Regrowth of myomas after magnetic resonance-guided focused ultrasound surgery (MRgFUS): Can a repeat procedure improve the clinical outcome?

• Main Authors: Funaki, M D Kaoru, Fukunishi, M D Hidenobu
• Format: Conference Proceeding
• Language: English
• ISSN: 0094-243X
• DOI: 10.1063/1.3131393

To estimate the efficacy of repeated magnetic resonance-guided focused ultrasound surgery (MRgFUS) for myomas in cases of established clinical failure. Significance: We previously reported that high-intensity myomas (type 3), evaluated by pretreatment T2-weighted magnetic resonance imaging, are less effectively treated by MRgFUS than low- and intermediate-intensity myomas (type 1 and type 2, respectively). These findings indicate that certain myomas resist ablation by focused ultrasound energy. Results: Ten of 111 patients who were followed up for at least 6 months after MRgFUS had regrowths and required a repeat procedure. Cases with myomas that required a second treatment because of a large volume or multiple myomas were excluded from the study. The 10 cases considered in this study included 2 with type 1, 4 with type 2, and 4 with type 3 myomas. Five patients were treated again approximately 6 months later, and 5 were retreated between 16 and 33 months after the first MRgFUS. The nonperfused ratio of the treated myomas immediately after the second MRgFUS was greater than that observed after the first MRgFUS. Two patients underwent myomectomy because of persistent hypermenorrhea, and one patient because of a rectal tumor. The volume of most of the myomas, which did not decrease 6 months after the first MRgFUS, noticeably decreased after the second MRgFUS. Conclusion: Repeat MRgFUS can improve the treatment outcome for some myomas that resist focused ultrasound energy.