Krzysztof R Gorny1, Bijan J Borah2, Douglas L Brown3, David A Woodrum3, Elizabeth A Stewart4, Gina K Hesley3. 1. Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Electronic address: gorny.krzysztof@mayo.edu. 2. Department of Health Sciences, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. 3. Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. 4. Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
Abstract
PURPOSE: To assess long-term outcomes of magnetic resonance (MR)-guided focused ultrasound (US) treatments of uterine fibroids. MATERIALS AND METHODS: A retrospective follow-up of 138 patients treated at a single institution between March 2005 and November 2011 was conducted. The patients were not part of a clinical study and were followed through retrospective review of their medical records and telephone interviews to assess additional treatments for fibroid-related symptoms. Survival methods, including Cox proportional hazards models, were used to assess the association between incidence of additional treatments and patient data obtained during screening before treatment. RESULTS: The average length of follow-up was 2.8 years (range, 1-7.2 y). The cumulative incidence of additional treatments at 36 months and 48 months after MR-guided focused US was 19% and 23%, respectively. Women who did not need additional treatment were older than women who did (46.3 y ± 5.6 vs 43.0 y ± 5.8; P = .006; hazard ratio, 0.855; 95% confidence interval, 0.789-0.925). Additionally, women with heterogeneous or bright fibroids on T2-weighted MR imaging were more likely to require additional treatment compared with women with homogeneously dark fibroids (hazard ratio, 5.185 or 5.937, respectively; 95% confidence interval, 1.845-14.569 or 1.401-25.166, respectively). Physician predictions of treatment success, recorded during the screening process, had significant predictive value (P = .018). CONCLUSIONS: The long-term rates of additional interventions after MR-guided focused US of symptomatic uterine fibroids were found to be comparable with other uterine-sparing procedures, such as uterine artery embolization or myomectomy. Older patient age and homogeneously dark fibroids were associated with fewer additional treatments. Physician assessment of treatment success was found to be a valuable tool in patient screening.
PURPOSE: To assess long-term outcomes of magnetic resonance (MR)-guided focused ultrasound (US) treatments of uterine fibroids. MATERIALS AND METHODS: A retrospective follow-up of 138 patients treated at a single institution between March 2005 and November 2011 was conducted. The patients were not part of a clinical study and were followed through retrospective review of their medical records and telephone interviews to assess additional treatments for fibroid-related symptoms. Survival methods, including Cox proportional hazards models, were used to assess the association between incidence of additional treatments and patient data obtained during screening before treatment. RESULTS: The average length of follow-up was 2.8 years (range, 1-7.2 y). The cumulative incidence of additional treatments at 36 months and 48 months after MR-guided focused US was 19% and 23%, respectively. Women who did not need additional treatment were older than women who did (46.3 y ± 5.6 vs 43.0 y ± 5.8; P = .006; hazard ratio, 0.855; 95% confidence interval, 0.789-0.925). Additionally, women with heterogeneous or bright fibroids on T2-weighted MR imaging were more likely to require additional treatment compared with women with homogeneously dark fibroids (hazard ratio, 5.185 or 5.937, respectively; 95% confidence interval, 1.845-14.569 or 1.401-25.166, respectively). Physician predictions of treatment success, recorded during the screening process, had significant predictive value (P = .018). CONCLUSIONS: The long-term rates of additional interventions after MR-guided focused US of symptomatic uterine fibroids were found to be comparable with other uterine-sparing procedures, such as uterine artery embolization or myomectomy. Older patient age and homogeneously dark fibroids were associated with fewer additional treatments. Physician assessment of treatment success was found to be a valuable tool in patient screening.
Authors: Alexander Moncion; Jonah S Harmon; Yan Li; Sam Natla; Easton C Farrell; Oliver D Kripfgans; Jan P Stegemann; Francisco M Martín-Saavedra; Nuria Vilaboa; Renny T Franceschi; Mario L Fabiilli Journal: Biomaterials Date: 2018-12-13 Impact factor: 12.479
Authors: Inez M Verpalen; Jolien P de Boer; Marlot Linstra; Roelien L I Pol; Ingrid M Nijholt; Chrit T W Moonen; Lambertus W Bartels; Arie Franx; Martijn F Boomsma; Manon N G Braat Journal: Eur Radiol Date: 2020-02-10 Impact factor: 5.315