Mid-term outcome of magnetic resonance-guided focused ultrasound surgery for uterine myomas: from six to twelve months after volume reduction.

STUDY OBJECTIVE

To clarify the volume change ratio of uterine myomas treated with magnetic resonance-guided focused ultrasound surgery (MRgFUS), in relation to the signal intensity of T(2)-weighted magnetic resonance (MR) images.

DESIGN

Prospective study (Canadian Task Force classification II-3).

SETTING

Department of Gynecology, Shinsuma General Hospital, Kobe, Japan.

PATIENTS

Forty-eight myomas in 35 patients were followed up with MR images 6 months after MRgFUS, and 23 myomas in 17 patients were followed up 12 months after MRgFUS. Before treatment, the myomas were classified into 3 types on the basis of the signal intensity of T(2)-weighted MR images as follows: Type 1, low intensity; type 2, intermediate intensity; type 3, high intensity.

INTERVENTIONS

Thermal ablation therapy was performed with an MRgFUS system (ExAblate 2000).

MEASUREMENTS AND MAIN RESULTS

MRgFUS produced a greater volume reduction in type 1 and type 2 myomas than in type 3 myomas. Nonperfused areas always diminished in the period after MRgFUS; however, the volume change was affected by the volume change ratio of perfused areas inside the treated myomas.

CONCLUSION

At present, type 3 myomas should be exempted from the application of MRgFUS, because the nonperfused ratio immediately after the procedure was small compared with that in type 1 and type 2 myomas, and the subsequent volume change was unfavorable.