At the beginning of the last century, the piezoelectric phenomenon and the piezoelectric potential of some materials were discovered, which allowed them to be used as a source of ultrasound.
The biological effects of ultrasonic ablation were first described in 1927 by Wood RW and Loomis AL.
In the 1930s, there was information about the possibility of tissue destruction by high-intensity ultrasonic waves by focusing them at one point.
The ability of focused high-intensity ultrasound to tissue ablation was first described in the 1940s on experimental equipment to obtain lesions in the liver in vitro.
In 1942, Lynn JG et al published their work on the possibilities of using focused ultrasound. The idea was the possible destruction of tissues due to the accumulation of a large amount of energy in them, which was complemented by the increasing intensity of the waves and their focusing at one point.
Used properly, this should increase the temperature to a level sufficient to induce irreversible changes in the discrete volume of tissue.
The fundamental physical mechanism of high-intensity focused ultrasound ablation — the absorption of ultrasonic waves and their conversion into heat — was first described in 1972.
In the 1990s, the possibilities of the method for the treatment of tumors were rediscovered, the development of which continues to this day. The vast majority of ultrasound ablations are performed under the control of ultrasound, which is explained by it's availability and cost-effectiveness.
This is the only way to get real-time images.
Most often, ultrasound ablation is performed for uterine fibroids. According to the Internet resource https://clinicaltrials.gov/, 37 studies have been registered on the study of ultrasound ablation of uterine fibroids, of which 20 have been completed, and the available results are in 7 researches. It is noteworthy that all the published results of the seven trails reveal the safety of medical equipment and are devoted to it's study, rather than the study of a new method of treatment of uterine fibroids.
The results of ultrasound ablation treatment of uterine fibroids were first reported by Wang et al. (2002). Since then, a number of research groups have confirmed the safety and effectiveness of the methodology. In 2019, the results of the fourth expert meeting of radiologists-gynecologists on ultrasound ablation, published by Kröncke T and David M.
The criterion for success is the elimination or improvement of symptoms associated with uterine fibroids. Volume reduction is desirable, but is a secondary goal. This is the so-called non-perfused volume, which should be the largest, as this indicator is associated with the control of symptoms and is a technical parameter for assessing the success of ultrasound ablation.
Pregnancy is possible 6 months after the procedure.
After ultrasound ablation, pregnancy is possible, the success of which, as well as quality of life, in general, is not inferior to that observed after laparoscopic myomectomy.
A systematic review of Clark NA et al (2014) with an analysis of 35 pregnancies gives the authors reason to draw the following conclusions: a) ultrasound ablation is a method of treatment of uterine fibroids, which is well tolerated by patients; b) the method has a low incidence of complications with a satisfactory subsequent pregnancy, so Zou M et al (2017) describes 80 cases of pregnancy after ultrasound ablation, the study Liu X et al (2018) describes 88 cases of pregnancy, of which childbirth occurred in 84% .
In 2010, the first HIFU unit in Ukraine was opened at the Center for Nuclear Medicine of the Kyiv City Clinical Oncology Center (KMCOC: https://onko.com.ua/), which installed a device for non-invasive extracorporeal treatment of tumors by ultrasound ablation.
One of the areas of work of the unit is the treatment of leiomyomas of the uterine body.
In 2018, a statistical model of the prognosis of achieving the effect of cavitation of the myoma and the calculation of the relevant technical parameters of HIFU was was based on of data on the treatment of patients with uterine neoplasms.
Also the mathematical model of the forecast of regression of a myomatous node during the set terms of local control depending on localization, volume and MR of type of a myomatous node was developed.
In 2019, based on these mathematical models, software was created - an innovative system of artificial intelligence MACROMED, which was used in a test mode at the Center for Nuclear Medicine.
The use of MACROMED during HIFU therapy allowed to optimize the parameters of the procedure, improve the results of treatment and make an optimal schedule for monitoring patients after treatment.
The work was carried out under the guidance of Stuley Volodymyr - PhD, Associate Professor of Mathematical Methods of Systems Analysis, Institute of Applied Systems Analysis NTUU " KPI. I. Sikorsky » .
The medical application of the results of these developments is practically tested and scientifically substantiated, which is reflected in the dissertation of the medical director of the HIFU MACROMED project Karacharova IY "Ultrasound ablation of uterine fibroids: justification of indications, procedures and methods of evaluating the effectiveness of treatment" 2020