MRI characterization of uterine fibroids may predict success of GnRH agonist therapy prior to magnetic resonance focused ultrasound (MRgFUS) treatment
© Bryant and LeBlang; licensee BioMed Central Ltd. 2015
Published: 30 June 2015
In managing women with large uterine fibroids, GnRH agonists can be used to reduce fibroid volume and decrease vascularity to enhance treatment outcomes with MRgFUS. GnRH agonists have been shown to reduce fibroid volume by as much as 30-40%. The purpose of this study was to examine the responsiveness of fibroids to pre-treatment with a GnRH agonist in relation to their appearance on T2 weighted images and MRgFUS treatment outcomes.
Fifteen women (ages 34-52) with symptomatic uterine fibroids were pre-treated with a GnRH agonist prior to undergoing MRgFUS treatment using the ExAblate device. 7 patients received treatment for 3 months, 4 received treatment for 4 months, 2 received treatment for 6 months and 2 received treatment for an unknown time before the MRgFUS procedure. Other than the 2 patients with unknown GnRH agonist therapy times, all patients obtained their last GnRH agonist injection 3-4 weeks before MRgFUS treatment. These women were selected to receive a GnRH agonist if they possessed fibroids in excess of 10 cm or had a fibroid volume greater than 300 cc. Fibroids were classified by their intensity on T2 weighted images relative to normal myometrium (hypointense, isointense, or hyperintense as well as tissue homogeneity or heterogeneity). A total of 22 fibroids were treated with MRgFUS: 17 hypointense, 3 heterogeneously hypointense, 1 heterogeneously hyperintense and 1 isointense fibroid. Data regarding fibroid volume reduction following GnRH administration, Joules of energy delivered per cc of fibroid tissue ablated and the final non-perfused volume (NPV) were investigated.
Results and conclusions
We would like to thank Lisa Mckenzie and Gina Boykin for their knowledge and dedication in helping to take care of our MRgFUS patients.
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