Focused Ultrasound for Treatment of Fibroids

In: Ultrasound Imaging in Reproductive Medicine · 2013 · pp. 341–350 · doi:10.1007/978-1-4614-9182-8_26 · W193992024
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Magnetic resonance-guided focused ultrasound (MRgFUS) is a safe and effective treatment for uterine fibroids, offering minimally invasive ablation with potential for favorable pregnancy outcomes.

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This chapter reviews magnetic resonance-guided focused ultrasound (MRgFUS) as a minimally invasive treatment for uterine fibroids (leiomyomas), describing the ExAblate 2000 system’s FDA approval and how MR imaging provides therapy targeting, guidance, and thermal feedback. It summarizes ongoing safety and long-term efficacy data across multiple clinical trials, reporting outcomes such as symptom improvement and leiomyoma shrinkage, with reports of favorable pregnancy outcomes after treatment. A key caveat noted is that longer-term evidence is still being established and clinical use relies on the integration of MR imaging to enable targeted ablation. The chapter also notes that MRgFUS applications have expanded into adenomyosis treatment. This paper is centrally about endometriosis and/or adenomyosis only tangentially—endometriosis is not discussed, while adenomyosis is mentioned as a recent application of MRgFUS.

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Abstract

Uterine fibroids are common smooth muscle tumors of myometrial cells, which can result in substantial symptoms affecting the quality of life of women. Currently, patients have several options available for treatment ranging from uterine-sparing surgeries (myomectomy), hysterectomy, and nonsurgical options, such as uterine artery embolization, magnetic resonance-guided focused ultrasound (MRgFUS), or cryoablation. MRgFUS is one of the least invasive treatment options outside medical therapy. MRgFUS ablation combines therapy delivered by an ultrasound transducer with imaging, guidance for therapy, and thermal feedback provided by magnetic resonance imaging. In 2004, the MRgFUS system ExAblate 2000 (InSightec, Haifa, Israel) was approved by the United States Food and Drug Administration for clinical treatments of uterine fibroids. Data on safety and long-term efficacy are ongoing to establish the unique usefulness of this therapy in targeted treatment of leiomyoma through the integration of MR imaging. Multiple clinical trials detail several efficacy outcomes including symptom improvement, leiomyoma shrinkage, and use of alternative procedures. Additionally, favorable pregnancy outcomes following MRgFUS have been reported. Applications of MRgFUS have recently expanded into the realm of adenomyosis treatment. MRgFUS has been deemed a safe and effective method of fibroid treatment and offers the advantages of no incisions or blood loss, speedy recovery, and a cost-effective means of treatment. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9182-8_26 Download citation DOI: https://doi.org/10.1007/978-1-4614-9182-8_26 Published: Publisher Name: Springer, New York, NY Print ISBN: 978-1-4614-9181-1 Online ISBN: 978-1-4614-9182-8 eBook Packages: MedicineMedicine (R0)

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