Increased MR-guided high intensity focused ultrasound (MR-HIFU) sonication efficiency of uterine fibroids after carbetocin administration

• Published in: European journal of radiology Open Vol. 9; p. 100413
• Main Authors: Anneveldt, Kimberley J., van ’t Oever, Heleen J., Verpalen, Inez M., Nijholt, Ingrid M., Bartels, Wilbert, Dijkstra, Jeroen R., van den Hoed, Rolf D., van ’t Veer - ten Kate, Miranda, de Boer, Erwin, Veersema, Sebastiaan, Huirne, Judith A.F., Schutte, Joke M., Boomsma, Martijn F.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.01.2022; Elsevier
• Subjects: Efficiency; High-intensity focused ultrasound ablation; MR guided interventional procedures; Myoma; Uterine fibroids; Uterus stimulant; Myoma; EEF; EM; SSI; MR guided interventional procedures; MaSS; High-intensity focused ultrasound ablation; MR-HIFU; Uterine fibroids; Uterus stimulant; NPV; T1w-CE; Efficiency; SI; T2w; EEF, Energy Efficiency Factor; T1w-CE, Contrast-enhanced T1-weighted imaging; EM, Equivalent Minutes; NPV, Non-Perfused Volume; SI, Signal Intensity; SSI, Scaled Signal Intensity; MR-HIFU, Magnetic Resonance image guided High Intensity Focused Ultrasound; MaSS, Myoma Screening Study; T2w, T2-weighted imaging
• ISSN: 2352-0477; 2352-0477
• DOI: 10.1016/j.ejro.2022.100413

We investigated whether administration of the long-acting uterus stimulant carbetocin increased intra-subject sonication efficiency during Magnetic Resonance image guided High Intensity Focused Ultrasound (MR-HIFU) treatment of uterine fibroids. In this prospective cohort study, thirty women with symptomatic uterine fibroids undergoing MR-HIFU treatment were included between January 2018 and January 2019. Treatment started with three sonications on one side of the uterine fibroid. Subsequently, one ampoule of 1 mL carbetocin (100 µg/mL) was administered intravenously and treatment continued with three sonications on the other side of the uterine fibroid. We compared the intra-subject sonication efficiency, in terms of Energy Efficiency Factor (EEF), thermal dose volume and sonication time to ablate one cm3 of fibroid tissue, before and after carbetocin administration. Adverse events that occurred within 30 min after carbetocin administration were recorded. Sonication efficiency improved after carbetocin administration as indicated by a significant decrease in EEF and sonication time (p = 0.006 and p = 0.001 respectively), and a significant increase in thermal dose volume reached (p = <0.001). Five women (16.7%) experienced temporary tachycardia, one women in combination with headache, within 30 min after carbetocin administration. Administration of the long-acting uterus stimulant carbetocin improved the MR-HIFU treatment intra-subject sonication efficiency in women with symptomatic uterine fibroids. •Carbetocin administration resulted in more efficient MR-HIFU fibroid sonications.•16.7% of the women experienced mild side effects of carbetocin administration.•Carbetocin may lead to a broader patient eligibility and reduced treatment times.