Magnetic resonance-guided focused ultrasound surgery.
Magnetic resonance guided focused ultrasound surgery (MRgFUS) is a noninvasive thermoablative therapy that was approved by the Food and Drug Administration in 2004 for the treatment of uterine fibroids (leiomyomas). Data on safety and long-term efficacy are accumulating to establish the unique usefulness of this therapy in targeting and treating leiomyomas through the integration of MR imaging. This article describes the established thermoablative therapies in the treatment of uterine fibroids, emphasizing their role in the genesis of MRgFUS. Treatment specifications are highlighted, and an overview of the procedure is given. Data from both clinical trials and commercial treatments are detailed for multiple efficacy outcomes, including symptom improvement, leiomyoma shrinkage, and use of alternative procedures. The concept of nonperfused volume as a surrogate marker for treatment success is discussed. Importantly, favorable pregnancy outcomes following MRgFUS have been reported. Applications of MRgFUS have recently expanded into the realm of adenomyosis treatment. MRgFUS has been deemed a safe and effective method of fibroid treatment and offers the advantages of no incisions or blood loss, speedy recovery, and a cost-effective means of treatment.
Al Hilli
Mariam M
MM
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Stewart
Elizabeth A
EA
D003362:Cost-Benefit Analysis; D004715:Endometriosis / Q000601:surgery; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects / Q000191:economics; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D053783:Magnetic Resonance Imaging, Interventional; D011184:Postoperative Period; D011247:Pregnancy; D011256:Pregnancy Outcome; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*