title: Safety and therapeutic efficacy of complete or near-complete ablation of symptomatic uterine fibroid tumors by MR imaging-guided high-intensity focused US therapy.
abstract: OBJECTIVE
  To evaluate the safety and therapeutic efficacy of magnetic resonance (MR) imaging-guided high-intensity focused ultrasound (US) ablation of symptomatic uterine fibroid tumors with an immediate nonperfused volume (NPV) ratio of 80% or more.
  
  
  METHODS
  A total of 79 women with 117 uterine tumors were treated with MR-guided high-intensity focused US ablation. Immediate NPV, complications, and therapeutic efficacy (tumor volume reduction ratio and symptom severity score [SSS] decrease at 3-mo follow-up) were retrospectively assessed. Statistical comparisons of the frequency of complications and therapeutic efficacy were performed between patients with NPV ratios of at least 80% and less than 80%.
  
  
  RESULTS
  Technical success was achieved in 93.7% of cases (n = 74) of cases, and the immediate NPV ratio was 62.7% ± 25.5. Twenty-four patients exhibited an NPV ratio of at least 80% (89.7% ± 5.8), and 50 patients showed an NPV ratio of less than 80% (49.8% ± 20.7). All complications were minor in severity, and the incidences were not significantly different between groups (P > .05). The 3-month volume reduction ratio was significantly greater in patients with an NPV ratio of at least 80% (0.43 ± 0.17) than in those with an NPV ratio of less than 80% (0.20 ± 0.26; P = .002), although the decreases in SSS were not significantly different (20.9 ± 19.6 vs 12.1 ± 10.1; P = .097).
  
  
  CONCLUSIONS
  In MR-guided high-intensity focused US ablation of symptomatic uterine fibroid tumors, achievement of an immediate NPV ratio of at least 80% is safe, with greater tumor volume shrinkage compared with cases with a lower NPV ratio.
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul.
authors.forename: Min Jung
authors.initials: MJ
authors.lastname: Park
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: youngskim@skku.edu.
authors.forename: Young-sun
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyunchul
authors.initials: H
authors.lastname: Rhim
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyo Keun
authors.initials: HK
authors.lastname: Lim
mesh_terms: D000328:Adult; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects; D006801:Humans; D007889:Leiomyoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D053783:Magnetic Resonance Imaging, Interventional; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D014594:Uterine Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*
keywords: FDA; Food and Drug Administration; NPV; SSS; UAE; nonperfused volume; symptom severity score; uterine artery embolization