Mid-term outcome of magnetic resonance-guided focused ultrasound surgery for uterine myomas: from six to twelve months after volume reduction

• Published in: Journal of minimally invasive gynecology Vol. 14; no. 5; p. 616
• Main Authors: Funaki, Kaoru, Fukunishi, Hidenobu, Funaki, Tsuyoshi, Kawakami, Chihiro
• Format: Journal Article
• Language: English
• Published: United States 01.09.2007
• Subjects: Adult; Diffusion Magnetic Resonance Imaging; Female; Follow-Up Studies; Humans; Leiomyomatosis - therapy; Magnetic Resonance Imaging, Interventional - methods; Middle Aged; Thermography; Treatment Outcome; Ultrasonic Therapy - methods; Uterine Neoplasms - therapy
• ISSN: 1553-4650
• DOI: 10.1016/j.jmig.2007.04.009

To clarify the volume change ratio of uterine myomas treated with magnetic resonance-guided focused ultrasound surgery (MRgFUS), in relation to the signal intensity of T(2)-weighted magnetic resonance (MR) images. Prospective study (Canadian Task Force classification II-3). Department of Gynecology, Shinsuma General Hospital, Kobe, Japan. Forty-eight myomas in 35 patients were followed up with MR images 6 months after MRgFUS, and 23 myomas in 17 patients were followed up 12 months after MRgFUS. Before treatment, the myomas were classified into 3 types on the basis of the signal intensity of T(2)-weighted MR images as follows: Type 1, low intensity; type 2, intermediate intensity; type 3, high intensity. Thermal ablation therapy was performed with an MRgFUS system (ExAblate 2000). MRgFUS produced a greater volume reduction in type 1 and type 2 myomas than in type 3 myomas. Nonperfused areas always diminished in the period after MRgFUS; however, the volume change was affected by the volume change ratio of perfused areas inside the treated myomas. At present, type 3 myomas should be exempted from the application of MRgFUS, because the nonperfused ratio immediately after the procedure was small compared with that in type 1 and type 2 myomas, and the subsequent volume change was unfavorable.