Focused Ultrasound for Treatment of Fibroids

Abstract

Uterine fibroids are common smooth muscle tumors of myometrial cells, which can result in substantial symptoms affecting the quality of life of women. Currently, patients have several options available for treatment ranging from uterine-sparing surgeries (myomectomy), hysterectomy, and nonsurgical options, such as uterine artery embolization, magnetic resonance-guided focused ultrasound (MRgFUS), or cryoablation. MRgFUS is one of the least invasive treatment options outside medical therapy. MRgFUS ablation combines therapy delivered by an ultrasound transducer with imaging, guidance for therapy, and thermal feedback provided by magnetic resonance imaging. In 2004, the MRgFUS system ExAblate 2000 (InSightec, Haifa, Israel) was approved by the United States Food and Drug Administration for clinical treatments of uterine fibroids. Data on safety and long-term efficacy are ongoing to establish the unique usefulness of this therapy in targeted treatment of leiomyoma through the integration of MR imaging. Multiple clinical trials detail several efficacy outcomes including symptom improvement, leiomyoma shrinkage, and use of alternative procedures. Additionally, favorable pregnancy outcomes following MRgFUS have been reported. Applications of MRgFUS have recently expanded into the realm of adenomyosis treatment. MRgFUS has been deemed a safe and effective method of fibroid treatment and offers the advantages of no incisions or blood loss, speedy recovery, and a cost-effective means of treatment.