Abstract
Objective
To examine the safety and re-intervention rates following magnetic resonance-guided
focused ultrasound (MRgFUS) for uterine fibroids at 5 years. To assess how the non-perfused
volume (NPV), fibroid signal intensity and use of gonadotrophin-releasing hormone
analogues (GnRHa) affect the re-intervention rates.
Study design
Cohort study of women undergoing MRgFUS for treatment of their uterine fibroids between
2003 and 2010.
Results
Of 280 women undergoing MRgFUS the rate of minor complications was 3.9% and there
were 3 serious complications (1.1%) including one skin burn, a fibroid expulsion and
one case of persistent neuropathy. The NPVs achieved following MRgFUS have increased
as the experience with this treatment has grown. In a 5-year follow-up study of 162
women, the overall re-intervention rate was 58.64%, but in those treatments with greater
than 50% NPV the re-intervention rate was 50%.
Conclusion
MRgFUS treatment of uterine fibroids is a safe treatment for uterine fibroids. The
re-intervention rate at 5 years is high, but the improvements in NPVs achieved may
further improve the long term results.
Keywords
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References
- Focused ultrasound treatment of uterine fibroid tumors: safety and feasibility of a noninvasive thermoablative technique.Am J Obstet Gynecol. 2003; 189: 48-54
- Pregnancy and live birth after focused ultrasound surgery for symptomatic focal adenomyosis: a case report.Hum Reprod. 2006; 21: 1255-1259
- Pregnancy outcome after magnetic resonance-guided focused ultrasound surgery (MRgFUS) for conservative treatment of uterine fibroids.Fertil Steril. 2010; 93: 199-209
- Clinical outcomes of magnetic resonance-guided focused ultrasound surgery for uterine myomas: 24-month follow-up.Ultrasound Obstet Gynecol. 2009; 34: 584-589
- Magnetic resonance-guided focused ultrasound (MRgFUS) compared with abdominal hysterectomy for treatment of uterine leiomyomas.Ultrasound Obstet Gynecol. 2009; 34: 572-578
- Clinical improvement and shrinkage of uterine fibroids after thermal ablation by magnetic resonance-guided focused ultrasound surgery.Ultrasound Obstet Gynecol. 2007; 30: 771-777
- Patient suitability for magnetic resonance guided focused ultrasound surgery of uterine fibroids.Eur J Obstet Gynecol Reprod Biol. 2009; 143: 98-102
- Outcome of uterine artery embolization versus MR-guided high-intensity focused ultrasound treatment for uterine fibroids: long-term results.Eur J Radiol. 2013; 82: 2265-2269
- Non-invasive magnetic resonance-guided focused ultrasound treatment of uterine fibroids in a large Japanese population: impact of the learning curve on patient outcome.Ultrasound Obstet Gynecol. 2009; 34: 579-583
- The UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata.Obstet Gynecol. 2002; 99: 290-300
- Measurement of uterine fibroid volume: a comparative accuracy and validation of methods study.Eur J Obstet Gynecol Reprod Biol. 2013; 171: 161-165
- A comparison of goodness-of-fit tests for the logistic regression model.Stat Med. 1997; 16: 965-980
- R: A language and environment for statistical computing [program].R Foundation for Statistical Computing, Vienna, Austria2012
- Hyperintense uterine leiomyoma at T2-weighted MR imaging: differentiation with dynamic enhanced MR imaging and clinical implications.Radiology. 1993; 189: 721-725
- Clinical outcomes of focused ultrasound surgery for the treatment of uterine fibroids.Fertil Steril. 2006; 85: 22-29
- Sustained relief of leiomyoma symptoms by using focused ultrasound surgery.Obstet Gynecol. 2007; 110: 279-287
- Clinical failure after uterine artery embolization: evaluation of patient and MR imaging characteristics.J Vasc Interv Radiol. 2008; 19: 662-667
- What factors currently limit magnetic resonance-guided focused ultrasound of leiomyomas? A survey conducted at the first international symposium devoted to clinical magnetic resonance-guided focused ultrasound.Fertil Steril. 2010; 94: 331-334
- Magnetic resonance guided focused ultrasound surgery of uterine fibroids – the tissue effects of GnRH agonist pre-treatment.Eur J Radiol. 2006; 59: 163-167
- Safety and treatment volumes achieved following new developments to the magnetic resonance guided focused ultrasound system in the treatment of uterine fibroids: a cohort study.J Ther Ultrasound. 2013; 1: 20
- Magnetic resonance imaging-guided focused ultrasound treatment of symptomatic uterine fibroids: impact of technology advancement on ablation volumes in 115 patients.Invest Radiol. 2013; 48: 359-365
- Incidence of additional treatments in women treated with MR-guided focused US for symptomatic uterine fibroids: review of 138 patients with an average follow-up of 2.8 years.J Vasc Interv Radiol. 2014; 25: 1506-1512
Article info
Publication history
Published online: October 06, 2014
Accepted:
September 29,
2014
Received in revised form:
September 19,
2014
Received:
April 11,
2014
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
