Safety and five-year re-intervention following magnetic resonance-guided focused ultrasound (MRgFUS) for uterine fibroids

Quinn, Stephen; Vedelago, John; Gedroyc, Wladyslaw; Regan, Lesley

doi:10.1016/j.ejogrb.2014.09.039

Cited by 48 publications

(34 citation statements)

References 24 publications

(16 reference statements)

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“…In 2014, Quinn et al31 reported overall re-intervention rate as high as 42.8% within 3 years and 59.3% within 5 years. They explained that, if NPV was lower than 50% or a uterine fibroid was Kunaki type III, the risk was higher.…”

Section: Discussionmentioning

confidence: 99%

Clinical Consideration of Treatment to Ablate Uterine Fibroids with Magnetic Resonance Imaging-guided High Intensity Focused Ultrasound (MRgFUS): Sonalleve

Jeong¹,

Hong²,

Kim³

et al. 2016

J Menopausal Med

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ObjectivesMagnetic resonance imaging (MRI)-guided high intensity focused ultrasound surgery (MRgFUS) is a newly emerging non-invasive technique for the treatment of uterine fibroids. The purpose of this study is to review the clinical impact of MRgFUS.MethodsThis study examined 157 patients. The high intensity focused ultrasound (HIFU) utilized in this study was Philips Achieva 1.5 Tesla MR (Philips Healthcare, Best, the Netherlands) and Sonalleve HIFU system. The patients were followed in post-operative Month 1, Month 3, and Month 6 to investigate any change. Then, these were further classified according to the use of uterine stimulant (oxytocin) in parallel, Funaki Type of uterine fibroid, HIFU intensity, and non-perfused volume (NPV) ratio.ResultsWhen the uterine stimulant was utilized, the HIFU intensity was measured at significantly lower levels, compared with the group not using uterine stimulant, and treatment duration was significantly. The NPV ratio was found significantly higher in the group using uterine stimulant. Concerning the correlation between Funaki Type of uterine fibroid and average sonication power, it was found that the closer to Type I, the lower the sonication power, the shorter the treatment duration, and the higher the NPV ratio significantly.ConclusionsIn this study, it was found that the lower the Funaki Types of uterine fibroids, and the higher the NPV ratio immediately after the operation, the larger the uterine fibroid volume decrease and SSS change were. Also, if uterine stimulant was used in parallel in treatment, treatment duration and HIFU intensity could become shorter and lower.

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Section: Discussionmentioning

confidence: 99%

Clinical Consideration of Treatment to Ablate Uterine Fibroids with Magnetic Resonance Imaging-guided High Intensity Focused Ultrasound (MRgFUS): Sonalleve

Jeong¹,

Hong²,

Kim³

et al. 2016

J Menopausal Med

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show abstract

“…[26][27][28] It has also been shown to be effective and safe for the treatment of leiomyomata. 29 HIFU ablation can be performed under MR guidance, MR-guided focused US surgery, or US guidance. MR guidance has excellent anatomic resolution, very high tumor sensitivity, and high thermal imaging sensitivity.…”

Section: Hifu Ablationmentioning

confidence: 99%

MR-guided focused ultrasound for the treatment of adenomyosis: current insights

Chin¹,

Walbridge²,

Quinn³

2015

RRFU

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Adenomyosis is a benign gynecological condition causing significant morbidity among women of reproductive age. The available treatments are currently limited in number and efficacy. While hysterectomy is curative, it is unacceptable to many women, particularly those wishing to conserve their fertility. Magnetic resonance-guided focused ultrasound surgery is a noninvasive treatment method that has been used to effectively treat uterine leiomyomata, but until recently has not been routinely used to treat adenomyosis. This review summarizes the current understanding of adenomyosis and high-intensity focused ultrasound, and the recent research into the safety and efficacy of this technique.

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“…They mentioned that 14% of Types I and II cases and 21.6% of Type III cases had received a surgical procedure or re-intervention such as second round of HIFU treatment 3. Quinn et al19, in their study on 5-year follow-up after MRI HIFU treatment, reported the re-intervention ratio at 42.8% for 3 years; and up to 58.6% for 5 years, arguing that it was related to post-treatment NPV ratio. However, these studies also did not report the kinds of re-intervention in details.…”

Section: Discussionmentioning

confidence: 99%

Expulsion of Fibroids to the Endometrial Cavity after Magnetic Resonance Imaging-guided High Intensity Focused Ultrasound Surgery (MRgFUS) Treatment of Intramural Uterine Fibroids

Jeong¹,

Hong²,

Kim³

et al. 2016

J Menopausal Med

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ObjectivesThis report seeks to introduce some cases of the patients who received magnetic resonance imaging (MRI)-guided high intensity focused ultrasound (HIFU) surgery (MRgFUS)-based intramural uterine fibroids treatment where the post-MRgFUS intramural uterine fibroids decreased in its volume and protruded towards the endometrial cavity to be expelled by hysteroscopy.MethodsOf the 157 patients who had received MRgFUS treatment in the Obstetrics and Gynecology of the Hospital from March, 2015 to February, 2016; this study examined 6 of the cases where, after high intensity focused ultrasound treatment, intramural uterine fibroids protruded towards the endometrial cavity to be removed by hysteroscopic myomectomy. The high intensity focused ultrasound utilized in the cases were Philips Achieva 1.5 Tesla MR (Philips Healthcare, Best, The Netherlands) and Sonalleve HIFU system.ResultsThe volume of fibroids ranged from 26.0 cm3 to 199.5 cm3, averaging 95.6 cm3. The major axis length ranged from 4.0 cm to 8.2 cm, averaging 6.3 cm. Fibroid location in all of the patients was in intramural uterine before treatment but after the high intensity focused ultrasound treatment, the fibroids were observed to protrude towards the endometrial cavity in at least Day 5 or up to Day 73 to allow hysteroscopic myomectomy.ConclusionsIn some cases, after an intramural uterine fibroid is treated with MRgFUS, fibroid volume is decreased and the fibroid protrudes towards the endometrial cavity. In this case, hysteroscopic myomectomy can be a useful solution.

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Safety and five-year re-intervention following magnetic resonance-guided focused ultrasound (MRgFUS) for uterine fibroids

Cited by 48 publications

References 24 publications

Clinical Consideration of Treatment to Ablate Uterine Fibroids with Magnetic Resonance Imaging-guided High Intensity Focused Ultrasound (MRgFUS): Sonalleve

Clinical Consideration of Treatment to Ablate Uterine Fibroids with Magnetic Resonance Imaging-guided High Intensity Focused Ultrasound (MRgFUS): Sonalleve

MR-guided focused ultrasound for the treatment of adenomyosis: current insights

Expulsion of Fibroids to the Endometrial Cavity after Magnetic Resonance Imaging-guided High Intensity Focused Ultrasound Surgery (MRgFUS) Treatment of Intramural Uterine Fibroids

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