Clinical Efficacy of Non-invasive Magnetic Resonance Guided Focused Ultrasound Therapy in Treatment of Multiple Uterine Fibroids

The purpose of this study was to evaluate the efficacy and outcome of magnetic resonance guided, focused ultrasound (MRgFUS) therapy in the treatment of women with symptomatic multiple uterine fibroids. As MRgFUS is a noninvasive, nonsurgical method and can be done as a day-care procedure, this was more acceptable for these women. In this single-site study, 40 Malaysian women with a mean age of 43.8 + 7.8 years who were candidates for surgical intervention due to symptomatic multiple uterine fibroids were recruited. The women had a minimum of two and a maximum of five uterine fibroids. Only the largest intramural fibroid (mean, 8.08 + 2.3 cm) was targeted for treatment. Fibroid size and volume were measured by magnetic resonance imaging before and 6 months after treatment. MRgFUS related adverse events that occurred during and within 1 week after treatment were monitored and recorded. Menorrhagia and pressure symptoms improved in 28 women (70%) at follow up. There was reduction in fibroid volume; with a mean difference of 79.3+51.7 cm3 (22%, p < 0.0001) 6 months after treatment. Hysterectomy was performed in seven (18%) patients who had persistent menorrhagia and five (12%) patients who had persistent menorrhagia responded to hormones, with improvement of symptoms within 6 months. The long-term efficacy of this promising non-invasive approach in the treatment of multiple uterine fibroids is being followed up. MRgFUS has a good safety profile, and no major adverse events were noted in this study. The symptoms of the women who were treated improved, with a moderate reduction in fibroid volume. Thus, the need for surgical intervention was avoided in most cases.