MRI-guided ultrasound therapy relieves symptoms in patients with uterine fibroids

Also helps some patients avoid hysterectomy

MRI-guided ultrasound therapy is an effective way to treat women with uterine fibroids, improving their quality of life and avoiding hysterectomy, a new study shows. The study reviewed the use of MRI and the ExAblate 2000, a device that was recently approved by the Food and Drug Administration.

About 25% of women have uterine fibroids with a substantial proportion of these experiencing symptoms, said Dr. Wladyslaw Gedroyc of St. Mary’s Hospital and the Imperial College School of Medicine in London. These symptoms include abdominal pain, bladder irritability and menstrual irregularities, he said. These patients are commonly treated with surgery. However, “our study of 109 patients found that combining MRI and ultrasound can be a viable alternative to a hysterectomy or myomectomy.”

Patients in the study answered a quality of life questionnaire before then after the MRI-ultrasound procedure. “Overall there was a significant improvement in the quality of life scores in 80% of the patients,” six months following the procedure, said Dr. Gedroyc. He added that updated results are being analyzed, but “at 12 months post procedure the improvements and changes are predominately maintained.”

The procedure includes using MRI to plan the treatment and guide the treatment as it is being done. Focused ultrasound destroys the fibroid tissue. The procedure is “completely non-invasive and can be done as an outpatient procedure. In addition the whole process is very safe with very few side effects,” Dr. Gedroyc said. One patient had sciatic nerve damage with pain and mild weakness, but this resolved itself quickly. One patient was kept overnight because she had a reaction to the sedation she was given, Dr. Gedroyc said. “There were several instances where patients had prolonged menstrual bleeding, but this was not any different than what they had experienced before the procedure so this was probably secondary to the underlying problem rather than a result of the treatment,” he said.

The success of this procedure in treating uterine fibroids might be just the beginning, said Dr. Gedroyc. “It points the way forward to the utilization of this technology in other areas such as the treatment of solid organ malignancies,” he said.