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MRgFUS Improved Fibroid Symptoms


 

Major Finding: In all, 74% rated their symptom improvement as excellent, 16% as considerable, 9% as moderate, and 1% as insignificant.

Data Source: A study of 69 women with fibroids who underwent MRgFUS and rated their percent improvement.

Disclosures: Dr. Hesley reported that she has received research grant support for other studies from InSightec, which makes the ExAblate system. However, this study was not funded by outside sources

TAMPA — Ninety percent of women who underwent magnetic resonance–guided focused ultrasound ablation for uterine fibroids reported their symptom improvement as excellent or considerable at 12 months' follow-up, in a small study of the noninvasive treatment.

“This is an effective noninvasive treatment option for patients, with an alternative treatment rate and reported symptom improvement in patients that is very comparable to the literature for myomectomy and uterine artery embolization,” Dr. Gina K. Hesley said at the annual meeting of the Society of Interventional Radiology.

In MR-guided focused ultrasound ablation (MRgFUS), high-intensity focused ultrasound is used during an MR scan to thermally destroy pathogenic tissue—in this case fibroids. The main advantage of MRgFUS is that the procedure is noninvasive. The concomitant use of MRI allows precise targeting of the fibroid and monitoring of the temperature increase in the fibroid tissue.

A total of 125 patients were scheduled for MRgFUS at the Mayo Clinic between March 2005 and September 2008. The researchers followed 119 patients who completed MRgFUS treatment for 12 months using phone interviews to assess symptomatic relief and any additional procedures for fibroid-related symptoms. Additional treatments included uterine embolization, myomectomy, hysterectomy, and gonadotropin-releasing hormone agonist treatment.

The women in the study were premenopausal and had no desire to have children in the future, noted Dr. Hesley, a radiologist at the Mayo Clinic in Rochester, Minn. They had to have at least one uterine fibroid of at least 3 cm in diameter.

Women with many uterine fibroids were counseled to have uterine embolization instead of MRgFUS.

Symptomatic improvement was self-reported based on percent improvement. The researchers considered 0%-10% improvement as insignificant, 11%-40% improvement as moderate, 41%-70% improvement as considerable, and 71%-100% as excellent.

Following treatment, 15 patients were lost to follow-up and 4 patients had their fibroids removed during surgeries performed for reasons unrelated to fibroid symptoms. Of the remaining 100 patients, 8 underwent alternative treatments: 6 patients had hysterectomies, and 2 had myomectomies.

A total of 11 patients did not provide any information about symptomatic improvement, leaving 89 patients available for a phone interview at 12-months' follow-up.

Of these, 97% reported overall symptom improvement. A total of 69 patients rated their percent improvement. In all, 74% rated their symptom improvement as excellent, 16% as considerable, 9% as moderate, and 1% as insignificant.

The researchers have received initial approval for National Institutes of Health funding of a randomized controlled trial comparing MRgFUS and uterine embolization.

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