Young-Sun Kim MD, Presenter: Nothing to Disclose

Hyunchul Rhim MD, PhD, Abstract Co-Author: Nothing to Disclose

Hyo Keun Lim MD, Abstract Co-Author: Research grant, Koninklijke Philips Electronics NV

Duk-Soo Bae, Abstract Co-Author: Nothing to Disclose

Byoung-Gie Kim, Abstract Co-Author: Nothing to Disclose

Jeong-Won Lee, Abstract Co-Author: Nothing to Disclose

Tae-Joong Kim, Abstract Co-Author: Nothing to Disclose

Chelhun Choi, Abstract Co-Author: Nothing to Disclose

Volumetric MR-HIFU (MR-guided high-intensity focused ultrasound) ablation has been recently developed to overcome a drawback of low time efficiency of the conventional method, especially in large tumor. The purpose of our study was to evaluate the initial clinical outcomes of volumetric MR-HIFU ablation technique in the treatment of huge uterine fibroids (>10cm) using ‘one-plane’ ablation strategy.

From Dec 2010 to Mar 2011, a total of 22 women (mean age 44.4, 35-50) with 22 symptomatic huge uterine fibroids over 10cm in diameter (11.6±1.4cm[10.1-16.0cm], 526.8±179.9mL[253.8-1184.0]; type I n=6, type II n=13, type III n=3) were treated with volumetric MR-HIFU ablation therapy. We adopted ‘one-plane’ ablation strategy. It implies that all treatment cells (4, 8, 12, and 16mm in axial diameter) are placed at one single plane that is located at the depth of anterior two-thirds of the fibroids. We assessed procedure time, NPV (non-perfused volume) at immediate contrast-enhanced MR, complications and changes of SSS (symptoms severity score) at 1 month follow-up.

All treatments showed technical successes. MR room time was 212.1±33.3 (145-271)min and treatment time from 1st to last sonication was 163.6±39.0 (83-231)min. The number of treatment cell used was 45.1±10.2 (4mm 0; 8mm 3.8±6.1; 12mm 15.8±5.2; 16mm 22.5±12.3). NPV at immediate follow-up MR was 311.3±126.6 (114.8-574.7)mL which was 60.8±20.0% (30.9-91.1%) of fibroid volume (>80% n=5; >50% and ≤80% n=12; >30% and ≤50% n=5). Treatment speed (NPV /treatment time) was calculated as 115.5±36.4 (53.8-179.0)mL/hr. Only minor complications occurred in three cases (13.6%; thermal injury of abdominal wall muscle n=1, self limiting numbness on the right shin area n=1, cystitis n=1). Mean SSS (n=14) was changed from 21.2 to 15.1 after 1 month follow-up (p<0.001).

Volumetric MR-HIFU ablation therapy with ‘one-plane’ ablation strategy showed safety as well as excellent NPV results within acceptable time range in the treatment of huge uterine fibroids.

The new volumetric MR-HIFU ablation technique can be effectively used for  huge symptomatic uterine fibroids which are currently difficult to treat by means of the conventional HIFU method.

Kim, Y, Rhim, H, Lim, H, Bae, D, Kim, B, Lee, J, Kim, T, Choi, C, Volumetric MR-HIFU Ablation for the Treatment of Huge Uterine Fibroids over 10cm in Diameter: Usefulness of ‘One Plane’ Ablation Strategy and Analysis of Initial Clinical Outcomes.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11010632.html