Pelvic applications of MR-guided high intensity focused ultrasound

review OA: closed CC0 ⤵ 3 in-corpus citations
AI-generated summary by claude@2026-06+body, 2026-06-13

MR-guided high intensity focused ultrasound is a tissue ablation technology reviewed here for its applications in treating uterine fibroids, adenomyosis, and prostate cancer.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text

This paper reviews MR-guided high intensity focused ultrasound (MRg HIFU), an MR-thermometry–enabled technique for stereotactic focused tissue ablation, and surveys its pelvic applications. It describes MRg HIFU’s use in treating uterine fibroids and highlights development/clinical use in other pelvic targets, including adenomyosis and prostate cancer, with the key principle being simultaneous targeting and real-time temperature monitoring during ablation. The article is framed as a review of technology and reported applications rather than a single primary study, and the included evidence spans different indications and study types. Relevance to endometriosis: adenomyosis is discussed as an application of MRg HIFU in the pelvic setting, alongside uterine fibroids and prostate cancer, so it is included through its direct connection to endometriosis-spectrum pelvic pathology via adenomyosis.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Full text 13,335 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Abstract

MR-guided high intensity focused ultrasound (MRg HIFU) is a novel method of tissue ablation that incorporates high energy focused ultrasound for tissue heating and necrosis within an MR scanner that provides simultaneous stereotactic tissue targeting and thermometry. To date, MRg HIFU has been used primarily to treat uterine fibroids, but many additional applications in the pelvis are in development. This article reviews the basic technology of MRg HIFU, and the use of MRg HIFU to treat uterine fibroids, adenomyosis, and prostate cancer. Similar content being viewed by others

References

Dobrotwir A, Pun E (2012) Clinical 24 month experience of the first MRgFUS unit for treatment of uterine fibroids in Australia. J Med Imaging Radiat Oncol 56:409–416 Lindstrom PA (1954) Prefrontal ultrasonic irradiation: a substitute for lobotomy. AMA Arch Neurol Psychiatry 72:399–425 Ren XL, Zhou XD, Yan RL, et al. (2009) Sonographically guided extracorporeal ablation of uterine fibroids with high-intensity focused ultrasound: midterm results. J Ultrasound Med 28:100–103 Tsakiris P, Thüroff S, de la Rosette J, Chaussy C (2008) Transrectal high-intensity focused ultrasound devices: a critical appraisal of the available evidence. J Endourol 22:221–229 Okolo S (2008) Incidence, aetiology and epidemiology of uterine fibroids. Best Pract Res Clin Obstet Gynaecol 22:571–588 Marshall LM, Spiegelman D, Barbieri RL, et al. (1997) Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol 90:967–973 Jacoby VL, Autry A, Jacobson G, et al. (2009) Nationwide use of laparoscopic hysterectomy compared with abdominal and vaginal approaches. Obstet Gynecol 114:1041–1048 http://www.alternativesurgeryblog.com/sexual-dysfunction-with-hysterectomy/. Accessed 28 Jan 2013 Mokate T, Wright C, Mander T (2006) Hysterectomy and sexual function. Menopause Int 12:153–157 Altman D, Granath F, Cnattingius S, Falconer C (2007) Hysterectomy and risk of stress-urinary-incontinence surgery: nationwide cohort study. Lancet 370:1494–1499 Walker WJ, Pelage JP (2002) Uterine artery embolisation for symptomatic fibroids: clinical results in 400 women with imaging follow up. BJOG 109:1262–1272 Harding G, Coyne KS, Thompson CL, Spies JB (2008) The responsiveness of the uterine fibroid symptom and health-related quality of life questionnaire (UFS-QOL). Health Qual Life Outcomes 6:99 Stewart EA, Gostout B, Rabinovici J, et al. (2007) Sustained relief of leiomyoma symptoms by using focused ultrasound surgery. Obstet Gynecol 110:279–287 Wyatt KM, Dimmock PW, Walker TJ, O’Brien PM (2001) Determination of total menstrual blood loss. Fertil Steril 76:125–131 http://www.accessdata.fda.gov/cdrh_docs/pdf4/P040003b.pdf. Accessed 28 Jan 2013 http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=20708. Accessed 28 Jan 2013 Pistofidis G, Makrakis E, Balinakos P, et al. (2012) Report of 7 uterine rupture cases after laparoscopic myomectomy: update of the literature. J Minim Invasive Gynecol 19:762–767 Pitter MC, Gargiulo AR, Bonaventura LM, Lehman JS, Srouji SS (2013) Pregnancy outcomes following robot-assisted myomectomy. Hum Reprod 28:99–108 Rabinovici J, David M, Fukunishi H, et al. (2010) Pregnancy outcome after magnetic resonance-guided focused ultrasound surgery (MRgFUS) for conservative treatment of uterine fibroids. Fertil Steril 93:199–209 http://www.clinicaltrials.gov/ct2/show/NCT00730886. Accessed 28 Jan 2013 Lénárd ZM, McDannold NJ, Fennessy FM, et al. (2008) Uterine leiomyomas: MR imaging-guided focused ultrasound surgery–imaging predictors of success. Radiology 249:187–194 deSouza NM, Williams AD (2002) Uterine arterial embolization for leiomyomas: perfusion and volume changes at MR imaging and relation to clinical outcome. Radiology 222:367–374 Stewart EA, Rabinovici J, Tempany CM, et al. (2006) Clinical outcomes of focused ultrasound surgery for the treatment of uterine fibroids. Fertil Steril 85:22–29 Judson O (2010) Enhancing the placebo. Op-Ed column. New York Times, May 4, 2010. http://www.nytimes.com/2010/05/04/opinion/04judson.html. Accessed 5 March 2011 Sanket D, Bero L, Redberg R, et al. (2009) Strength of study evidence examined by the FDA in premarket approval of cardiovascular devices. JAMA 302:2679–2685 http://clinicaltrials.gov/ct2/show/NCT00656305?term=mrgfus&rank=7. Accessed 5 March 2011 Bodenheimer T (2000) Uneasy alliance–clinical investigators and the pharmaceutical industry. N Engl J Med 342:1539–1544 Angell M (2008) Industry-sponsored clinical research: a broken system. JAMA 300:1069–1071 Steinbrook R (2009) Controlling conflict of interest—proposals from the institute of medicine. N Engl J Med 360:2160–2163 Jacoby V, Jacoby A, Kohi M, et al. (2012) MR guided focused ultrasound for uterine fibroids: a pilot randomized placebo controlled trial. In: Current and future applications of focused ultrasound 2012, 3rd International Symposium, Program Book. p 44 Yoo EH, Lee PI, Huh CY, et al. (2007) Predictors of leiomyoma recurrence after laparoscopic myomectomy. J Minim Invasive Gynecol 14:690–697 Hanafi M (2005) Predictors of leiomyoma recurrence after myomectomy. Obstet Gynecol 105:877–881 Funaki K, Fukunishi H, Sawada K (2009) Clinical outcomes of magnetic resonance-guided focused ultrasound surgery for uterine myomas: 24-month follow-up. Ultrasound Obstet Gynecol 34:584–589 Spies J, Bruno J, Czeyda-Pommersheim F, et al. (2005) Long-term outcome of uterine artery embolization of leiomyomas. Obstet Gynecol 106:933–939 Katsumori T, Kasahara T, Akazawa K (2006) Long-term outcomes of uterine artery embolization using gelatin sponge particles alone for symptomatic fibroids. AJR Am J Roentgenol 186:848–854 Ruuskanen A, Sipola P, Hippeläinen M, Wüstefeld M, Manninen H (2009) Pain after uterine fibroid embolisation is associated with the severity of myometrial ischaemia on magnetic resonance imaging. Eur Radiol 19:2977–2985 Kim KA, Yoon SW, Yoon BS, et al. (2011) Spontaneous vaginal expulsion of uterine myoma after magnetic resonance-guided focused ultrasound surgery. J Minim Invasive Gynecol 18:131–134 Radeleff B, Eiers M, Bellemann N, et al. (2010) Expulsion of dominant submucosal fibroids after uterine artery embolization. Eur J Radiol 75:e57–e63 http://lawmedconsultant.com/385/recent-large-malpractice-verdicts/. Accessed 28 Jan 2013 Cockerham AZ (2012) Adenomyosis: a challenge in clinical gynecology. J Midwifery Womens Health 57:212–220 Vercellini P, Vigano P, Somigliana E, et al. (2006) Adenomyosis: epidemiological factors. Best Pract Res Clin Obstet Gynecol 20:465–477 Fan TY, Zhang L, Chen W, et al. (2012) Feasibility of MRI-guided high intensity focused ultrasound treatment for adenomyosis. Eur J Radiol 81:3624–3630 Fukunishi H, Funaki K, Yamaguchi K, Sawada K (2011) Two-year outcome of MRgFUS treatment of adenomyosis. Poster at 21st World Congress of the International Society of Ultrasound in Obstetrics and Gynecology, 2011 Kim MD, Kim S, Kim NK, et al. (2007) Long-term results of uterine artery embolization for symptomatic adenomyosis. AJR Am J Roentgenol 188:176–181 Stamey TA, McNeal JE (1992) Adenocarcinoma of the prostate. In: Walsh PC, Retik AB, Stamey TA, Vaughan ED (eds) Campbell’s urology, vol. 2, 6th edn. Philadelphia: WB Saunders, pp 1159–1221 Epstein JI, Walsh PC, Carmichael M, Brendler CB (1994) Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. JAMA 271:368–374 Carter HB, Sauvageot J, Walsh PC, Epstein JI (1997) Prospective evaluation of men with stage T1C adenocarcinoma of the prostate. J Urol 157:2206–2209 Eggener SE, Mueller A, Berglund RK, et al. (2013) A multi-institutional evaluation of active surveillance for low risk prostate cancer. J Urol 189(1 Suppl):S19–S25 Ahmed HU, Moore C, Emberton M (2009) Minimally-invasive technologies in uro-oncology: the role of cryotherapy, HIFU and photodynamic therapy in whole gland and focal therapy of localised prostate cancer. Surg Oncol 18:219–232 Marberger M, Carroll PR, Zelefsky MJ, et al. (2008) New treatments for localized prostate cancer. Urology 72(6 Suppl):S36–S43 Polascik TJ, Mouraviev V (2008) Focal therapy for prostate cancer. Curr Opin Urol 18:269–274 Shelley M, Wilt TJ, Coles B, Mason MD (2007) Cryotherapy for localised prostate cancer. Cochrane Database Syst Rev 18:CD005010 Barqawi AB, Crawford ED (2007) The current use and future trends of focal surgical therapy in the management of localized prostate cancer. Cancer J 13:313–317 Muto S, Yoshii T, Saito K, et al. (2008) Focal therapy with high-intensity-focused ultrasound in the treatment of localized prostate cancer. Jpn J Clin Oncol 38:192–199 Ahmed HU, Emberton M (2008) Active surveillance and radical therapy in prostate cancer: can focal therapy offer the middle way? World J Urol 26:457–467 Miller DC, Sanda MG, Dunn RL, et al. (2005) Long-term outcomes among localized prostate cancer survivors: health-related quality-of-life changes after radical prostatectomy, external radiation, and brachytherapy. J Clin Oncol 23:2772–2780 Barocas DA, Cowan JE, Smith JAJr, Carroll PR, CaPSURE Investigators (2008) What percentage of patients with newly diagnosed carcinoma of the prostate are candidates for surveillance? An analysis of the CaPSURE database. J Urol 180:1330–1334 Schröder FH, Hugosson J, Roobol MJ, et al. (2009) Screening and prostate-cancer mortality in a randomized European study. N Engl J Med 360:1320–1328 Andriole GL, Crawford ED, Grubb RL III, et al. (2009) Mortality results from a randomized prostate-cancer screening trial. N Engl J Med 360:1310–1319 Sanghvi NT, Foster RS, Bihrle R, et al. (1999) Noninvasive surgery of prostate tissue by high intensity focused ultrasound: an updated report. Eur J Ultrasound 9:19–29 Lee HM, Hong JH, Choi HY (2006) High-intensity focused ultrasound therapy for clinically localized prostate cancer. Prostate Cancer Prostatic Dis 9:439–443 Blana A, Walter B, Rogenhofer S, Wieland WF (2004) High-intensity focused ultrasound for the treatment of localized prostate cancer: 5-year experience. Urology 63:297–300 Vallancien G, Prapotnich D, Cathelineau X, Baumert H, Rozet F (2004) Transrectal focused ultrasound combined with transurethral resection of the prostate for the treatment of localized prostate cancer: feasibility study. J Urol 171(6 Pt 1):2265–2267 Ficarra V, Antoniolli SZ, Novara G, et al. (2006) Short-term outcome after high-intensity focused ultrasound in the treatment of patients with high-risk prostate cancer. BJU Int 98:1193–1198 Han KR, Cohen JK, Miller RJ, et al. (2003) Treatment of organ confined prostate cancer with third generation cryosurgery: preliminary multicenter experience. J Urol 170(4 Pt 1):1126–1130 Mouraviev V, Mayes JM, Polascik TJ (2009) Pathologic basis of focal therapy for early-stage prostate cancer. Nat Rev Urol 6:205–215 Jayram G, Eggener SE (2009) Patient selection for focal therapy of localized prostate cancer. Curr Opin Urol 19:268–273 Scheidler J, Hricak H, Vigneron DB, et al. (1999) Prostate cancer: localization with three-dimensional proton MR spectroscopic imaging–clinicopathologic study. Radiology 213:473–480 Yu KK, Scheidler J, Hricak H, et al. (1999) Prostate cancer: prediction of extracapsular extension with endorectal MR imaging and three-dimensional proton MR spectroscopic imaging. Radiology 213:481–488 Coakley FV, Kurhanewicz J, Lu Y, et al. (2002) Prostate cancer tumor volume: measurement with endorectal MR and MR spectroscopic imaging. Radiology 223:91–97 Chang S, Westphalen A, Jha P, et al. (2011) Endorectal MRI and MR spectroscopic imaging of prostate cancer: developing selection criteria for MR-guided focused ultrasound surgery-preliminary experience. American Roentgen Ray Society Annual Program. p 33 Anwar MM, Westphalen AC, Jung A, et al. (2012) Role of endorectal MRI and MRSI in defining the dominant intraprostatic lesion in prostate cancer: quantitative analysis of imaging contour compared to whole-mount histopathology. Int J Radiat Oncol Biol Phys 84:S403 Yerram N, Hoang A, Partanen A, et al. (2012) MR-guided trans-urethral prostate HIFU in a preclinical model. Mid Atlantic Section of the American Urological Association 2012 Annual Meeting Abstract. http://meeting.maaua.org/abstracts/2012/MP24.cgi. Accessed 11 April 2013 Kinsey AM, Diederich CJ, Rieke V, et al. (2008) Transurethral ultrasound applicators with dynamic multi-sector control for prostate thermal therapy: in vivo evaluation under MR guidance. Med Phys 35:2081–2093 Zini C, Hipp E, Thomas S, et al. (2012) Ultrasound- and MR-guided focused ultrasound surgery for prostate cancer. World J Radiol 4:247–252 Falk MH, Issels RD (2001) Hyperthermia in oncology. Int J Hyperthermia 17:1–18 Mukhopadhaya A, Mendecki J, Dong X, et al. (2007) Localized hyperthermia combined with intratumoral dendritic cells induces systemic antitumor immunity. Cancer Res 67:7798–7806 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Coakley, F.V., Foster, B.R., Farsad, K. et al. Pelvic applications of MR-guided high intensity focused ultrasound. Abdom Imaging 38, 1120–1129 (2013). https://doi.org/10.1007/s00261-013-9999-2 Published: Issue date: DOI: https://doi.org/10.1007/s00261-013-9999-2

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

MeSH descriptors

High-Intensity Focused Ultrasound Ablation Leiomyoma Magnetic Resonance Imaging, Interventional Uterine Neoplasms Contrast Media Female Humans Leiomyoma Patient Safety Uterine Neoplasms

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (73)

Cited by (3)

Source provenance

europepmc
last seen: 2026-06-20T06:14:18.781669+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-05-13T22:19:05.543671+00:00
License: CC0 · commercial use OK