Clinical outcomes of magnetic resonance‐guided focused ultrasound surgery for uterine myomas: 24‐month follow‐up
Objectives To assess the volume reduction ratio, symptom improvement and reintervention rate following magnetic resonance‐guided focused ultrasound surgery (MRgFUS) for uterine myomas. Methods A total of 91 Japanese women with symptomatic myomas underwent MRgFUS between June 2004 and June 2008 using...
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| Veröffentlicht in: | Ultrasound in obstetrics & gynecology 2009-11, Vol.34 (5), p.584-589 |
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| creator | Funaki, K. Fukunishi, H. Sawada, K. |
| description | Objectives
To assess the volume reduction ratio, symptom improvement and reintervention rate following magnetic resonance‐guided focused ultrasound surgery (MRgFUS) for uterine myomas.
Methods
A total of 91 Japanese women with symptomatic myomas underwent MRgFUS between June 2004 and June 2008 using the ExAblate 2000 system. The volume change ratio was calculated at 6, 12 and 24 months following MRgFUS based on T2‐weighted magnetic resonance images. The symptom severity score (SSS) was examined before and after the treatment (at 3, 6, 12 and 24 months). Additional post‐MRgFUS treatments, such as hysterectomy, myomectomy, uterine artery embolization or repeat MRgFUS, were recorded and the reinterventional treatment rates were compared according to the signal intensity of pretreatment T2‐weighted magnetic resonance images of the myomas.
Results
The mean volume change ratios of low‐ and intermediate‐intensity (Type 1/2) myomas were −36.5% 6 months post‐procedure and −39.5% 24 months post‐procedure. The mean ± SD SSS value for patients with Type 1/2 myomas before MRgFUS was 35.1 ± 21.0, and the values diminished significantly during the 24‐month follow‐up period to a mean value of around 15.0. High‐intensity (Type 3) myomas were not observed to have decreased in size 6 months after MRgFUS. Of the 45 Type 1/2 myoma patients with complete follow‐up, seven required reinterventional treatment within 24 months. The reintervention rates were 14.0% for Type 1/2 patients and 21.6% for Type 3 patients at 24 months post‐treatment.
Conclusions
Moderate volume reductions of Type 1/2 myomas were noted following MRgFUS, and the reduction in SSS values and the relatively low reintervention rates observed are encouraging. We found MRgFUS to be an appropriate treatment method for Type 1/2 uterine myomas. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd. |
| doi_str_mv | 10.1002/uog.7455 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_734112770</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1017973188</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4495-f2d8901b69bd30b6e90381f0be24230a56fdfdc1011adf15d719577252afdf2d3</originalsourceid><addsrcrecordid>eNp9kctu1DAUhi0EokNB4gkqbxDdpBw7dhx3h0a9IFXqhq4jx5fBlRNP7ZhqdjxCn7FPgktHdAWrI-v_fH7pfAh9JHBCAOiXEjcngnH-Cq0I62QDAvhrtALZQSM6SQ_Qu5xvAaBjbfcWHRDZcwqMrNDPdfCz1yrgWBYdJ5txdHhSm9kuXuNkc5zVrO3jr4dN8cYa7KIuuc4SlqRyLLPBuaSNTbsaJVwWm_xs8bSLk8qnmLL6dYrz8qPGIcT7-izb9-iNUyHbD_t5iG7Oz76vL5ur64tv669XjWZM8sZR00sgYydH08LYWQltTxyMljLaguKdM85oAoQo4wg3gkguBOVU1YCa9hB9ft67TfGu2LwMk8_ahqBmG0seRMsIoUJAJY__S9YOIUVL-v4F1SnmnKwbtslPKu0qNDz5GKqP4clHRY_2W8s4WfMC7gVU4NMeULlacKke2-e_HKXQ95yzyjXP3L0PdvfPwuHm-uJP8W_-mKVs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1017973188</pqid></control><display><type>article</type><title>Clinical outcomes of magnetic resonance‐guided focused ultrasound surgery for uterine myomas: 24‐month follow‐up</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Access via Wiley Online Library</source><source>Wiley Online Library (Open Access Collection)</source><creator>Funaki, K. ; Fukunishi, H. ; Sawada, K.</creator><creatorcontrib>Funaki, K. ; Fukunishi, H. ; Sawada, K.</creatorcontrib><description>Objectives
To assess the volume reduction ratio, symptom improvement and reintervention rate following magnetic resonance‐guided focused ultrasound surgery (MRgFUS) for uterine myomas.
Methods
A total of 91 Japanese women with symptomatic myomas underwent MRgFUS between June 2004 and June 2008 using the ExAblate 2000 system. The volume change ratio was calculated at 6, 12 and 24 months following MRgFUS based on T2‐weighted magnetic resonance images. The symptom severity score (SSS) was examined before and after the treatment (at 3, 6, 12 and 24 months). Additional post‐MRgFUS treatments, such as hysterectomy, myomectomy, uterine artery embolization or repeat MRgFUS, were recorded and the reinterventional treatment rates were compared according to the signal intensity of pretreatment T2‐weighted magnetic resonance images of the myomas.
Results
The mean volume change ratios of low‐ and intermediate‐intensity (Type 1/2) myomas were −36.5% 6 months post‐procedure and −39.5% 24 months post‐procedure. The mean ± SD SSS value for patients with Type 1/2 myomas before MRgFUS was 35.1 ± 21.0, and the values diminished significantly during the 24‐month follow‐up period to a mean value of around 15.0. High‐intensity (Type 3) myomas were not observed to have decreased in size 6 months after MRgFUS. Of the 45 Type 1/2 myoma patients with complete follow‐up, seven required reinterventional treatment within 24 months. The reintervention rates were 14.0% for Type 1/2 patients and 21.6% for Type 3 patients at 24 months post‐treatment.
Conclusions
Moderate volume reductions of Type 1/2 myomas were noted following MRgFUS, and the reduction in SSS values and the relatively low reintervention rates observed are encouraging. We found MRgFUS to be an appropriate treatment method for Type 1/2 uterine myomas. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.</description><identifier>ISSN: 0960-7692</identifier><identifier>ISSN: 1469-0705</identifier><identifier>EISSN: 1469-0705</identifier><identifier>DOI: 10.1002/uog.7455</identifier><identifier>PMID: 19852041</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Adult ; Arteries ; Biological and medical sciences ; clinical effects ; coagulative necrosis ; Embolization ; Endometrial Ablation Techniques - methods ; Female ; Female genital diseases ; focused ultrasound ; Follow-Up Studies ; Gynecology ; Gynecology. Andrology. Obstetrics ; High-Intensity Focused Ultrasound Ablation - methods ; Humans ; Hysterectomy ; Japan ; Leiomyoma - diagnostic imaging ; Leiomyoma - pathology ; Leiomyoma - therapy ; Magnetic resonance imaging ; Magnetic Resonance Imaging, Interventional - methods ; Medical sciences ; MRgFUS ; myoma ; non‐perfused volume ; Obstetrics ; Surgery ; symptom improvement ; Treatment Outcome ; Tumors ; Ultrasonography ; Ultrasound ; Uterine Neoplasms - diagnostic imaging ; Uterine Neoplasms - pathology ; Uterine Neoplasms - therapy ; Uterus ; volume reduction</subject><ispartof>Ultrasound in obstetrics & gynecology, 2009-11, Vol.34 (5), p.584-589</ispartof><rights>Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.</rights><rights>2009 INIST-CNRS</rights><rights>Copyright (c) 2009 ISUOG. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4495-f2d8901b69bd30b6e90381f0be24230a56fdfdc1011adf15d719577252afdf2d3</citedby><cites>FETCH-LOGICAL-c4495-f2d8901b69bd30b6e90381f0be24230a56fdfdc1011adf15d719577252afdf2d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fuog.7455$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fuog.7455$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,1434,27929,27930,45579,45580,46414,46838</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22088554$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19852041$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Funaki, K.</creatorcontrib><creatorcontrib>Fukunishi, H.</creatorcontrib><creatorcontrib>Sawada, K.</creatorcontrib><title>Clinical outcomes of magnetic resonance‐guided focused ultrasound surgery for uterine myomas: 24‐month follow‐up</title><title>Ultrasound in obstetrics & gynecology</title><addtitle>Ultrasound Obstet Gynecol</addtitle><description>Objectives
To assess the volume reduction ratio, symptom improvement and reintervention rate following magnetic resonance‐guided focused ultrasound surgery (MRgFUS) for uterine myomas.
Methods
A total of 91 Japanese women with symptomatic myomas underwent MRgFUS between June 2004 and June 2008 using the ExAblate 2000 system. The volume change ratio was calculated at 6, 12 and 24 months following MRgFUS based on T2‐weighted magnetic resonance images. The symptom severity score (SSS) was examined before and after the treatment (at 3, 6, 12 and 24 months). Additional post‐MRgFUS treatments, such as hysterectomy, myomectomy, uterine artery embolization or repeat MRgFUS, were recorded and the reinterventional treatment rates were compared according to the signal intensity of pretreatment T2‐weighted magnetic resonance images of the myomas.
Results
The mean volume change ratios of low‐ and intermediate‐intensity (Type 1/2) myomas were −36.5% 6 months post‐procedure and −39.5% 24 months post‐procedure. The mean ± SD SSS value for patients with Type 1/2 myomas before MRgFUS was 35.1 ± 21.0, and the values diminished significantly during the 24‐month follow‐up period to a mean value of around 15.0. High‐intensity (Type 3) myomas were not observed to have decreased in size 6 months after MRgFUS. Of the 45 Type 1/2 myoma patients with complete follow‐up, seven required reinterventional treatment within 24 months. The reintervention rates were 14.0% for Type 1/2 patients and 21.6% for Type 3 patients at 24 months post‐treatment.
Conclusions
Moderate volume reductions of Type 1/2 myomas were noted following MRgFUS, and the reduction in SSS values and the relatively low reintervention rates observed are encouraging. We found MRgFUS to be an appropriate treatment method for Type 1/2 uterine myomas. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.</description><subject>Adult</subject><subject>Arteries</subject><subject>Biological and medical sciences</subject><subject>clinical effects</subject><subject>coagulative necrosis</subject><subject>Embolization</subject><subject>Endometrial Ablation Techniques - methods</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>focused ultrasound</subject><subject>Follow-Up Studies</subject><subject>Gynecology</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>High-Intensity Focused Ultrasound Ablation - methods</subject><subject>Humans</subject><subject>Hysterectomy</subject><subject>Japan</subject><subject>Leiomyoma - diagnostic imaging</subject><subject>Leiomyoma - pathology</subject><subject>Leiomyoma - therapy</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging, Interventional - methods</subject><subject>Medical sciences</subject><subject>MRgFUS</subject><subject>myoma</subject><subject>non‐perfused volume</subject><subject>Obstetrics</subject><subject>Surgery</subject><subject>symptom improvement</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Ultrasonography</subject><subject>Ultrasound</subject><subject>Uterine Neoplasms - diagnostic imaging</subject><subject>Uterine Neoplasms - pathology</subject><subject>Uterine Neoplasms - therapy</subject><subject>Uterus</subject><subject>volume reduction</subject><issn>0960-7692</issn><issn>1469-0705</issn><issn>1469-0705</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctu1DAUhi0EokNB4gkqbxDdpBw7dhx3h0a9IFXqhq4jx5fBlRNP7ZhqdjxCn7FPgktHdAWrI-v_fH7pfAh9JHBCAOiXEjcngnH-Cq0I62QDAvhrtALZQSM6SQ_Qu5xvAaBjbfcWHRDZcwqMrNDPdfCz1yrgWBYdJ5txdHhSm9kuXuNkc5zVrO3jr4dN8cYa7KIuuc4SlqRyLLPBuaSNTbsaJVwWm_xs8bSLk8qnmLL6dYrz8qPGIcT7-izb9-iNUyHbD_t5iG7Oz76vL5ur64tv669XjWZM8sZR00sgYydH08LYWQltTxyMljLaguKdM85oAoQo4wg3gkguBOVU1YCa9hB9ft67TfGu2LwMk8_ahqBmG0seRMsIoUJAJY__S9YOIUVL-v4F1SnmnKwbtslPKu0qNDz5GKqP4clHRY_2W8s4WfMC7gVU4NMeULlacKke2-e_HKXQ95yzyjXP3L0PdvfPwuHm-uJP8W_-mKVs</recordid><startdate>200911</startdate><enddate>200911</enddate><creator>Funaki, K.</creator><creator>Fukunishi, H.</creator><creator>Sawada, K.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>200911</creationdate><title>Clinical outcomes of magnetic resonance‐guided focused ultrasound surgery for uterine myomas: 24‐month follow‐up</title><author>Funaki, K. ; Fukunishi, H. ; Sawada, K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4495-f2d8901b69bd30b6e90381f0be24230a56fdfdc1011adf15d719577252afdf2d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Arteries</topic><topic>Biological and medical sciences</topic><topic>clinical effects</topic><topic>coagulative necrosis</topic><topic>Embolization</topic><topic>Endometrial Ablation Techniques - methods</topic><topic>Female</topic><topic>Female genital diseases</topic><topic>focused ultrasound</topic><topic>Follow-Up Studies</topic><topic>Gynecology</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>High-Intensity Focused Ultrasound Ablation - methods</topic><topic>Humans</topic><topic>Hysterectomy</topic><topic>Japan</topic><topic>Leiomyoma - diagnostic imaging</topic><topic>Leiomyoma - pathology</topic><topic>Leiomyoma - therapy</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging, Interventional - methods</topic><topic>Medical sciences</topic><topic>MRgFUS</topic><topic>myoma</topic><topic>non‐perfused volume</topic><topic>Obstetrics</topic><topic>Surgery</topic><topic>symptom improvement</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Ultrasonography</topic><topic>Ultrasound</topic><topic>Uterine Neoplasms - diagnostic imaging</topic><topic>Uterine Neoplasms - pathology</topic><topic>Uterine Neoplasms - therapy</topic><topic>Uterus</topic><topic>volume reduction</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Funaki, K.</creatorcontrib><creatorcontrib>Fukunishi, H.</creatorcontrib><creatorcontrib>Sawada, K.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Ultrasound in obstetrics & gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Funaki, K.</au><au>Fukunishi, H.</au><au>Sawada, K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical outcomes of magnetic resonance‐guided focused ultrasound surgery for uterine myomas: 24‐month follow‐up</atitle><jtitle>Ultrasound in obstetrics & gynecology</jtitle><addtitle>Ultrasound Obstet Gynecol</addtitle><date>2009-11</date><risdate>2009</risdate><volume>34</volume><issue>5</issue><spage>584</spage><epage>589</epage><pages>584-589</pages><issn>0960-7692</issn><issn>1469-0705</issn><eissn>1469-0705</eissn><abstract>Objectives
To assess the volume reduction ratio, symptom improvement and reintervention rate following magnetic resonance‐guided focused ultrasound surgery (MRgFUS) for uterine myomas.
Methods
A total of 91 Japanese women with symptomatic myomas underwent MRgFUS between June 2004 and June 2008 using the ExAblate 2000 system. The volume change ratio was calculated at 6, 12 and 24 months following MRgFUS based on T2‐weighted magnetic resonance images. The symptom severity score (SSS) was examined before and after the treatment (at 3, 6, 12 and 24 months). Additional post‐MRgFUS treatments, such as hysterectomy, myomectomy, uterine artery embolization or repeat MRgFUS, were recorded and the reinterventional treatment rates were compared according to the signal intensity of pretreatment T2‐weighted magnetic resonance images of the myomas.
Results
The mean volume change ratios of low‐ and intermediate‐intensity (Type 1/2) myomas were −36.5% 6 months post‐procedure and −39.5% 24 months post‐procedure. The mean ± SD SSS value for patients with Type 1/2 myomas before MRgFUS was 35.1 ± 21.0, and the values diminished significantly during the 24‐month follow‐up period to a mean value of around 15.0. High‐intensity (Type 3) myomas were not observed to have decreased in size 6 months after MRgFUS. Of the 45 Type 1/2 myoma patients with complete follow‐up, seven required reinterventional treatment within 24 months. The reintervention rates were 14.0% for Type 1/2 patients and 21.6% for Type 3 patients at 24 months post‐treatment.
Conclusions
Moderate volume reductions of Type 1/2 myomas were noted following MRgFUS, and the reduction in SSS values and the relatively low reintervention rates observed are encouraging. We found MRgFUS to be an appropriate treatment method for Type 1/2 uterine myomas. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>19852041</pmid><doi>10.1002/uog.7455</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via Wiley Online Library; Wiley Online Library (Open Access Collection) |
| subjects | Adult Arteries Biological and medical sciences clinical effects coagulative necrosis Embolization Endometrial Ablation Techniques - methods Female Female genital diseases focused ultrasound Follow-Up Studies Gynecology Gynecology. Andrology. Obstetrics High-Intensity Focused Ultrasound Ablation - methods Humans Hysterectomy Japan Leiomyoma - diagnostic imaging Leiomyoma - pathology Leiomyoma - therapy Magnetic resonance imaging Magnetic Resonance Imaging, Interventional - methods Medical sciences MRgFUS myoma non‐perfused volume Obstetrics Surgery symptom improvement Treatment Outcome Tumors Ultrasonography Ultrasound Uterine Neoplasms - diagnostic imaging Uterine Neoplasms - pathology Uterine Neoplasms - therapy Uterus volume reduction |
| title | Clinical outcomes of magnetic resonance‐guided focused ultrasound surgery for uterine myomas: 24‐month follow‐up |
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