Literature DB >> 23385396

Magnetic resonance imaging-guided focused ultrasound treatment of symptomatic uterine fibroids: impact of technology advancement on ablation volumes in 115 patients.

Christoph G Trumm1, Robert Stahl, Dirk-André Clevert, Peter Herzog, Irene Mindjuk, Sabine Kornprobst, Christina Schwarz, Ralf-Thorsten Hoffmann, Maximilian F Reiser, Matthias Matzko.   

Abstract

OBJECTIVES: The aim of this study was to assess the impact of the advanced technology of the new ExAblate 2100 system (Insightec Ltd, Haifa, Israel) for magnetic resonance imaging (MRI)-guided focused ultrasound surgery on treatment outcomes in patients with symptomatic uterine fibroids, as measured by the nonperfused volume ratio.
MATERIALS AND METHODS: This is a retrospective analysis of 115 women (mean age, 42 years; range, 27-54 years) with symptomatic fibroids who consecutively underwent MRI-guided focused ultrasound treatment in a single center with the new generation ExAblate 2100 system from November 2010 to June 2011. Mean ± SD total volume and number of treated fibroids (per patient) were 89 ± 94 cm and 2.2 ± 1.7, respectively. Patient baseline characteristics were analyzed regarding their impact on the resulting nonperfused volume ratio.
RESULTS: Magnetic resonance imaging-guided focused ultrasound treatment was technically successful in 115 of 123 patients (93.5%). In 8 patients, treatment was not possible because of bowel loops in the beam pathway that could not be mitigated (n = 6), patient movement (n = 1), and system malfunction (n = 1). Mean nonperfused volume ratio was 88% ± 15% (range, 38%-100%). Mean applied energy level was 5400 ± 1200 J, and mean number of sonications was 74 ± 27. No major complications occurred. Two cases of first-degree skin burn resolved within 1 week after the intervention. Of the baseline characteristics analyzed, only the planned treatment volume had a statistically significant impact on nonperfused volume ratio.
CONCLUSIONS: With technological advancement, the outcome of MRI-guided focused ultrasound treatment in terms of the nonperfused volume ratio can be enhanced with a high safety profile, markedly exceeding results reported in previous clinical trials.

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Mesh:

Year:  2013        PMID: 23385396     DOI: 10.1097/RLI.0b013e3182806904

Source DB:  PubMed          Journal:  Invest Radiol        ISSN: 0020-9996            Impact factor:   6.016


  27 in total

1.  High sensitivity MR acoustic radiation force imaging using transition band balanced steady-state free precession.

Authors:  Yuan Zheng; Michael Marx; G Wilson Miller; Kim Butts Pauly
Journal:  Magn Reson Med       Date:  2017-06-20       Impact factor: 4.668

2.  [MRI for monitoring of high intensity focused ultrasound: current developments].

Authors:  C G Trumm; R Stahl; M Peller; D-A Clevert; A Huber; M F Reiser; M Matzko
Journal:  Radiologe       Date:  2013-11       Impact factor: 0.635

3.  The role of T1 perfusion-based classification in magnetic resonance-guided high-intensity focused ultrasound ablation of uterine fibroids.

Authors:  Bilgin Keserci; Nguyen Minh Duc
Journal:  Eur Radiol       Date:  2017-06-14       Impact factor: 5.315

Review 4.  Reproductive impact of MRI-guided focused ultrasound surgery for fibroids: a systematic review of the evidence.

Authors:  Natalie A Clark; Sunni L Mumford; James H Segars
Journal:  Curr Opin Obstet Gynecol       Date:  2014-06       Impact factor: 1.927

Review 5.  Review of influential clinical factors in reducing the risk of unsuccessful MRI-guided HIFU treatment outcome of uterine fibroids.

Authors:  Nguyen Minh Duc; Bilgin Keserci
Journal:  Diagn Interv Radiol       Date:  2018-09       Impact factor: 2.630

6.  [MR-guided focused ultrasound. Current and future applications].

Authors:  C G Trumm; A Napoli; M Peller; D-A Clevert; R Stahl; M Reiser; M Matzko
Journal:  Radiologe       Date:  2013-03       Impact factor: 0.635

7.  Temperature-dependent MR signals in cortical bone: potential for monitoring temperature changes during high-intensity focused ultrasound treatment in bone.

Authors:  Elizabeth Ramsay; Charles Mougenot; Mohammad Kazem; Theodore W Laetsch; Rajiv Chopra
Journal:  Magn Reson Med       Date:  2014-10-13       Impact factor: 4.668

Review 8.  Updates on MR-Guided Focused Ultrasound for Symptomatic Uterine Fibroids.

Authors:  Divya Sridhar; Maureen P Kohi
Journal:  Semin Intervent Radiol       Date:  2018-04-05       Impact factor: 1.513

Review 9.  Transcranial MRI-Guided Focused Ultrasound: A Review of the Technologic and Neurologic Applications.

Authors:  Pejman Ghanouni; Kim Butts Pauly; W Jeff Elias; Jaimie Henderson; Jason Sheehan; Stephen Monteith; Max Wintermark
Journal:  AJR Am J Roentgenol       Date:  2015-07       Impact factor: 3.959

Review 10.  Update on Clinical Magnetic Resonance-Guided Focused Ultrasound Applications.

Authors:  Thiele Kobus; Nathan McDannold
Journal:  Magn Reson Imaging Clin N Am       Date:  2015-07-07       Impact factor: 2.266

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