Impact of Hemoglobin Levels on Therapeutic Efficacy and Energy Dosage in Ultrasound‐Guided <scp>HIFU</scp> Ablation of Uterine Fibroids

OBJECTIVES: To investigate the impact of hemoglobin (HGB) levels on therapeutic efficacy and energy dosage during ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation of symptomatic uterine fibroids (UFs). METHODS: A total of 1196 patients who underwent USgHIFU for symptomatic UFs were retrospectively enrolled. Patients were stratified into 8 subgroups based on preprocedural HGB concentrations (g/L): <60, 60-70, 70-80, 80-90, 90-100, 100-110, 110-120, and >120. The energy efficiency factor (EEF) was used to quantify the ablation dose, and non-perfused volume ratio (NPVR) was adopted to evaluate ablation efficacy. RESULTS: ), and the 80-90 g/L group had higher EEF than the >120 g/L group. The proportion of T2-weighted imaging hyperintense fibroids (Funaki type 3) and NPVR was both higher in the 80-90 g/L group than in the >120 g/L group. CONCLUSION: Lower preprocedural HGB levels correlate with higher NPVR. During moderate anemia, EEF increases with rising HGB, which may serve as useful reference evidence for individualized energy dose adjustment in clinical practice.