title: MRI guidance of focused ultrasound therapy of uterine fibroids: early results.
abstract: OBJECTIVE
  The purpose of this study was to explore our hypothesis that MRI-guided focused ultrasound therapy for the treatment of uterine fibroids will lead to a significant reduction in symptoms and improvement in quality of life. We describe focused ultrasound therapy applications and the method for monitoring the thermal energy deposited in the fibroids, including the MRI parameters required, in a prospective review of 108 treatments.
  
  
  METHODS
  Patients presenting with symptomatic uterine fibroids who attained a minimal symptom severity score and who would otherwise have been offered a hysterectomy were recruited. Thermal lesions were created within target fibroids using an MRI-guided focused ultrasound therapy system. The developing lesion was monitored using real-time MR thermometry, which was used to assess treatment outcome in real time to change treatment parameters and achieve the desired outcome. Fibroid volume, fibroid symptoms, and quality-of-life scores were measured before treatment and 6 months after treatment. Adverse events were actively monitored and recorded.
  
  
  RESULTS
  In this study, 79.3% of women who had been treated reported a significant improvement in their uterine fibroid symptoms on follow-up health-related quality-of-life questionnaires, which supports our hypothesis. The mean reduction in fibroid volume at 6 months was 13.5%, but nonenhancing volume (mean, 51 cm(3)) remained within the treated fibroid at 6 months.
  
  
  CONCLUSIONS
  This early description of MRI-guided focused ultrasound therapy treatment of fibroids includes follow-up data and shows that, although the volume reduction is moderate, it correlates with treatment volume and the symptomatic response to this treatment is encouraging.
authors.affiliation: Department of Magnetic Resonance Imaging, Interventional MR Unit, St Mary's Hospital London and Imperial College School of Medicine, Praed St., London W2 1NY, England.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hindley
authors.forename: Wladyslaw M
authors.initials: WM
authors.lastname: Gedroyc
authors.forename: Lesley
authors.initials: L
authors.lastname: Regan
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Stewart
authors.forename: Clare
authors.initials: C
authors.lastname: Tempany
authors.forename: Kullervo
authors.initials: K
authors.lastname: Hynyen
authors.forename: Kullervo
authors.initials: K
authors.lastname: Hynnen
authors.forename: Nathan
authors.initials: N
authors.lastname: Mcdannold
authors.forename: Nathan
authors.initials: N
authors.lastname: Macdanold
authors.forename: Yael
authors.initials: Y
authors.lastname: Inbar
authors.forename: Yacov
authors.initials: Y
authors.lastname: Itzchak
authors.forename: Jaron
authors.initials: J
authors.lastname: Rabinovici
authors.forename: Hyun S
authors.initials: HS
authors.lastname: Kim
authors.forename: Kevin
authors.initials: K
authors.lastname: Kim
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Geschwind
authors.forename: Gina
authors.initials: G
authors.lastname: Hesley
authors.forename: Bobbie
authors.initials: B
authors.lastname: Gostout
authors.forename: Brian
authors.initials: B
authors.lastname: Gostout
authors.forename: Tillman
authors.initials: T
authors.lastname: Ehrenstein
authors.forename: Sylvia
authors.initials: S
authors.lastname: Hengst
authors.forename: Miri
authors.initials: M
authors.lastname: Sklair-Levy
authors.forename: Asher
authors.initials: A
authors.lastname: Shushan
authors.forename: Ferenc
authors.initials: F
authors.lastname: Jolesz
mesh_terms: D000328:Adult; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011187:Posture; D011788:Quality of Life; D016896:Treatment Outcome; D014464:Ultrasonic Therapy; D014594:Uterine Neoplasms / Q000628:therapy*
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA