Irene Mindjuk, Presenter: Nothing to Disclose

Matthias Matzko MD, Abstract Co-Author: CEO, Imaging Service AG Shareholder, Imaging Service AG

To assess the MRgFUS treatment results in a single institution and factors that are related to treatment success.

A total of 252 patients (mean age, 42.1 ± 6.9 years) with uterine fibroids underwent MR guided Focused Ultrasound treatment on an ExAblate 2100 system (Insightec Ltd.). All patients underwent MRI screening before the treatment. Results were evaluated by post- treatment non-perfused volume, symptom severity score (SSS), reintervention, fibroid expulsion, pregnancy, and safety data. Clinical information and data from the MR screening was evaluated with the treatment results, such as fibroid location, volume, intensity and blood perfusion.

The percentage of the NPV was significantly higher in lesions with low signal intesity in T2w and CE-T1w MRI, nonseptated, distanced to the spine >3cm and with no subserosal component (p< 0.001). NPV ratio is highly correlative to clinical success, specifically NPV of >80 % result a clinical success of >80% of patients. Reintervention rate was 12.7% in the mean follow up time of 19.4 month (± 8, range 3-38). Thirty-six patients (16%) experienced complete fibroid expulsions that significantly correlated with a high success rate without requiring additional intervention. Successful pregnancy and delivery rate was 14% out of patients with incomplete family planning. No severe adverse events were reported.

NPV results of >80 % represent a threshold correlating with high clinical success and a probability for reintervention similar with other common treatments for uterine fibroids. Patient selection is a crucial factor in achieving high NPV ratios. Expulsion of fibroids after MRgFUS was associated with a high symptomatic relief and a low complication rate. Successful pregnancy and delivery rate in this study is promising for further investigations.

MRI screening parameters are correlated with the amount of fibroids ablation achieved using MRgFUS treatment and therefore is recommended to determine patient suitability for MRgFUS treatment.

Mindjuk, I, Matzko, M, MRI Predictors for High Success Rates of MRgFUS for Uterine Fibroids.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14004365.html