OC049: Factors influencing patient candidacy for magnetic resonance guided focused ultrasound (MRgFUS) treatment of uterine leiomyoma

To provide insight on the percentage of women with symptomatic uterine fibroids who are suitable for MRgFUS. A selection criteria for MRgFUS was developed defining a suitable patient as having potential to obtain a post-treatment non-perfused volume of at least 50%. T2 and post-contrast fat-saturation MR images from 179 patients who inquired about MRgFUS for symptomatic fibroids were used to determine candidacy. Of 179 patients screened for MRgFUS, 131 were considered candidates and 118 were treated. 13 candidates are still considering the treatment. Of the 49 non-candidates, 12 had significant adenomyosis with or without fibroids, 8 had non-enhancing fibroids (calcified, hemorrhagic or necrotic), and 6 had too many fibroids (> 6). 5 patients had findings suspicious for cancer, of those, 2 were proven malignancies (endometrial cancer and uterine sarcoma) 1 had a benign fibroid at pathology, and 2 had no pathology. 4 patients had fibroids that were too vascular, 4 had metal in the beam path, 3 patients had endometrial polyps (in addition to the fibroids) that probably necessitated treatment and removal. 2 patients had previous liposuction scars that would hinder treatment, 2 had fibroids too small for treatment. 1 patient had fibroids that were too large, 1 had fibroids that were too posterior, and 1 had a pedunculated fibroid. MRgFUS is an effective treatment for uterine fibroids provided that a sufficient non-perfused volume of the fibroid is obtained. The ability for physicians to be able to advise patients of their suitability to MRgFUS and to choose ideal patients for the procedure is important to treatment satisfaction and success. This study shows that approximately 73% (131/179) of patients screened for the procedure will be candidates who can achieve the desired treatment volume leading to symptom relief.