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Leiomyoma shrinkage after MRI-guided focused ultrasound treatment: report of 80 patients LeBlang SD; Hoctor K; Steinberg FLAJR Am J Roentgenol 2010[Jan]; 194 (1): 274-80OBJECTIVE: The purpose of this study was to assess the degree of leiomyoma ablation and shrinkage after MRI-guided focused ultrasound treatment performed according to U.S. Food and Drug Administration protocols for commercial trials. MATERIALS AND METHODS: A total of 147 symptomatic leiomyomas in 80 women (average age, 46 years; range, 34-55 years) were managed with MRI-guided focused ultrasound. The average volume of treated fibroids was 175+/-201 (SD) cm3. Before treatment, T2-weighted MR images in three planes were obtained to measure leiomyoma volume. Immediately after treatment, T1-weighted contrast-enhanced fat-suppressed MR images in three planes were used to measure nonperfused volume ratio. Similar images obtained 6 months after treatment were used to determine leiomyoma shrinkage. Qualitative and quantitative relations between fibroid volume, nonperfused volume ratio at treatment, and 6-month shrinkage were measured. RESULTS: The average nonperfused volume ratio was 55%+/-25% immediately after treatment. Six months after treatment, the average volume of treated fibroids had decreased to 112+/-141 cm3 (n=81) (p<0.0001) with an average volume reduction of 31%+/-28%. A linear regression model showed highly significant correlation between posttreatment nonperfused volume ratio and shrinkage at 6 months (p<0.0001). CONCLUSION: MRI-guided focused ultrasound therapy for leiomyoma can result in nonperfused volume ratio and shrinkage that exceed those in previous clinical trials because the treatment guidelines have been relaxed to allow a greater amount of tissue ablation. The results suggest that a larger nonperfused volume ratio can be achieved, resulting in greater shrinkage and improved relief of symptoms.|*Magnetic Resonance Imaging, Interventional[MESH]|Adult[MESH]|Analysis of Variance[MESH]|Female[MESH]|Humans[MESH]|Leiomyoma/*therapy[MESH]|Linear Models[MESH]|Middle Aged[MESH]|Treatment Outcome[MESH]|Ultrasonic Therapy/*methods[MESH]|Uterine Neoplasms/*therapy[MESH] |
