A novel method to aid in the visualisation and treatment of uterine fibroids with MRgFUS in patients with abdominal scars.

The purpose of this research was to identify a method for performing Magnetic Resonance Imaging Guided Focused Ultrasound Surgery (MRgFUS) of symptomatic uterine fibroids in patients with abdominal scars, by visualisation of these scars on MR images. 25 patients who presented with treatable symptomatic uterine fibroids and having transverse abdominal scars were treated with MRgFUS. A solution containing MRI contrast paramagnetic iron oxide particles was used to demark the skin surface scar tissue on the treatment planning MR images. During treatment, the focused ultrasound energy was steered around the scar based on its enhanced visual location. After the treatment, contrast enhanced MR images were acquired for immediate results evaluation. Adverse events and fibroid related symptoms were captured during the 6-months follow up period. All the women were treated with no complications. No episodes of skin burns, ulceration or skin redness were reported. The post-treatment contrast-enhanced MR images showed an average fibroid non-perfused volume ratio of 64%. At their 6-month follow-up, 92% of the patients reported a clinical improvement. Using paramagnetic iron oxide solution to highlight transverse abdominal scars helps in their identification on MR images, thereby enabling the operator to avoid scars and facilitating the treatment of women who were previously excluded.