<b>MRI Guidance of Focused Ultrasound Therapy of Uterine Fibroids:</b> Early Results

TLDR

The study aimed to test whether MRI‑guided focused ultrasound therapy for uterine fibroids reduces symptoms and improves quality of life. The authors conducted a prospective review of 108 treatments, creating thermal lesions monitored by real‑time MR thermometry and adjusting parameters, while measuring fibroid volume, symptoms, and quality‑of‑life before and six months after treatment. Adverse events were minimal, and 79.3 % of women reported significant symptom improvement; mean fibroid volume decreased 13.5 % at six months, with residual nonenhancing volume, yet the moderate reduction correlated with symptomatic relief, indicating encouraging results.

Abstract

The purpose of this study was to explore our hypothesis that MRI-guided focused ultrasound therapy for the treatment of uterine fibroids will lead to a significant reduction in symptoms and improvement in quality of life. We describe focused ultrasound therapy applications and the method for monitoring the thermal energy deposited in the fibroids, including the MRI parameters required, in a prospective review of 108 treatments.Patients presenting with symptomatic uterine fibroids who attained a minimal symptom severity score and who would otherwise have been offered a hysterectomy were recruited. Thermal lesions were created within target fibroids using an MRI-guided focused ultrasound therapy system. The developing lesion was monitored using real-time MR thermometry, which was used to assess treatment outcome in real time to change treatment parameters and achieve the desired outcome. Fibroid volume, fibroid symptoms, and quality-of-life scores were measured before treatment and 6 months after treatment. Adverse events were actively monitored and recorded.In this study, 79.3% of women who had been treated reported a significant improvement in their uterine fibroid symptoms on follow-up health-related quality-of-life questionnaires, which supports our hypothesis. The mean reduction in fibroid volume at 6 months was 13.5%, but nonenhancing volume (mean, 51 cm(3)) remained within the treated fibroid at 6 months.This early description of MRI-guided focused ultrasound therapy treatment of fibroids includes follow-up data and shows that, although the volume reduction is moderate, it correlates with treatment volume and the symptomatic response to this treatment is encouraging.