Hyun Park1, Sang Wook Yoon2. 1. Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam-Si, Gyunggi-do, Republic of Korea. 2. Department of Diagnostic Radiology, CHA Bundang Medical Center, CHA University, Seongnam-Si, Gyunggi-do, Republic of Korea. jansons@cha.ac.kr.
Abstract
PURPOSE: To investigate the effects of a single-dose GnRHa on the thermal ablation of MRgFUS in women with symptomatic fibroids. MATERIALS AND METHOD: In this pilot study, a single-dose GnRHa was administered in 17 patients with a total of 20 fibroids. Volume and scaled signal intensity (SSI) as an objective marker of fluid contents were prospectively followed up with serial MR scans. The control group of 17 patients with 19 fibroids were retrospectively enrolled and compared with GnRHa group in terms of non-perfused volume (NPV) and thermal dosimetry to assess the efficiency of thermal ablation. RESULTS: About 29 days after GnRHa administration, SSI and volume of fibroids were reduced by 55.1 and 10.6%, respectively (p < 0.05) but no adverse events were reported. NPV per unit energy (0.046 cm3/J ± 0.026 vs. 0.031 cm3/J ± 0.018, p = 0.041) was larger and SSI (8.4 ± 8.0 vs. 13.9 ± 12.0, p = 0.053) was lower in GnRHa group. Linear regression analysis showed that these two parameters were in a reverse correlation (p = 0.011). CONCLUSION: GnRHa is supposed to reduce the fluid contents of fibroids including blood vessels and enhance the tissue responsiveness to thermal energy. A single dose prior to MRgFUS has the potential to improve treatment efficiency, while avoiding the side effects of multiple doses of GnRHa.
PURPOSE: To investigate the effects of a single-dose GnRHa on the thermal ablation of MRgFUS in women with symptomatic fibroids. MATERIALS AND METHOD: In this pilot study, a single-dose GnRHa was administered in 17 patients with a total of 20 fibroids. Volume and scaled signal intensity (SSI) as an objective marker of fluid contents were prospectively followed up with serial MR scans. The control group of 17 patients with 19 fibroids were retrospectively enrolled and compared with GnRHa group in terms of non-perfused volume (NPV) and thermal dosimetry to assess the efficiency of thermal ablation. RESULTS: About 29 days after GnRHa administration, SSI and volume of fibroids were reduced by 55.1 and 10.6%, respectively (p < 0.05) but no adverse events were reported. NPV per unit energy (0.046 cm3/J ± 0.026 vs. 0.031 cm3/J ± 0.018, p = 0.041) was larger and SSI (8.4 ± 8.0 vs. 13.9 ± 12.0, p = 0.053) was lower in GnRHa group. Linear regression analysis showed that these two parameters were in a reverse correlation (p = 0.011). CONCLUSION:GnRHa is supposed to reduce the fluid contents of fibroids including blood vessels and enhance the tissue responsiveness to thermal energy. A single dose prior to MRgFUS has the potential to improve treatment efficiency, while avoiding the side effects of multiple doses of GnRHa.
Authors: Nathan McDannold; Clare M Tempany; Fiona M Fennessy; Minna J So; Frank J Rybicki; Elizabeth A Stewart; Ferenc A Jolesz; Kullervo Hynynen Journal: Radiology Date: 2006-07 Impact factor: 11.105
Authors: Zsuzsanna M Lénárd; Nathan J McDannold; Fiona M Fennessy; Elizabeth A Stewart; Ferenc A Jolesz; Kullervo Hynynen; Clare M C Tempany Journal: Radiology Date: 2008-08-11 Impact factor: 11.105