Federica Ciolina MD, Presenter: Nothing to Disclose

Alessandro Napoli MD, Abstract Co-Author: Nothing to Disclose

Michele Anzidei MD, Abstract Co-Author: Nothing to Disclose

Vincenzo Noce MD, Abstract Co-Author: Nothing to Disclose

Gaia Cartocci, Abstract Co-Author: Nothing to Disclose

Carlo Catalano MD, Abstract Co-Author: Nothing to Disclose

To establish the efficacy of sonication in symptoms relief and volume reduction over time.

36 leiomyomas in 30 women (average age 40 years, range 32-46 range) were treated with MRI-guided focused ultrasound (MRgFUS). The system (ExAblate 2100, InSightec), equipped with a phased-array transducer (0.95-1.3 MHz), computer-controlled positioning system, radiofrequency amplifier system, operates in conjunction with a 3 T MR unit (GE). We scored severity of symptoms (as menorrhagia, urinary frequency, pelvic pain or bulk symptoms) using a 0-3 points scale before and after treatment. We also measured their impact on quality of life using a visual analog scale (VAS), the choice-based waiting trade-off (WTO) and the time trade-off (TTO). Pre-treatment imaging set (T2-w and T1-w images, pre- and post-Gd - BOPTA) were obtained to measure leiomyoma volume. Immediately after treatment, T1-w contrast-enhanced fat-suppressed MR images in three planes were used to measure non-perfused volume (NPV). The average volume of treated fibroids was 63 ± 55 (SD) cm3. Follow-up images were obtained 3, 6 and 12 months after treatment and served to determine leiomyoma shrinkage. Qualitative and quantitative relations between fibroid volume, NPV ratio at treatment, and 6-month shrinkage were measured.

All patients showed a complete relief of symptoms related to uterine fibroids and an increased quality of life. The average NPV ratio was 70 % ± 25 % immediately after treatment. At follow-up treated fibroids showed volume decrease to 54 ± 40 cm3 with an average volume reduction of 20 % ± 15 %. A linear regression model showed highly significant correlation between post-treatment non-perfused volume ratio and shrinkage at 6 months.

MRgFUS therapy of leyomioma results in a significant relief of symptoms, a good NPV ratio and in a mild shrinkage at 3, 6 and 12 months in a safe and noninvasive manner.

This study shows how it is possible to non invasively treat symptoms related to uterine fibroids with short and long term increased quality of life.

Ciolina, F, Napoli, A, Anzidei, M, Noce, V, Cartocci, G, Catalano, C, MRgFUS Treatment of Uterine Leiomyomas: Results on Quality of Life, Nonperfused Volume Ratio, and Size Reduction over 12 Months.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11014946.html