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Magnetic Resonance-guided
Focused Ultrasound of Uterine
Fibroids: Patient Follow-up 12
Months after Treatment
GK Hesley, KR Gorny, DA Woodrum,
DL Brown, KR Brandt, TL Henrichsen,
JP Felmlee, NJ Hangiandreou, BS
Gostout, and EA Stewart.
Disclosures
• This study had no funding from
outside sources.
• Presenting investigator has received
funding for other focused ultrasound
projects from Insightec: Haifa, Israel.
Manufacturer of Exablate 2000
device.
Fibroids
• 25-40% of women age 35 and older have
uterine fibroids of a significant size.
• In the US, 2 million women seek treatment
each year.
• Symptoms include: heavy menstrual
bleeding, pelvic pain and pressure, back
and leg pain, and urinary frequency.
Treatment Options
• Observation and Medical Therapy
• Surgical
• Hysterectomy
• Myomectomy
• Uterine Artery Embolization(UAE)
Treatment Options
• Focused Ultrasound
Background
Animation courtesy of Insightec
Planning
Beam Path
Thermal Imaging
Pre-Treatment
Post Treatment
One Year Post-Treatment
Treatment Benefits
• Non-invasive outpatient procedure
• No radiation
• Next day return to normal activity
• Low rate of complications
• Mild post-procedural pain
• Over the counter medications such as
acetaminophen
Patient Selection
• Pre-menopausal women
• Have fibroid symptoms
• Size: typically 3cm and larger
• Number:
• Depend on experience of center
• Patients with numerous similar
size fibroids usually better suited
for UAE.
Purpose
• Assess outcomes after 12 months
following Magnetic Resonance-guided
Focused Ultrasound(MRgFUS).
Pre MRgFUS
Post MRgFUS
Materials and Methods
• Patients scheduled for treatment at
Mayo Clinic, Rochester MN between
March 2005 and September 2008.
Materials and Methods
• Patients were followed for 12 months
with phone interviews to assess
• Interval alternative treatments
• Symptomatic relief after procedure
• Self reported symptomatic
improvement:
• 0-10% insignificant
• 11-40% moderate
• 41-70% considerable
• 71-100% excellent
Results and Discussion
• Of the 100 patients
• 8 required alternative treatments
for their fibroid symptoms
• 6 hysterectomies
• 2 myomectomies
12 month Data
Number of Patients
80
70
60
50
97%
(out of 89)
40
30
20
3%
10
0
improved
did not improve
ig
ni
an
t
fic
16%
In
s
le
at
e
od
er
ab
id
er
nt
74%
M
on
s
lle
60
50
40
30
20
10
0
C
Ex
ce
Number of patients
Degree of Symptom Change at 12
months
9%
1%
Conclusion
• MRgFUS is an effective non-invasive
therapy
• 8% alternative treatment rate at 12
months
• 97% of patients reported
improvement of symptoms
Conclusion
• 90% of patients rating their
improvement as considerable or
excellent at 12 months.
• Results are similar to UAE
and myomectomy data.
•Obsteterics& Gynecology. 2005, 106: 933-939.
•Obstet & Gynecol. 2005;106(6): 1309-1318.
•Hum Reprod, 1995, 10:1795-1796.
•Obstet & Gynecol. 2002;100(5): 864-868.
•Obstetrics & Gynecology, 2005, 106:1309-1318.
•Obstetrics & Gynecology, 2001, 98:583-587.
•J. Am. Assoc. Gynecol. Laparosc., 2001,
8:495-500.
•Obstet Gynecol 2001;98(1):29-34
•N Engl J Med. 2007;110(3):625-632.
Thank You
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