Abstract No. 85: Uterine artery embolization (UAE) for symptomatic fibroids and adenomyosis following failure of MR guided focused ultrasound (MRgFUS)

Abstract

PurposeTo evaluate the effectiveness of uterine artery embolization (UAE) for symptomatic fibroids and adenomyosis following either recurrence or immediate failure after MR guided focused ultrasound (MRgFUS).Materials and Methods7 patients with symptomatic fibroids or adenomyosis (5 with fibroids only, one with fibroids and adenomyosis, one with pure adenomyosis) who underwent UAE after MRgFUS were retrospectively analyzed. Pre-procedural MRI was evaluated in all patients. Three patients had recurrence of symptoms after 10 months (mean) following MRgFUS and four patients experienced failure immediately after MRgFUS. Necrosis of fibroids or adenomyosis with their volumes were assessed by MRI 3-months after UAE. Symptom status in terms of menorrhagia was scored on a scale of 0-10, 0 being no symptoms and 10 being the baseline symptoms.ResultsPre-procedural MRI revealed sequentially increased viable portion of previously non-perfused area following MRgFUS in three patients (3 with only fibroids, one with pure adenomyosis). All seven patients underwent successful UAE and had an average of 68% reduction in size of fibroids and 45 % reduction in size of uterus (in patients with adenomyosis). All fibroids and adenomyosis treated with UAE demonstrated complete necrosis at three months follow-up MRI. Vaginal expulsion of the fibroids occurred in two patients. Change in mean menorrhagia scores at three months follow-up was 6.7 (70% reduction, p < 0.0001) representing significant relief of symptoms.ConclusionUAE was an effective treatment in patients who had recurrent fibroids or immediate failure after MRgFUS. PurposeTo evaluate the effectiveness of uterine artery embolization (UAE) for symptomatic fibroids and adenomyosis following either recurrence or immediate failure after MR guided focused ultrasound (MRgFUS). To evaluate the effectiveness of uterine artery embolization (UAE) for symptomatic fibroids and adenomyosis following either recurrence or immediate failure after MR guided focused ultrasound (MRgFUS). Materials and Methods7 patients with symptomatic fibroids or adenomyosis (5 with fibroids only, one with fibroids and adenomyosis, one with pure adenomyosis) who underwent UAE after MRgFUS were retrospectively analyzed. Pre-procedural MRI was evaluated in all patients. Three patients had recurrence of symptoms after 10 months (mean) following MRgFUS and four patients experienced failure immediately after MRgFUS. Necrosis of fibroids or adenomyosis with their volumes were assessed by MRI 3-months after UAE. Symptom status in terms of menorrhagia was scored on a scale of 0-10, 0 being no symptoms and 10 being the baseline symptoms. 7 patients with symptomatic fibroids or adenomyosis (5 with fibroids only, one with fibroids and adenomyosis, one with pure adenomyosis) who underwent UAE after MRgFUS were retrospectively analyzed. Pre-procedural MRI was evaluated in all patients. Three patients had recurrence of symptoms after 10 months (mean) following MRgFUS and four patients experienced failure immediately after MRgFUS. Necrosis of fibroids or adenomyosis with their volumes were assessed by MRI 3-months after UAE. Symptom status in terms of menorrhagia was scored on a scale of 0-10, 0 being no symptoms and 10 being the baseline symptoms. ResultsPre-procedural MRI revealed sequentially increased viable portion of previously non-perfused area following MRgFUS in three patients (3 with only fibroids, one with pure adenomyosis). All seven patients underwent successful UAE and had an average of 68% reduction in size of fibroids and 45 % reduction in size of uterus (in patients with adenomyosis). All fibroids and adenomyosis treated with UAE demonstrated complete necrosis at three months follow-up MRI. Vaginal expulsion of the fibroids occurred in two patients. Change in mean menorrhagia scores at three months follow-up was 6.7 (70% reduction, p < 0.0001) representing significant relief of symptoms. Pre-procedural MRI revealed sequentially increased viable portion of previously non-perfused area following MRgFUS in three patients (3 with only fibroids, one with pure adenomyosis). All seven patients underwent successful UAE and had an average of 68% reduction in size of fibroids and 45 % reduction in size of uterus (in patients with adenomyosis). All fibroids and adenomyosis treated with UAE demonstrated complete necrosis at three months follow-up MRI. Vaginal expulsion of the fibroids occurred in two patients. Change in mean menorrhagia scores at three months follow-up was 6.7 (70% reduction, p < 0.0001) representing significant relief of symptoms. ConclusionUAE was an effective treatment in patients who had recurrent fibroids or immediate failure after MRgFUS. UAE was an effective treatment in patients who had recurrent fibroids or immediate failure after MRgFUS.