Archive for January 29th, 2012
January 29th, 2012 | 
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The current options for treatment of uterine fibroids mainly involve surgery.
Today surgery does not necessarily require a full removal of the uterus, though, in extreme cases a hysterectomy is the only available option. Other types of directed or laparoscopic surgery may be able to remove the discomforting fibroids while saving the uterus. However these procedures are still somewhat invasive and risk damaging the uterus to a point where the patient could not support a viable pregnancy.
MR guided Focused Ultrasound Surgery (MRgFUS) is a non-invasive, outpatient procedure which uses high doses of focused ultrasound waves (HIFU) to destroy uterine fibroids, without affecting any of the other tissues around the fibroid. The procedure is conducted in a magnetic resonance imaging (MRI) scanner which helps the physician “see” inside the body to pinpoint, guide, and continuously monitor the treatment.
Imagine using a magnifying glass to focus the sun’s energy on a single point to create a flame to burn a leaf. The focused ultrasound energy is directed at a small volume of the fibroid, raising its temperature high enough to cause thermal ablation (killing of the cells) without impacting other tissues. Pulses of energy are repeated until the entire volume is treated.
Magnetic resonance imaging (MRI) is an advanced diagnostic technology which provides 3D imaging of internal organs without radiation. The MR guided FUS treatment uses the MR images to identify where the fibroid is and what portion has been treated, without the need for any incisions. It also provides real time feedback about temperature changes of the treated fibroid to make sure that the fibrotic tissue has been ablated (destroyed).
Before treatment you are given a sedative and pain medication to help you relax. You lie on a patient table and are made comfortable before starting treatment. The treatment takes place with you lying on the patient table inside the MR scanner. Your clinical team will be in the next room with two-way communication using a microphone and a speaker. The doctor will inform you when images are being acquired (scanning) and when the system is sonicating (treatment).
First, the doctor identifies the fibroid(s) on MR images taken of your pelvic region. Then, after detailed planning, high energy focused ultrasound waves heat a small spot in the uterine fibroid to a temperature of up to 85oC. During the pulse or sonication, which lasts about 15 seconds, the doctor monitors the progress and reviews temperature-sensitive images. Since each sonication treats a very small volume, this process will be repeated until the required volume is treated. The procedure lasts about 2-3 hours depending upon the size and number of fibroids treated.
During the uterine fibroids treatment, it is normal to feel a warming sensation in the pelvic region. You will be given a safety stop button that allows you to immediately stop the sonication if the treatment becomes painful.
You are conscious the entire time and provide feedback during the procedure to the physician. Afterwards you’ll be asked to rest for a couple of hours in the clinic, while the mild sedation wears off. Then you’ll be able to go home and resume normal activity.
Following the treatment the body gradually removes the treated tissue over a period of months, providing symptom relief.
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