recurrence rate in the HIFU combined with GnRH-a group was lower than that in the HIFU alone group (RR 0.28, 95% CI 0.10–0.82, p = 0.02).Conclusions: Compared with HIFU treatment alone, HIFU combined with GnRH-a for the treatment of adenomyosis has greater efficacy in decreasing the volumes of the uterine and adenomyotic lesions and alleviating symptoms. However, since the number of the included studies was too small and most of them were written in Chinese, this conclusion needs to be referenced with caution. And the long-term evidence of its efficacy is still insufficient.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/ identifier [CRD42021234].

scholarly journals Is High-intensity Focused Ultrasound Effective for the Treatment of Adenomyosis? A Systematic Review and Meta-analysis

2020 ◽  
Vol 27 (2) ◽  
pp. 332-343 ◽  
Author(s):  
Ana Luiza Santos Marques ◽  
Marina Paula Andres ◽  
Rosanne M. Kho ◽  
Mauricio Simões Abrão
Keyword(s):  
Systematic Review ◽  
High Intensity ◽  
Focused Ultrasound ◽  
Meta Analysis ◽  
High Intensity Focused Ultrasound
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