Leiomyoma shrinkage after MRI-guided focused ultrasound treatment: report of 80 patients.
OBJECTIVE
The purpose of this study was to assess the degree of leiomyoma ablation and shrinkage after MRI-guided focused ultrasound treatment performed according to U.S. Food and Drug Administration protocols for commercial trials.


METHODS
A total of 147 symptomatic leiomyomas in 80 women (average age, 46 years; range, 34-55 years) were managed with MRI-guided focused ultrasound. The average volume of treated fibroids was 175+/-201 (SD) cm3. Before treatment, T2-weighted MR images in three planes were obtained to measure leiomyoma volume. Immediately after treatment, T1-weighted contrast-enhanced fat-suppressed MR images in three planes were used to measure nonperfused volume ratio. Similar images obtained 6 months after treatment were used to determine leiomyoma shrinkage. Qualitative and quantitative relations between fibroid volume, nonperfused volume ratio at treatment, and 6-month shrinkage were measured.


RESULTS
The average nonperfused volume ratio was 55%+/-25% immediately after treatment. Six months after treatment, the average volume of treated fibroids had decreased to 112+/-141 cm3 (n=81) (p<0.0001) with an average volume reduction of 31%+/-28%. A linear regression model showed highly significant correlation between posttreatment nonperfused volume ratio and shrinkage at 6 months (p<0.0001).


CONCLUSIONS
MRI-guided focused ultrasound therapy for leiomyoma can result in nonperfused volume ratio and shrinkage that exceed those in previous clinical trials because the treatment guidelines have been relaxed to allow a greater amount of tissue ablation. The results suggest that a larger nonperfused volume ratio can be achieved, resulting in greater shrinkage and improved relief of symptoms.
LeBlang
Suzanne D
SD
Department of Radiology, University Imaging-Guided Therapy Center, 3848 FAU Blvd., Ste. 200, Boca Raton, FL 33431, USA. sleblang@universitymri.com
Hoctor
Katherine
K
Steinberg
Fred L
FL
D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D016014:Linear Models; D053783:Magnetic Resonance Imaging, Interventional; D008875:Middle Aged; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*; D014594:Uterine Neoplasms / Q000628:therapy*