title: Patient selection guidelines in MR-guided focused ultrasound surgery of uterine fibroids: a pictorial guide to relevant findings in screening pelvic MRI.
abstract: Uterine leiomyomas (fibroids), the most common benign tumor in women of childbearing age, can cause symptoms including dysmenorrhea, menorrhagia, urinary symptoms, pain and infertility. Hysterectomy is a common approach to treating uterine fibroids, and less invasive surgical approaches such as myomectomy and uterine artery embolization also have been shown to alleviate symptoms. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is the only totally non-invasive surgical approved method for treating uterine fibroids. In clinical trials, MRgFUS resulted in significant relief of uterine fibroid symptoms. The safe and effective use of MRgFUS is affected by fibroid type and location, position relative to adjacent anatomical structures and the presence of co-existent pelvic disease. Additionally, successful outcomes with MRgFUS have been correlated with the volume of fibroids ablated during the procedure. Thus, selection of patients in whom sufficient fibroid volumes can be treated safely using the MRgFUS system is critical for successful outcomes. The MR images in this pictorial essay provide examples of uterine fibroids for which MRgFUS should be considered and is designed to facilitate the selection of patients for whom MRgFUS is most likely to provide sustained symptom relief.
authors.affiliation: Department of Diagnostic Radiology, College of Medicine, Pochon CHA University Bundang CHA General Hospital, 351, Yatap-dong, Bundang-gu, Sungnam-si, Gyunggi-do, Republic of Korea, 463-712. jansons@cha.ac.kr
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Yoon
authors.forename: Chan
authors.initials: C
authors.lastname: Lee
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Cha
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Yu
authors.forename: Young-Jeong
authors.initials: YJ
authors.lastname: Na
authors.forename: Kyoung Ah
authors.initials: KA
authors.lastname: Kim
authors.forename: Sang-Geun
authors.initials: SG
authors.lastname: Jung
authors.forename: Seung-Jo
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D005260:Female; D006801:Humans; D007723:Korea; D007889:Leiomyoma / Q000175:diagnosis* / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000592:standards*; D018579:Patient Selection; D010388:Pelvis / Q000473:pathology; D011300:Preoperative Care / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000592:standards*; D014464:Ultrasonic Therapy / Q000592:standards*; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000628:therapy*