RSNA 2019

Abstract Archives of the RSNA, 2019


RC514-08

Treatment of Type 2 and 3 Uterine Fibroids with MR-Guided Focused Ultrasound Surgery: Study of 248 Fibroids

Wednesday, Dec. 4 10:00AM - 10:10AM Room: S105AB



Participants
Ritu M. Kakkar, MBBS, DMRD, Mumbai, India (Abstract Co-Author) Nothing to Disclose
Shrinivas B. Desai, MD, Mumbai, India (Presenter) Nothing to Disclose

For information about this presentation, contact:

riturupesh@gmail.com

PURPOSE

To evaluate the role of Magnetic Resonance guided Focussed Ultrasound Surgery (MRgFUS) in treatment of type 2 and 3 uterine fibroids by evaluating post treatment non perfused volume .To evaluate difference in treatment energies and duration of treatment as compared to type 1 fibroids

METHOD AND MATERIALS

248 symptomatic fibroids enhancing type 2 and 3 (T2 iso and hyperintense) uterine fibroids in 104 Indian women , were selected for study after approval from ethics committee following .Pre treatment baseline MRI with contrast was performed and fbroids were classified on basis of T2 signal intensity .Fibroids were classified as Type 1 - hypointense to muscle ,Type 2 - isointense to muscle and type 3- hyperintense to muscle .Treatment was performed on a 1.5-T whole-body system (Signa; GE Healthcare) in the ExAblate 2000 (InSightec) device, using nominal spot protocol .The mean energies ranged between 3500-4200J,while the duration of treatment was 3.5 to 4 hours .Pretreatment fibroid volumes and post treatment non perfused volumes were calculated.

RESULTS

The mean volume of fibroids before treatment was 127 cc with SD, 71.22 cc.The post treatment contrast enhanced images showed that the volume of fibroid that was nonperfused was 92.21 cc (mean) with SD of 44.12 cc. The average percentage NPV of the total fibroid volume was 72.44 % with a SD of 5.60%.The mean energies used in the treatment ranged between 3500-4200 J ,which is 15 -16 % higher than type 1 fibroids 2000-3000J .The average duration of treatment was 3.5 -4 hours ,1.4 times higher than type 1 fibroids.78%patients has no significant adverse effects.Skin burn with blisters were seen 2%patients .Post treatment leg pain was seen 10% patients immediaterly after treatment

CONCLUSION

MRgFUS is a non invasive technology providing good treatment and volume reduction in patients with T2 iso and hyperintense fibroids ,with acceptable adverse effect profile inspite of higher energies used

CLINICAL RELEVANCE/APPLICATION

MRgFUS can be considered treatment of T2 iso and hyperintense fibroids and can used as an alternative to Uterine artery embolization and in patients not willing for surgery

Printed on: 03/01/22