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Hysterectomy is currently the gold standard of therapy for uterine fibroids, Dr. However, women are increasingly seeking minimally invasive or noninvasive alternatives to hysterectomy. Fennessy and colleagues studied 160 women with symptomatic fibroids treated as part of a clinical trial at five medical centers. The women received pre-treatment MR imaging to identify and define the target fibroids for MRgFUS. Radiologists then used focused ultrasound to deliver heat to the targeted fibroid volume. Temperature-sensitive MR guidance allowed the team to monitor the location of the ultrasound beam and to track temperature changes in tissue during the procedure. One hundred eleven patients were treated under the original study protocol (A), and 51 patients were treated under an optimized protocol (B). Protocol A allowed a maximum treatment time of 120 minutes or a maximum treatment volume of 100ccs (roughly six centimeters (cm) in diameter), or up to 33 percent of total fibroid volume.
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Protocol B allowed a maximum treatment time of 180 minutes and maximum treatment volume of 150ccs (about 7 cm in diameter), or up to 33 percent of total volume in subserosal fibroids (those on the outer wall of the uterus) and 50 percent of volume in non-subserosal fibroids. Treatment outcomes were assessed by Uterine Fibroids Symptoms and Quality of Life (UFSQOL) scores obtained at baseline, three, six and 12 months post-treatment. The findings showed significant symptom relief at three and six months and sustained relief at one year. Women treated with the optimized protocol reported greater symptom relief and quality of life improvement than those treated with the original protocol. Initial findings in follow-up of patients 24 and 36 months after treatment suggest that symptom relief is maintained. We have shown that treating fibroids with an optimized, less restrictive protocol allows for treatment of a greater fibroid volume, which results in even greater symptomatic relief at clinical follow-up, Dr. Maureen Morley Radiological Society of North America The treatment of uterine fibroids with 3T MR-guided focused ultrasound (MRgFUS) is safe, non-invasive and effective, according to a recent study conducted by researchers at Weill Cornell Medical College in New York, NY. Approximately 25% of women in the United States have clinically symptomatic fibroids, and treatment has most commonly been surgical with hysterectomy or myomectomy.
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