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MRI-Guided focused ultrasound therapy relieves
symptoms, avoids hysterectomy in some patients with uterine fibroids
Dec. 2, 2004.MRI-guided ultrasound therapy is an effective
way to treat women with uterine fibroids, improving their quality of
life and avoiding hysterectomy, a new study shows. The study reviewed
the use of MRI and the ExAblate 2000, a device that was recently approved
by the Food and Drug Administration.
About 25% of women have uterine fibroids with a substantial proportion
of these experiencing symptoms, said Dr. Wladyslaw Gedroyc of St. Mary's
Hospital and the Imperial College School of Medicine in London. These
symptoms include abdominal pain, bladder irritability and menstrual
irregularities, he said. These patients are commonly treated with surgery.
However, "our study of 109 patients found that combining MRI and
ultrasound can be a viable alternative to a hysterectomy or myomectomy."
Patients in the study answered a quality of life questionnaire before
then after the MRI-ultrasound procedure. "Overall there was a significant
improvement in the quality of life scores in 80% of the patients,"
six months following the procedure, said Dr. Gedroyc. He added that
updated results are being analyzed, but "at 12 months post procedure
the improvements and changes are predominately maintained."
The procedure includes using MRI to plan the treatment and guide the
treatment as it is being done. Focused ultrasound destroys the fibroid
tissue. The procedure is "completely non-invasive and can be done
as an
outpatient procedure. In addition the whole process is very safe with
very few side effects," Dr. Gedroyc said. One patient had sciatic
nerve damage with pain and mild weakness, but this resolved itself quickly.
One patient was kept overnight because she had a reaction to the sedation
she was given, Dr. Gedroyc said. "There were several instances
where patients had prolonged menstrual bleeding, but this was not any
different than what they had experienced before the procedure so this
was probably secondary to the underlying problem rather than a result
of the treatment," he said.
The success of this procedure in treating uterine fibroids might be
just the beginning, said Dr. Gedroyc. "It points the way forward
to the utilization of this technology in other areas such as the treatment
of solid organ malignancies," he said.
The study was published in the December issue of the American Journal
of Roentgenology.
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