Avoiding treatment of leiomyosarcomas: the role of magnetic resonance in focused ultrasound surgery

Samuel, Amber; Fennessy, Fiona M.; Tempany, Clare M.; Stewart, Elizabeth A.

doi:10.1016/j.fertnstert.2007.08.019

Cited by 19 publications

(12 citation statements)

References 18 publications

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“…Another entity that may be differentiated from fibroids is the rare possibility of leiomyosarcoma. However, while the presence of an irregular border and intrafibroid necrotic area with hemorrhage and variable signal intensity may appear suspicious, there are no strict imaging criteria to differentiate benign from malignant smooth muscle tumor so a diagnosis of leiomyosarcoma cannot always be made through imaging [5, 6]. …”

Section: Uterine Fibroidsmentioning

confidence: 99%

Image-Guided Thermal Therapy of Uterine Fibroids

Shen

Fennessy

McDannold

et al. 2009

Seminars in Ultrasound, CT and MRI

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Thermal ablation is an established treatment for tumor. The merging of newly developed imaging techniques has allowed precise targeting and real-time thermal mapping. This article provides an overview of the image-guided thermal ablation techniques in the treatment of uterine fibroids. Background on uterine fibroids, including epidemiology, histology, symptoms, imaging findings and current treatment options, is first outlined. After describing the principle of magnetic resonance thermal imaging, we introduce the applications of image-guided thermal therapies, including laser ablation, radiofrequency ablation, cryotherapy and particularly the newest, magnetic resonance-guided focused ultrasound surgery, and how they apply to uterine fibroid treatment.

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Section: Uterine Fibroidsmentioning

confidence: 99%

Image-Guided Thermal Therapy of Uterine Fibroids

Shen

Fennessy

McDannold

et al. 2009

Seminars in Ultrasound, CT and MRI

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“…Figure 10c describes a previously undetected 1.5-cm polypoid mass with relatively high signal intensity in the endometrial cavity. This was diagnosed as endometrial cancer, and the patient underwent surgery [22]. Figure 10d shows a patient that was also identified with a large teratoma in the right ovary.…”

Section: Malignancymentioning

confidence: 99%

Patient selection guidelines in MR-guided focused ultrasound surgery of uterine fibroids: a pictorial guide to relevant findings in screening pelvic MRI

et al. 2008

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Uterine leiomyomas (fibroids), the most common benign tumor in women of childbearing age, can cause symptoms including dysmenorrhea, menorrhagia, urinary symptoms, pain and infertility. Hysterectomy is a common approach to treating uterine fibroids, and less invasive surgical approaches such as myomectomy and uterine artery embolization also have been shown to alleviate symptoms. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is the only totally non-invasive surgical approved method for treating uterine fibroids. In clinical trials, MRgFUS resulted in significant relief of uterine fibroid symptoms. The safe and effective use of MRgFUS is affected by fibroid type and location, position relative to adjacent anatomical structures and the presence of co-existent pelvic disease. Additionally, successful outcomes with MRgFUS have been correlated with the volume of fibroids ablated during the procedure. Thus, selection of patients in whom sufficient fibroid volumes can be treated safely using the MRgFUS system is critical for successful outcomes. The MR images in this pictorial essay provide examples of uterine fibroids for which MRgFUS should be considered and is designed to facilitate the selection of patients for whom MRgFUS is most likely to provide sustained symptom relief.

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“…Imaging modalities that have been found to be useful in the diagnosis of uterine sarcomas are ultrasound, positron emission tomography (PET), and MRI, but not CT [7]. On sonography, we may see mixed echogenic and poor echogenic parts, central necrosis, and irregular vessel distribution, low impedance to flow, and high peak systolic velocity on doppler, but these findings may prevail in benign fibroids as well [8]. MRI may show intralesional haemorrhage, necrosis, ill-defined margins, and consistent absence of calcifications.…”

Section: Discussionmentioning

confidence: 99%

Unexpected Histopathological Diagnosis of Undifferentiated Uterine Sarcoma after Simple Hysterectomy: Extrapolating Limited Evidence

Davis

2020

Cureus

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Avoiding treatment of leiomyosarcomas: the role of magnetic resonance in focused ultrasound surgery

Cited by 19 publications

References 18 publications

Image-Guided Thermal Therapy of Uterine Fibroids

Image-Guided Thermal Therapy of Uterine Fibroids

Patient selection guidelines in MR-guided focused ultrasound surgery of uterine fibroids: a pictorial guide to relevant findings in screening pelvic MRI

Unexpected Histopathological Diagnosis of Undifferentiated Uterine Sarcoma after Simple Hysterectomy: Extrapolating Limited Evidence

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