Magnetic resonance-guided high-intensity focused ultrasound for uterine fibroids: Mid-term outcomes of 36 patients treated with the Sonalleve system

Abstract

Treatment of uterine fibroids by MRgFUS is efficient and results in low morbidity and satisfactory clinical efficacy with a mean follow-up of 21.4 months.

Clinical Consideration of Treatment to Ablate Uterine Fibroids with Magnetic Resonance Imaging-guided High Intensity Focused Ultrasound (MRgFUS): Sonalleve

“…Anne et al also utilized the same HIFU equipment as that of the Hospital to follow up 36 patients for 21.4 months on average. As a result, they reported to have found clinical effectiveness in 61.1% of the patients and significant fall in SSS from 42.8 ± 16 to 25.4 ± 18 on average 30. Statistically significant recovery was found especially in symptoms such as pelvic heaviness in profuse menstruation and swelling.…”

Expulsion of Fibroids to the Endometrial Cavity after Magnetic Resonance Imaging-guided High Intensity Focused Ultrasound Surgery (MRgFUS) Treatment of Intramural Uterine Fibroids

“…Anne et al utilized the equipment identical to the Hospital’s HIFU equipment and they examined 36 patients for 21.4 months on average. As a result, they found 61.1% showed clinical effectiveness and reported re-intervention in 12, 18, and 24 months was 2.8%, 8.5%, and 21.6%, respectively 17. Morita et al18 followed up 48 patients receiving HIFU treatment for 6 months; then reported 33% reduction in their fibroid volumes, indicating a significant correlation with P value 0.037 between the NPV ration right after the operation and fibroid volume reduction.…”

Magnetic resonance texture parameters are associated with ablation efficiency in MR-guided high-intensity focussed ultrasound treatment of uterine fibroids

“…In our institution, MRgFUS treatment was offered to patients meeting the following conditions: (1) age 18 years old without menopause, (2) one or two fibroids larger than 3 cm and less than 15 cm and (3) a Transformed Symptom Severity Score (tSSS) of at least 10 points. Exclusion criteria for MRgFUS treatment were (1) sub-mucosal fibroids, (2) type 3 fibroids based on Funaki et al [14], (3) more than 8 cm between the skin and the fibroid, (4) intra-fibroid calcification, (5) evidence of degeneration, (6) other pelvic disease (endometriosis, adenomyosis and inflammatory disease), (7) bowel interposition between the ultrasound beam and the fibroid, (8) large abdominal scar and (9) more than five fibroids [6]. For 36 patients, mid-term clinical efficiency assessed by decrease of the symptom severity score [22] was already reported in a previous study [6] that did not assess MR-texture parameters and treatment efficiency.…”

“…Magnetic resonance imaging-guided high-intensity focussed ultrasound system Two radiologists each with 8 years' experience in MRgFUS ablation [6,7,23] performed all treatment procedures on a clinical MRgFUS platform (Sonalleve Philips Vantaa, Finland) integrated into a 1.5-Tesla clinical MRI (Achieva 1.5T, Philips Healthcare, Best, Netherlands), as described in previous publications [6,7].…”

“…Magnetic resonance imaging-guided high-intensity focussed ultrasound (MRgFUS) is an emerging and promising noninvasive treatment for symptomatic uterine fibroids. Shortand mid-term follow-up has shown satisfactory clinical success using either "point-by-point" sonication [1][2][3][4][5] or volumetric ablation with the binary feedback control technique [6][7][8][9]. However, despite the established clinical effectiveness of this safe and non-invasive treatment, it has not yet been widely adopted in clinical practice due to the time required to achieve sufficient tumour necrosis (around 2-3 h).…”