Irene Mindjuk1, Christoph G Trumm, Peter Herzog, Robert Stahl, Matthias Matzko. 1. Department of Diagnostic and Interventional Radiology, Helios-Amper Klinikum Dachau, Dachau, Helios-Amper Klinikum Dachau, Krankenhausstr. 15, 85221, Dachau, Germany, Irene.Mindjuk@helios-kliniken.de.
Abstract
OBJECTIVES: To assess the technical and clinical results of MRgFUS treatment and factors affecting clinical treatment success. MATERIALS AND METHODS: A total of 252 women (mean age, 42.1 ± 6.9 years) with uterine fibroids underwent MRgFUS. All patients underwent MRI before treatment. Results were evaluated with respect to post-treatment nonperfused volume (NPV), symptom severity score (SSS), reintervention rate, pregnancy and safety data. RESULTS: NPV ratio was significantly higher in fibroids characterized by low signal intensity in contrast-enhanced T1-weighted fat saturated MR images and in fibroids distant from the spine (>3 cm). NPV ratio was lower in fibroids with septations, with subserosal component and in skin-distant fibroids (p < 0.001). NPV ratio was highly correlated with clinical success: NPV of more than 80 % resulted in clinical success in more than 80 % of patients. Reintervention rate was 12.7 % (mean follow-up time, 19.4 ± 8 months; range, 3-38). Expulsion of fibroids (21 %) was significantly correlated with a high clinical success rate. No severe adverse events were reported. CONCLUSIONS: Adequate patient selection and correct treatment techniques, based on the learning curve of this technology, combined with technical advances of the system, lead to higher clinical success rates with low complications rate, comparable to other uterine-sparing treatment options. KEY POINTS: • MRgFUS appears to be a valid alternative to other uterus-preserving therapies • Patient selection is a significant factor in achieving high NPV ratios • MRI screening parameters correlate with the amount of fibroid ablation in MRgFUS • NPV results of more than 80 % correlate with higher clinical success rates.
OBJECTIVES: To assess the technical and clinical results of MRgFUS treatment and factors affecting clinical treatment success. MATERIALS AND METHODS: A total of 252 women (mean age, 42.1 ± 6.9 years) with uterine fibroids underwent MRgFUS. All patients underwent MRI before treatment. Results were evaluated with respect to post-treatment nonperfused volume (NPV), symptom severity score (SSS), reintervention rate, pregnancy and safety data. RESULTS: NPV ratio was significantly higher in fibroids characterized by low signal intensity in contrast-enhanced T1-weighted fat saturated MR images and in fibroids distant from the spine (>3 cm). NPV ratio was lower in fibroids with septations, with subserosal component and in skin-distant fibroids (p < 0.001). NPV ratio was highly correlated with clinical success: NPV of more than 80 % resulted in clinical success in more than 80 % of patients. Reintervention rate was 12.7 % (mean follow-up time, 19.4 ± 8 months; range, 3-38). Expulsion of fibroids (21 %) was significantly correlated with a high clinical success rate. No severe adverse events were reported. CONCLUSIONS: Adequate patient selection and correct treatment techniques, based on the learning curve of this technology, combined with technical advances of the system, lead to higher clinical success rates with low complications rate, comparable to other uterine-sparing treatment options. KEY POINTS: • MRgFUS appears to be a valid alternative to other uterus-preserving therapies • Patient selection is a significant factor in achieving high NPV ratios • MRI screening parameters correlate with the amount of fibroid ablation in MRgFUS • NPV results of more than 80 % correlate with higher clinical success rates.
Authors: Gaylene Pron; Eva Mocarski; John Bennett; George Vilos; Andrew Common; Mukarram Zaidi; Kenneth Sniderman; Murray Asch; Roman Kozak; Martin Simons; Cuong Tran; John Kachura Journal: J Vasc Interv Radiol Date: 2003-10 Impact factor: 3.464
Authors: Gina K Hesley; Krzysztof R Gorny; Tara L Henrichsen; David A Woodrum; Douglas L Brown Journal: Ultrasound Q Date: 2008-06 Impact factor: 1.657
Authors: Fiona M Fennessy; Clare M Tempany; Nathan J McDannold; Minna J So; Gina Hesley; Bobbie Gostout; Hyun S Kim; George A Holland; Dennis A Sarti; Kullervo Hynynen; Ferenc A Jolesz; Elizabeth A Stewart Journal: Radiology Date: 2007-04-19 Impact factor: 11.105
Authors: Wouter J Hehenkamp; Nicole A Volkers; Alexander D Montauban Van Swijndregt; Sjoerd De Blok; Jim A Reekers; Willem M Ankum Journal: Am J Obstet Gynecol Date: 2004-11 Impact factor: 8.661
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: Carlo Masciocchi; Francesco Arrigoni; Fabiana Ferrari; Aldo Victor Giordano; Sonia Iafrate; Ilaria Capretti; Ester Cannizzaro; Alfonso Reginelli; Anna Maria Ierardi; Chiara Floridi; Alessio Salvatore Angileri; Luca Brunese; Antonio Barile Journal: Med Oncol Date: 2017-02-24 Impact factor: 3.064
Authors: Shannon Laughlin-Tommaso; Emily P Barnard; Ahmed M AbdElmagied; Lisa E Vaughan; Amy L Weaver; Gina K Hesley; David A Woodrum; Vanessa L Jacoby; Maureen P Kohi; Thomas M Price; Angel Nieves; Michael J Miller; Bijan J Borah; James P Moriarty; Krzysztof R Gorny; Phyllis C Leppert; Amanda L Severson; Maureen A Lemens; Elizabeth A Stewart Journal: Am J Obstet Gynecol Date: 2018-10-26 Impact factor: 8.661