Abstract
BackgroundThis research investigates whether modifications to the magnetic resonance-guided focused ultrasound ablation of uterine fibroid (MRgFUS) system used resulted in improved treatment volumes of uterine fibroids, while maintaining safety.MethodsThis study is a prospective cohort analysis of 34 women undergoing the ExAblate 2100 MRgFUS treatment for their uterine fibroids.ResultsThe percentage of non-perfused volume (NPV) achieved with the ExAblate 2100 system was 54.92% compared with 50.49 % with the ExAblate 2000 system over the preceding year (p = 0.543). The ExAblate 2100 system resulted in a greater NPV in hyper-intense fibroids compared with the ExAblate 200 system (43.20% versus 36.33%, p = 0.005). There have been no recorded hospital admissions, no skins burns, and no reported major adverse events since the introduction of this new system.ConclusionOverall, the new system has thus far shown an encouraging safety record and an improvement in non-perfused volumes achieved, especially in hyper-intense fibroids.
Highlights
This research investigates whether modifications to the magnetic resonance-guided focused ultrasound ablation of uterine fibroid (MRgFUS) system used resulted in improved treatment volumes of uterine fibroids, while maintaining safety
It is known that the signal intensity of the uterine fibroids (UF) at baseline T2-weighted Magnetic resonance (MR) imaging and the non-perfused volume (NPV) of the fibroid post-treatment are important determinants of outcome following MRgFUS [2]
MR thermal maps depict the precise location of treated tissue, providing the operator with a high degree of control throughout the procedure
Summary
This research investigates whether modifications to the magnetic resonance-guided focused ultrasound ablation of uterine fibroid (MRgFUS) system used resulted in improved treatment volumes of uterine fibroids, while maintaining safety. Magnetic resonance-guided focused ultrasound (MRgFUS) treatment of uterine fibroids uses MR guidance to direct high-intensity focused ultrasound into a fibroid, resulting in coagulative necrosis within the tissue. The system allows transducers to be shut off in banks which allows for sculpting and steering of the ultrasound beam This affords the operator enhanced control in avoiding non-target structures and defining the location of energy dissipation posterior to the fibroid. The introduction of ‘scar tape’, an adhesive barrier that prevents build-up of heat within the scar tissue, reduces the risk of cutaneous thermal injury for treating patients who have an anterior abdominal wall scar [3] This tape enables women with low transverse abdominal scars to be treated safely while avoiding the build-up of excess heat within the scar and subsequent burns. This tape was not available to us when we were treating patients with the ExAblate 2000 system; this could be used by other units using the earlier system
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