Factors influencing the volume reduction rate of ultrasound-guided high-intensity focused ultrasound for breast fibroadenoma

OBJECTIVES: To investigate the factors influencing the volume reduction rate (VRR) at 12 months after ultrasound (US)-guided high-intensity focused ultrasound (HIFU) for breast fibroadenoma (FA). MATERIALS AND METHODS: A retrospective analysis of 104 patients with 302 FAs who underwent US-guided HIFU from January 2021 to May 2023 was conducted. All patients received US assessment and contrast-enhanced US (CEUS) evaluation, and treatment information was recorded. VRR ≥ 80% was set as the dependent variable, while nineteen baseline- and treatment-related factors were considered as the independent variables. A logistic regression model was constructed to predict 12-month VRR. RESULTS: All patients successfully underwent one-session HIFU. Significant differences were observed in volume, distance from the superficial margin of FA to skin, distance from the deep margin of FA to chest wall, mean power, energy efficacy factor, type of near-field acoustic pathway, and appearance of hyperechoic changes. Multivariate analysis revealed that type of near-field acoustic pathway, distance from the deep margin of FA to chest wall, and appearance of hyperechoic changes were independent predictors of the 12-month VRR after HIFU. The area under Receiver Operating Characteristic curve was 0.688. CONCLUSIONS: The type of near-field acoustic pathway, distance from the deep margin of FA to chest wall, and appearance of hyperechoic changes could serve as predictors of 12-month VRR following HIFU treatment for FA.