title: MR-guided focused ultrasound (MRgFUS) is effective for the distinct pattern of uterine fibroids seen in African-American women: data from phase III/IV, non-randomized, multicenter clinical trials.
abstract: BACKGROUND
  Uterine fibroids are common among women at the reproductive age. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a novel and a conservative treatment for symptomatic cases. The aim of the study was to evaluate the efficacy of MRgFUS in African-American (AA) women compared with that in non-African-Americans (non-AA).
  
  
  METHODS
  A single-armed phase IV study was conducted to establish the efficacy of treatment in AA women. Comparison of patient, fibroid, and treatment characteristics from this trial was compared with that of the previously published phase III trial. Both studies were approved by the IRB of each medical center.
  
  
  RESULTS
  Sixty-three AA and 59 non-AA women were treated with MRgFUS. Although AA women had a different pattern of disease, outcomes were similar in both groups. AA patients had a significant higher total number of fibroids compared with non-AA (median 6.0, interquartile range (IQR) 3.0-10.0 vs. 2.0, IQR 1.0-4.0, respectively, p < 0.001), although their total fibroid volume was significantly smaller (median 196.9 cm(3), IQR 112.8-415.3 cm(3) vs. 394.8 cm(3), IQR 189.8-674.4 cm(3), respectively, p < 0.001). AA women were younger compared with non-AA (mean ± SD 43.4 ± 5.1 vs. 46.3 ± 4.1 years of age, respectively, p = 0.001) when they presented for treatment. The rate of alternative treatments as well as fibroid-associated symptoms at follow-up time points (3, 6, 12, 24, and 36 months, period following MRgFUS treatment) did not differ according to race (p ≥ 0.62).
  
  
  CONCLUSIONS
  Despite differences in the pattern of fibroid disease, MRgFUS for uterine fibroids has a similar efficacy for AA women compared with non-AA women.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115, USA ; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan 52561, Israel.
authors.forename: Ronit
authors.initials: R
authors.lastname: Machtinger
authors.affiliation: Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 45 Francis St., Boston, MA 02115, USA.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Fennessy
authors.affiliation: Department of Obstetrics and Gynecology, Mayo Medical School, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Stewart
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115, USA ; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA ; Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Missmer
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
authors.forename: Katharine F
authors.initials: KF
authors.lastname: Correia
authors.affiliation: Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 45 Francis St., Boston, MA 02115, USA.
authors.forename: Clare Mc
authors.initials: CM
authors.lastname: Tempany
keywords: African-American; Alternative treatment; Fibroids; Leiomyoma; MRgFUS