MRI-based thermal dosimetry and diffusion-weighted imaging of MRI-guided focused ultrasound thermal ablation of uterine fibroids

Magdalini C. Pilatou, Elizabeth A. Stewart, Stephan E. Maier, Fiona M. Fennessy, Kullervo Hynynen, Clare M.C. Tempany, Nathan McDannold

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

Purpose: To investigate tissue changes observed in diffusion-weighted imaging (DWI) and its relation to contrast imaging, thermal dosimetry, and changes in the apparent diffusion coefficient (ADC) after MRI-guided focused ultrasound surgery (MRgFUS) of uterine fibroids. Materials and Methods: Imaging data were analyzed from 45 fibroids in 42 women treated with MRgFUS. The areas of the hyperintense regions in DWI and of nonperfused regions in T1-weighted contrast enhanced imaging (both quired immediately after treatment) were compared with each other and to thermal dosimetry based estimates. Changes in ADC were also calculated. Results: Hyperintense regions were observed in 35/45 fibroids in DWI. When present, the areas of these regions were comparable on average to the thermal dose estimates and to the nonperfused regions, except for in several large treatments in which the nonperfused region extended beyond the treated area. ADC increased in 19 fibroids and decreased in the others. Conclusion: DWI changes, which includes changes in both in T2 and ADC, may be useful in many cases to delineate the treated region resulting from MRgFUS. However, clear DWI changes were not always observed, and in some large treatments, the extent of the nonperfused region was under estimated. ADC changes immediately after MRgFUS were unpredictable.

Original languageEnglish (US)
Pages (from-to)404-411
Number of pages8
JournalJournal of Magnetic Resonance Imaging
Volume29
Issue number2
DOIs
StatePublished - Feb 2009

Keywords

  • Diffusion imaging
  • Focused ultrasound surgery
  • Uterine fibroids

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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