MRI-guided focused ultrasound surgery of uterine fibroids: evaluation of one-year outcome

Abstract

Objective To evaluate the safety,feasibility and one-year outcome of magnetic resonance imaging-guided focused ultrasound surgery(MRgFUS) in treating uterine fibroids.Methods MRgFUS was carried out in 21 female patients with symptomatic uterine fibroids,which was immediately followed by T1-weighted fast spoiled gradient echo MRI scanning with the use of gadolinium-based contrast agent.The size of non-perfused area of the fibroids was measured in all patients,based on which the safety of the procedure and the ablation effect of the lesion were evaluated.Follow-up assessments were completed at one year after the treatment.The questionnaire about uterine fibroid symptoms and quality of life(UFS-QOL) was conducted,the symptoms severity score(SSS) was calculated,and the improvement of the symptoms and the occurrence of undesirable events related to the procedure were recorded.Pelvic MRI re-examination was made,and the size of the fibroids was compared with that determined before the treatment.Results A total of 23 fibroid lesions were detected in 21 patients.MRgFUS was successfully accomplished for all the 23 lesions.The mean operation time for each patient was 3 hours and 50 minutes.The mean non-perfused volume(NPV) on the treatment day was 62.86%(25%-99%).No serious adverse events occurred during the treatment.Seventeen patients completed one-year follow-up.The mean SSS was reduced to 8.27 ± 6.06(a reduction by 68.79%,P 0.05).Follow-up MRI showed that the fibroids volume was reduced by 49.60% on average(P 0.05).Conclusion As a kind of noninvasive technique,MRgFUS is a safe treatment for uterine fibroids with reliable short-term effectiveness.