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- Title
Volumetric MR-guided high-intensity focused ultrasound ablation of uterine fibroids: treatment speed and factors influencing speed.
- Authors
Park, Min; Kim, Young-sun; Keserci, Bilgin; Rhim, Hyunchul; Lim, Hyo
- Abstract
Objectives: To assess the treatment speed of volumetric magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablation of symptomatic uterine fibroids, with a focus on factors affecting treatment speed. Methods: We received Institutional Review Board approval, and informed consent was obtained from all participants. Among 109 patients referred, 43 women (39.4 %) (mean age, 43.7 years), with 112 fibroids passed the screening. We treated 53 symptomatic uterine fibroids (47.3 %, 53/112) (volume, 341.2 ± 256.5 ml) using volumetric MR-HIFU ablation. We assessed procedure times, non-perfused volume (NPV) and treatment speed (NPV/treatment time). We statistically analysed the factors affecting treatment speed using multiple logistic regression tests. Results: Technical success was achieved in 42 of 43 cases. MR room time (from entrance to exit) and treatment time (from first to last sonication) were 216.0 ± 40.6 min and 131.5 ± 55.9 min, respectively. Immediate NPV was 178.9 ± 147.3 ml, which was 57.4 ± 25.5 % of the fibroid volume. Treatment speed was 81.8 ± 48.0 ml/h. Multivariate analysis showed that a large fibroid volume ( P < 0.001), a low signal intensity ratio of fibroid to skeletal muscle on T2-weighted images ( P = 0.009) and timing after completion of the learning curve ( P < 0.001) significantly increased treatment speed. Conclusion: Volumetric MR-HIFU ablation can effectively treat symptomatic uterine fibroids. The treatment speed appeared to improve when treating large and/or dark fibroids as well as upon completion of the learning curve. Key Points: • High-intensity focused ultrasound (HIFU) offers another interventional radiological option for treating fibroids • Volumetric MR-guided HIFU ablation can treat uterine fibroids in a timely fashion • Treatment speed appeared to improve when treating large and/or dark fibroids • Treatment speed appeared to improve upon completion of the learning curve
- Subjects
MEDICAL imaging systems; ULTRASONIC imaging; MAGNETIC resonance; UTERINE fibroids; MYOMETRIUM tumors; MEDICAL care
- Publication
European Radiology, 2013, Vol 23, Issue 4, p943
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-012-2665-1