Magnetic resonance-guided percutaneous cryoablation of uterine fibroids: early clinical experiences.
OBJECTIVE
Uterine fibroids (leiomyomas) are the most common tumors of the uterus. The present study evaluated the feasibility and effectiveness of magnetic resonance (MR)-guided percutaneous cryoablation for uterine fibroids as a minimally invasive treatment alternative.


METHODS
From August 2001 to June 2002, MR-guided percutaneous cryoablation was performed on seven uterine fibroids in 6 patients who displayed clinical symptoms related to tumors. Using a horizontal-type open MR system, cryoablation probes were percutaneously placed in fibroids. Fibroids were ablated, and the site and size of ice balls were monitored on MR imaging. Postoperatively, patients completed a questionnaire to assess changes in presenting clinical symptoms, and MR images were obtained for all patients at follow-up. Changes in clinical symptoms and tumor volume were evaluated in each patient.


RESULTS
All treated patients showed reductions in tumor size. Mean volume reduction rate was 40.3% at 6 weeks postoperatively, and 79.4% at 9-12 months. All patients reported fever after treatment. Surgical drainage was required for abscess in the probe channel in one patient, and transient liver damage occurred in another. Subjective symptoms improved in all patients except one who had multiple tumors, and no patient complained of new symptoms after cryoablation during follow-up.


CONCLUSIONS
MR-guided percutaneous cryoablation represents a feasible and effective treatment for uterine fibroids.
Department of Radiology, Hokkaido University School of Medicine, N-15, Sapporo, Hokkaido 060-8638, Japan. YRB03514@nifty.com
Yusuke
Y
Sakuhara
Tadashi
T
Shimizu
Yoshihisa
Y
Kodama
Akihiro
A
Sawada
Hideho
H
Endo
Daisuke
D
Abo
Tenshu
T
Hasegawa
Kazuo
K
Miyasaka
D000328:Adult; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*