MRI guidance of focused ultrasound therapy of uterine fibroids: Early results

Jonathan Hindley, Wladyslaw M. Gedroyc, Lesley Regan, Elizabeth A Stewart, Clare Tempany, Kullervo Hynnen, Nathan Macdanold, Yael Inbar, Yacov Itzchak, Jaron Rabinovici, Kevin Kim, Jean François Geschwind, Gina Hesley, Brian Gostout, Tillman Ehrenstein, Sylvia Hengst, Miri Sklair-Levy, Asher Shushan, Ferenc Jolesz

Research output: Contribution to journalArticle

318 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study was to explore our hypothesis that MRI-guided focused ultrasound therapy for the treatment of uterine fibroids will lead to a significant reduction in symptoms and improvement in quality of life. We describe focused ultrasound therapy applications and the method for monitoring the thermal energy deposited in the fibroids, including the MRI parameters required, in a prospective review of 108 treatments. MATERIALS AND METHODS. Patients presenting with symptomatic uterine fibroids who attained a minimal symptom severity score and who would otherwise have been offered a hysterectomy were recruited. Thermal lesions were created within target fibroids using an MRI-guided focused ultrasound therapy system. The developing lesion was monitored using real-time MR thermometry, which was used to assess treatment outcome in real time to change treatment parameters and achieve the desired outcome. Fibroid volume, fibroid symptoms, and quality-of-life scores were measured before treatment and 6 months after treatment. Adverse events were actively monitored and recorded. RESULTS. In this study, 79.3% of women who had been treated reported a significant improvement in their uterine fibroid symptoms on follow-up health-related quality-of-life questionnaires, which supports our hypothesis. The mean reduction in fibroid volume at 6 months was 13.5%, but nonenhancing volume (mean, 51 cm3) remained within the treated fibroid at 6 months. CONCLUSION. This early description of MRI-guided focused ultrasound therapy treatment of fibroids includes follow-up data and shows that, although the volume reduction is moderate, it correlates with treatment volume and the symptomatic response to this treatment is encouraging.

Original languageEnglish (US)
Pages (from-to)1713-1719
Number of pages7
JournalAmerican Journal of Roentgenology
Volume183
Issue number6
StatePublished - Dec 2004

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Leiomyoma
Therapeutics
Quality of Life
Hot Temperature
Thermometry
Hysterectomy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Hindley, J., Gedroyc, W. M., Regan, L., Stewart, E. A., Tempany, C., Hynnen, K., ... Jolesz, F. (2004). MRI guidance of focused ultrasound therapy of uterine fibroids: Early results. American Journal of Roentgenology, 183(6), 1713-1719.

MRI guidance of focused ultrasound therapy of uterine fibroids : Early results. / Hindley, Jonathan; Gedroyc, Wladyslaw M.; Regan, Lesley; Stewart, Elizabeth A; Tempany, Clare; Hynnen, Kullervo; Macdanold, Nathan; Inbar, Yael; Itzchak, Yacov; Rabinovici, Jaron; Kim, Kevin; Geschwind, Jean François; Hesley, Gina; Gostout, Brian; Ehrenstein, Tillman; Hengst, Sylvia; Sklair-Levy, Miri; Shushan, Asher; Jolesz, Ferenc.

In: American Journal of Roentgenology, Vol. 183, No. 6, 12.2004, p. 1713-1719.

Research output: Contribution to journalArticle

Hindley, J, Gedroyc, WM, Regan, L, Stewart, EA, Tempany, C, Hynnen, K, Macdanold, N, Inbar, Y, Itzchak, Y, Rabinovici, J, Kim, K, Geschwind, JF, Hesley, G, Gostout, B, Ehrenstein, T, Hengst, S, Sklair-Levy, M, Shushan, A & Jolesz, F 2004, 'MRI guidance of focused ultrasound therapy of uterine fibroids: Early results', American Journal of Roentgenology, vol. 183, no. 6, pp. 1713-1719.
Hindley J, Gedroyc WM, Regan L, Stewart EA, Tempany C, Hynnen K et al. MRI guidance of focused ultrasound therapy of uterine fibroids: Early results. American Journal of Roentgenology. 2004 Dec;183(6):1713-1719.
Hindley, Jonathan ; Gedroyc, Wladyslaw M. ; Regan, Lesley ; Stewart, Elizabeth A ; Tempany, Clare ; Hynnen, Kullervo ; Macdanold, Nathan ; Inbar, Yael ; Itzchak, Yacov ; Rabinovici, Jaron ; Kim, Kevin ; Geschwind, Jean François ; Hesley, Gina ; Gostout, Brian ; Ehrenstein, Tillman ; Hengst, Sylvia ; Sklair-Levy, Miri ; Shushan, Asher ; Jolesz, Ferenc. / MRI guidance of focused ultrasound therapy of uterine fibroids : Early results. In: American Journal of Roentgenology. 2004 ; Vol. 183, No. 6. pp. 1713-1719.
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abstract = "OBJECTIVE. The purpose of this study was to explore our hypothesis that MRI-guided focused ultrasound therapy for the treatment of uterine fibroids will lead to a significant reduction in symptoms and improvement in quality of life. We describe focused ultrasound therapy applications and the method for monitoring the thermal energy deposited in the fibroids, including the MRI parameters required, in a prospective review of 108 treatments. MATERIALS AND METHODS. Patients presenting with symptomatic uterine fibroids who attained a minimal symptom severity score and who would otherwise have been offered a hysterectomy were recruited. Thermal lesions were created within target fibroids using an MRI-guided focused ultrasound therapy system. The developing lesion was monitored using real-time MR thermometry, which was used to assess treatment outcome in real time to change treatment parameters and achieve the desired outcome. Fibroid volume, fibroid symptoms, and quality-of-life scores were measured before treatment and 6 months after treatment. Adverse events were actively monitored and recorded. RESULTS. In this study, 79.3{\%} of women who had been treated reported a significant improvement in their uterine fibroid symptoms on follow-up health-related quality-of-life questionnaires, which supports our hypothesis. The mean reduction in fibroid volume at 6 months was 13.5{\%}, but nonenhancing volume (mean, 51 cm3) remained within the treated fibroid at 6 months. CONCLUSION. This early description of MRI-guided focused ultrasound therapy treatment of fibroids includes follow-up data and shows that, although the volume reduction is moderate, it correlates with treatment volume and the symptomatic response to this treatment is encouraging.",
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AU - Hindley, Jonathan

AU - Gedroyc, Wladyslaw M.

AU - Regan, Lesley

AU - Stewart, Elizabeth A

AU - Tempany, Clare

AU - Hynnen, Kullervo

AU - Macdanold, Nathan

AU - Inbar, Yael

AU - Itzchak, Yacov

AU - Rabinovici, Jaron

AU - Kim, Kevin

AU - Geschwind, Jean François

AU - Hesley, Gina

AU - Gostout, Brian

AU - Ehrenstein, Tillman

AU - Hengst, Sylvia

AU - Sklair-Levy, Miri

AU - Shushan, Asher

AU - Jolesz, Ferenc

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N2 - OBJECTIVE. The purpose of this study was to explore our hypothesis that MRI-guided focused ultrasound therapy for the treatment of uterine fibroids will lead to a significant reduction in symptoms and improvement in quality of life. We describe focused ultrasound therapy applications and the method for monitoring the thermal energy deposited in the fibroids, including the MRI parameters required, in a prospective review of 108 treatments. MATERIALS AND METHODS. Patients presenting with symptomatic uterine fibroids who attained a minimal symptom severity score and who would otherwise have been offered a hysterectomy were recruited. Thermal lesions were created within target fibroids using an MRI-guided focused ultrasound therapy system. The developing lesion was monitored using real-time MR thermometry, which was used to assess treatment outcome in real time to change treatment parameters and achieve the desired outcome. Fibroid volume, fibroid symptoms, and quality-of-life scores were measured before treatment and 6 months after treatment. Adverse events were actively monitored and recorded. RESULTS. In this study, 79.3% of women who had been treated reported a significant improvement in their uterine fibroid symptoms on follow-up health-related quality-of-life questionnaires, which supports our hypothesis. The mean reduction in fibroid volume at 6 months was 13.5%, but nonenhancing volume (mean, 51 cm3) remained within the treated fibroid at 6 months. CONCLUSION. This early description of MRI-guided focused ultrasound therapy treatment of fibroids includes follow-up data and shows that, although the volume reduction is moderate, it correlates with treatment volume and the symptomatic response to this treatment is encouraging.

AB - OBJECTIVE. The purpose of this study was to explore our hypothesis that MRI-guided focused ultrasound therapy for the treatment of uterine fibroids will lead to a significant reduction in symptoms and improvement in quality of life. We describe focused ultrasound therapy applications and the method for monitoring the thermal energy deposited in the fibroids, including the MRI parameters required, in a prospective review of 108 treatments. MATERIALS AND METHODS. Patients presenting with symptomatic uterine fibroids who attained a minimal symptom severity score and who would otherwise have been offered a hysterectomy were recruited. Thermal lesions were created within target fibroids using an MRI-guided focused ultrasound therapy system. The developing lesion was monitored using real-time MR thermometry, which was used to assess treatment outcome in real time to change treatment parameters and achieve the desired outcome. Fibroid volume, fibroid symptoms, and quality-of-life scores were measured before treatment and 6 months after treatment. Adverse events were actively monitored and recorded. RESULTS. In this study, 79.3% of women who had been treated reported a significant improvement in their uterine fibroid symptoms on follow-up health-related quality-of-life questionnaires, which supports our hypothesis. The mean reduction in fibroid volume at 6 months was 13.5%, but nonenhancing volume (mean, 51 cm3) remained within the treated fibroid at 6 months. CONCLUSION. This early description of MRI-guided focused ultrasound therapy treatment of fibroids includes follow-up data and shows that, although the volume reduction is moderate, it correlates with treatment volume and the symptomatic response to this treatment is encouraging.

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