Magnetic resonance focused ultrasound fibroid treatment
Magnetic resonance focused ultrasound fibroid treatment is an alternative option for women who have fibroids. It can be an effective treatment for those who might otherwise have a hysterectomy, myomectomy or uterine artery embolisation. The procedure is non-invasive, requires no general anaesthetic or overnight hospitalisation which means patients may be able to return to work within a few days.
The procedure is done in an MRI scanner, where high intensity focused ultrasound waves target the fibroids and heat the tissue until the fibroids are destroyed. The MRI provides real time thermal imaging to guide the treatment. The treatment typically last 1-3 hours and is done as an outpatient procedure so it requires no overnight stay in the hospital. After treatment, women can usually return to their daily routine in 1-3 days. MRgFUS is safe and lowers risk of adverse events.
NICE, the National Institute for Health and Care Excellence guidance about the procedure: http://publications.nice.org.uk/magnetic-resonance-image-guided-transcutaneous-focused-ultrasound-for-uterine-fibroids-ipg413 states that whilst the treatment is reasonably effective in the short term, women may need further courses of treatment. They also state that the effects on fertility and pregnancy are still not known. Patients may also suffer from skin burns.
It was approved by the FDA (USA) in 2004, (http://www.insightec.com/clinical/womens-health/). A cost effectiveness study conducted by the London School of Tropical Medicine [Zowall, 2008] and published in BJOG in 2008 compared Magnetic resonance focused ultrasound fibroid treatment to the other treatment strategies and concluded that “A treatment strategy for symptomatic uterine fibroids starting with MRgFUS is likely to be cost-effective”
References:
- Zaher S, Gedroyc W, Regan L. Patient Suitability for Magnetic Resonance guided Focused Ultrasound Surgery of Uterine Fibroids, Eur J Obstet Gynecol Reprod Biol., 2009.
- Rabinovici J, David M, Fukunishi M, Morita Stewart E, “MR guided Focused Ultrasound Pregnancies: Pregnancy outcome following magnetic resonance guided focused ultrasound surgery (MRgFUS) for conservative treatment of uterine fibroids.” Fertility and Sterility, 2008 Nov 13. [Epub].