title: Magnetic resonance-guided focused ultrasound myomectomy: safety, efficacy, subsequent fertility and quality-of-life improvements, a systematic review.
abstract: We performed a systematic review about studies reporting data of myomectomy performed by magnetic resonance-guided focused ultrasound (MRgFUS) technique in order to define its safety, feasibility, indications, complications, and impact on uterine fibroid symptom and health-related quality of life (UFS-QOL) and fertility. Outcomes were considered according to fibroids shrinkage, nonperfused volume (NPV), NPV ratio, and uterine fibroid symptoms assessed with UFS-QOL questionnaire (baseline 3, 4, 6, and 12 months). We analyzed 38 eligible studies reporting outcomes about 2500 patients (mean age 43.67 years). The MRgFUS results a safe, efficient, and cost-effective minimal invasive technique for treatment of uterine fibroids. Increasing experience, device improvements, and availability for a larger number of patients are enhancing the outcomes, while the obstetrical ones should be more extensively explored. The MRgFUS could be considered as a minimal invasive alternative to traditional surgical or radiological procedures for the treatment of symptomatic uterine myomas improving both QOL and subsequent fertility.
authors.affiliation: 1Department of Woman and Child Health, University of Padua, Padua, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gizzo
authors.forename: Carlo
authors.initials: C
authors.lastname: Saccardi
authors.forename: Tito Silvio
authors.initials: TS
authors.lastname: Patrelli
authors.forename: Emanuele
authors.initials: E
authors.lastname: Ancona
authors.forename: Marco
authors.initials: M
authors.lastname: Noventa
authors.forename: Simone
authors.initials: S
authors.lastname: Fagherazzi
authors.forename: Bruno
authors.initials: B
authors.lastname: Mozzanega
authors.forename: Donato
authors.initials: D
authors.lastname: D'Antona
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Nardelli
mesh_terms: D000328:Adult; D005260:Female; D005298:Fertility; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis / Q000601:surgery*; D053783:Magnetic Resonance Imaging, Interventional; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000009:adverse effects / Q000379:methods*; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000601:surgery*
keywords: MRgFUS; fertility preservation; high-intensity focused ultrasounds; magnetic resonance-guided focused ultrasounds; quality of life.; uterine myomas