MRgFUS relieves fibroid symptoms.(News)(MR-guided focused ultrasound surgery )

CHICAGO -- The first noninvasive therapy for the treatment of uterine fibroids provides symptom relief for 1 year and beyond without serious side effects, according to a clinical trial of MR-guided focused ultrasound surgery presented at the annual meeting of the Radiological Society of North America.

"The purpose of this study was to evaluate an expanded protocol using MR-guided focused ultrasound surgery [MRgFUS] for the treatment of symptomatic uterine fibroids," said Dr. Fiona M. Fennessy of the Brigham and Women's Hospital in Boston.

"Initially, we treated up to 2 hours and in the expanded protocol we treated up to 3 hours and increased the volume of fibroid treated from 100 to 150 cc, which means we're now treating fibroids up to 7 cm in diameter," she said. "We've shown that patients get a significant reduction of symptoms at 1 year, and our preliminary clinical reports suggest this extends up to 24 months."

During the procedure the patient lies prone with her uterus directly over a transducer that is situated within the MRI table. High-intensity ultrasound waves from the transducer heat and kill fibroid tissue, Dr. Fennessy said. "The role of MRI is to direct the beam and we can see exactly where the target is, and the MR also monitors the temperature within the fibroid; we also can monitor normal tissue to make sure it isn't damaged."

The availability of 3-D scanning allows the radiologist to make sure no bowel lies between the transducer and the target tissue. Later, results of the procedure are checked by injecting a contrast agent that is not absorbed by dead tissue, which shows up as a black spot on the radiograph.

A total of 149 patients were treated at five centers, including Johns Hopkins Hospital, Baltimore; the Mayo Clinic; the Lahey Clinic in Boston; and Radnet Management in Beverly Hills, Calif. Of these, 105 were treated under the initial guidelines, and 44 were treated under the expanded guidelines. The mean age in both cohorts was about 45 years and 90% of the women were white. Symptom improvement was based on the Uterine Fibroid Quality of Life Questionnaire. A healthy person without fibroid symptoms would score about 22 in a range of 1-100, Dr. Fennessy explained.

"Patients ...