MR-guided transvaginal cryotherapy of uterine fibroids with a horizontal open MRI system: initial experience.
OBJECTIVE
We evaluated the feasibility of MR-guided transvaginal cryotherapy for treating intramural, submucosal, and sub-serosal uterine fibroids with a horizontal open MRI system.


METHODS
Using an MR-compatible cryotherapy system and a horizontal magnetic open-configuration MR scanner, we performed transvaginal cryotherapies using a Cusco speculum on eight uterine fibroids whose longest diameter ranged from 2.9 to 10.0 cm. We assessed the ratio of pre-treatment to post-treatment volume of the uterine fibroids as well as the patients' symptoms (anemia, abdominal pain, dysfunctional uterine bleeding, etc.).


RESULTS
All procedures were carried out safely and accurately without any complications that required surgical treatment. MRI enabled clear visualization of the cryoneedle and freezing area as band-like and ellipsoid-like signal losses, respectively. The mean ratio of reduction in uterine fibroid volume was 31.0% at 9-12 months (0-75.0%). Symptoms caused by uterine fibroids improved in seven cases.


CONCLUSIONS
This is the first report on a transvaginal approach to cryotherapy for uterine fibroids. MR-guided transvaginal cryotherapy appears to be feasible and promising as a minimally invasive therapy for symptomatic uterine fibroids.
Dohi
Michiko
M
Department of Radiology, Jikei University, Kashiwa Hospital, Chiba, Japan.
Harada
Junta
J
Mogami
Takuji
T
Fukuda
Kunihiko
K
Kobayashi
Shigemitsu
S
Yasuda
Makoto
M
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000740:Anemia / Q000209:etiology; D003452:Cryosurgery; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications; D015642:Radiology, Interventional; D014592:Uterine Hemorrhage / Q000209:etiology; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*