Focused ultrasound treatment of uterine fibroid tumors: safety and feasibility of a noninvasive thermoablative technique.
OBJECTIVE
The purpose of this study was to determine the safety and efficacy of focused ultrasound surgery with magnetic resonance imaging guidance for the noninvasive treatment of uterine leiomyomas.


METHODS
Fifty-five women with clinically significant uterine leiomyomas were treated. Pain and complications were assessed prospectively, and posttreatment magnetic resonance imaging was used to measure the treatment effects. Patients in three of the five centers underwent planned hysterectomy after treatment, which provided pathologic correlation of treatment.


RESULTS
Seventy-six percent of the enrolled patients completed the full treatment session. All treatments were conducted in an outpatient setting with minimal discomfort for subjects and no major complications. Pathologic examination of the uterus confirmed that magnetic resonance imaging guidance provides the safe and accurate delivery of effective levels of thermal energy with a 3-fold increase in volume of histologically documented necrosis, compared with treatment volume (6.6 +/- 0.8 vs 18.4 +/- 3.9 mL, P <.005).


CONCLUSIONS
Magnetic resonance imaging-guided focused ultrasound surgery appears to be a well-tolerated treatment for uterine leiomyomas.
Stewart
Elizabeth A
EA
Departments of Obstetrics, Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. eastwart@partners.org
Gedroyc
Wladyslaw M W
WM
Tempany
Clare M C
CM
Quade
Bradley J
BJ
Inbar
Yael
Y
Ehrenstein
Tilman
T
Shushan
Asher
A
Hindley
Jonathan T
JT
Goldin
Robert D
RD
David
Matthias
M
Sklair
Miri
M
Rabinovici
Jaron
J
D000328:Adult; D000698:Analgesia; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D001569:Benzodiazepines / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D007889:Leiomyoma / Q000473:pathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010146:Pain; D011446:Prospective Studies; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000009:adverse effects; D014594:Uterine Neoplasms / Q000473:pathology / Q000628:therapy*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001569:Benzodiazepines