Efficacy and safety of magnetic resonance-guided focused ultrasound surgery (MRgFUS) ablation in the management of abnormal uterine bleeding due to uterine leiomyoma or adenomyosis.

Yaoqu Huang, Shangcheng Zhou, Shouguo Zhou, Juan Wang, Zhuochao Pang
American journal of translational research · 2022 · vol. 14(1) , pp. 656–663 · PMID:35173883 · W4213392292
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Abstract

PURPOSE: To investigate the efficacy and safety of magnetic resonance-guided focused ultrasound surgery (MRgFUS) ablation for abnormal uterine bleeding (AUB) due to uterine leiomyoma or adenomyosis. METHODS: In total, thirty patients with AUB due to uterine leiomyoma (AUB-L group) or adenomyosis (AUB-A group) were treated by MRgFUS ablation. After MRgFUS ablation, the short-term clinical efficacy within one year was assessed. RESULTS: Sixteen patients were classified into the AUB-L group and 14 patients into the AUB-A group. The average nonperfused volume (NPV) ratios of the AUB-L and AUB-A groups were 82.7% ± 13.6% and 83.3% ± 11.1%, respectively. Compared with the baseline, the lesion volumes in the AUB-L and AUB-A groups were reduced by 45.6% and 34.6%, respectively, at 3 months after MRgFUS ablation. The hemoglobin concentration was increased by 22.4% in the AUB-L group and 15.3% in the AUB-A group at 3 months posttreatment. No amenorrhea occurred during the 12-month follow-up. The duration of bleeding decreased significantly in the AUB-A group. The mean PBAC scores at 3, 6 and 12 months posttreatment were reduced by 50.8%, 48.4% and 42.8%, respectively, in the AUB-L group and by 50.9%, 53.8% and 47.9%, respectively, in the AUB-A group. Compared with the baseline, at 3, 6 and 12 months posttreatment, the HRQL score increased by 41.5%, 43.3% and 33.3%, respectively, in the AUB-L group and by 24.7%, 31.1% and 28.2%, respectively, in the AUB-A group. CONCLUSION: MRgFUS is an effective and safe noninvasive uterine-sparing treatment modality in the management of AUB-L and AUB-A. MRgFUS can target lesion for ablation effectively, remove the factors that lead to AUB, retain a normal menstrual cycle, relieve AUB symptoms significantly and improve quality of life.

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