ParticipantsGiulia Alfieri, MD, Rome, Italy (Presenter) Nothing to Disclose
Andrea Leonardi, MD , Roma, Italy (Abstract Co-Author) Nothing to Disclose
Alessandro Napoli, MD, Rome, Italy (Abstract Co-Author) Nothing to Disclose
Roberto Scipione, MD , Terracina, Italy (Abstract Co-Author) Nothing to Disclose
Susan Dababou, Rome, Italy (Abstract Co-Author) Nothing to Disclose
Carlo Catalano, MD, Rome, Italy (Abstract Co-Author) Nothing to Disclose
giulia.alfieri@uniroma1.it
PURPOSETo prospectively evaluate clinical outcome of Magnetic Resonance Focused Ultrasound (MRgFUS), Uterine Artery Embolization (UAE) and Surgery for Symptomatic Uterine Fibroid
METHOD AND MATERIALS600 symptomatic uterine fibroids underwent pre-treatment MR evaluation in order to assess myoma characteristics. 202 (34%) were considered eligible to MRgFUS and treated with ExAblate-InSightec 2100 system, while 398 resulted ineligible and were directed toward other therapeutic strategies. Of these, 137 underwent to UAE, 143 to myomectomy and 61 to hysterectomy. Clinical outcome was evaluated comparing pre-treatment Symptoms Severity Score (SSS) with post-treatment SSS at 3-month and 12-month follow-up. Data concerning number and type of complications, days of hospitalization and days of convalescence were also collected and compared
RESULTSSSS mean reduction at 3 and 12-months was of 27,4% and 56,3%, respectively, for MRgFUS group; 48,7% and 56,9% for UAE group; 69,8% and 67,1% for myomectomy group; 96,6% and 94,5% for hysterectomy group. MRgFUS group demonstrated fewer complications (4 patients, 2,0 %), while the major adverse events rate was reported in UAE group (33 patients, 25,4 %). All MRgFUS patients were treated in outpatient setting, while mean days for hospitalisation and convalescence for other groups were respectively 3,4±2 and 11,7±9 days for UAE group; 4,1±2 and 16,9±12 days for myomectomy group; 4,5±1 and 24,6±14 days for hysterectomy group
CONCLUSIONClinical efficacy of MRgFUS for uterine fibroids treatment is comparable to UAE but slightly lower than myomectomy. However, MRgFUS is feasible in an outpatient setting and adverse events rate is significantly lower than other therapeutic strategies
CLINICAL RELEVANCE/APPLICATIONMRgFUS treatment has clinical efficacy comparable to UAE but lower than myoectomy for the treatment of uterine fibroids. MRgFUS has an advers events rate significantly lower than UAE and myoectomy.