Document Detail

MR-guided focus ultrasound (MRgFUS) for symptomatic uterine fibroids: predictors of treatment success.
MedLine Citation:
PMID:  23019304     Owner:  NLM     Status:  MEDLINE    
STUDY QUESTION: What are the factors associated with long-term success in patients with symptomatic uterine fibroids treated by magnetic resonance-guided focus ultrasound (MRgFUS) and can they be employed to create a clinically useful index that predicts long-term efficacy?
SUMMARY ANSWER: Hypo-intense fibroids on T2-weighted magnetic resonance imaging (MRI) and older age were associated with higher success rates and can be used to predict success rates on the basis of their presence or absence as pre-treatment parameters.
WHAT IS KNOWN ALREADY: The signal intensity of baseline T2-weighted MRI images and non-perfused volume at the end of the treatment can be correlated with MRgFUS outcome.
STUDY DESIGN, SIZE AND DURATION: This was a retrospective analysis of 81 patients who were treated by MRgFUS for symptomatic uterine fibroids, in an academic affiliated center between 2003 and 2008.
PARTICIPANTS/MATERIALS, SETTING AND METHODS: There was a post-treatment phone interview >6 months following MRgFUS for symptomatic uterine fibroids.
MAIN RESULTS AND THE ROLE OF CHANCE: The eighty-one patients completed a successful MRgFUS treatment during this period, of whom 74 were included in the final analysis (1 was post-menopausal at treatment and 5 were lost for follow-up). The mean time for the phone interview was 33.0 ± 15.1 months (range: 6-53 months) after the MRgFUS treatment. Fifty-five patients (69%) did not need any additional alternative treatment following MRgFUS. Nineteen patients (24%) underwent other surgical interventions. Hypo-intense fibroids were associated with a higher chance of success than hyper-intense fibroids [odds ratio = 2.96 (1.01-8.71); P = 0.04] for surgery in hyper-intense fibroids). Women with long-term treatment success were significantly older at the time of treatment [46.3 ± 3.8 (range: 37-53) years versus 43.6 ± 4.4 (range: 36-51) years, respectively; P = 0.02].
LIMITATIONS AND REASONS FOR CAUTION: Retrospective non-comparative studies are suboptimal and might overemphasize favorable outcomes.
WIDER IMPLICATIONS OF THE FINDINGS: This paper can contribute to selection of suitable candidates for the MRgFUS treatment for patients with uterine fibroids' and can serve as a guide for gynecologists for a better patient selection.
Ronit Machtinger; Yael Inbar; Shlomo Cohen-Eylon; Dahlia Admon; Aviva Alagem-Mizrachi; Jaron Rabinovici
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Publication Detail:
Type:  Journal Article     Date:  2012-09-26
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  27     ISSN:  1460-2350     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-20     Completed Date:  2013-04-29     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  3425-31     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
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MeSH Terms
Leiomyoma / therapy*
Magnetic Resonance Imaging / methods
Middle Aged
Patient Selection
Retrospective Studies
Risk Factors
Treatment Outcome
Ultrasonic Therapy / methods*
Uterine Neoplasms / therapy*

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