Skip to main content
Log in

Midterm Results after Uterine Artery Embolization Versus MR-Guided High-Intensity Focused Ultrasound Treatment for Symptomatic Uterine Fibroids

  • Clinical Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To compare the rate of reintervention and midterm changes in symptom severity (SS) and Total health-related quality of life (HRQoL) scores after uterine artery embolization (UAE) and magnetic resonance–guided high-intensity focused ultrasound (MR-g HIFU) for symptomatic uterine fibroids.

Methods

Eighty women (median age 38.3 years), equally eligible for MR-g HIFU and UAE who underwent one of both treatments between 2002 and 2009 at our institution, were included. The primary end point of the study was defined as the rate of reintervention after both therapies. The secondary outcome was defined as changes in SS and Total HRQoL scores after treatment. SS and Total HRQoL scores before treatment and at midterm follow-up (median 13.3 months) were assessed by the uterine fibroid symptom and quality-of-life questionnaire (UFS-QoL) and compared.

Results

The rate of reintervention was significantly lower after UAE than after MR-g HIFU (p = 0.002). After both treatments, SS and Total HRQoL scores improved significantly from baseline to follow-up (UAE: p < 0.001, p < 0.001; MR-g HIFU: p = 0.002, p < 0.001). Total HRQoL scores were significantly higher after UAE than after MR-g HIFU (p = 0.032). Changes in the SS scores did not differ significantly for both treatments (p = 0.061).

Conclusion

UAE and MR-g HIFU significantly improved the health-related quality of life of women with symptomatic uterine fibroids. After UAE, the change in Total HRQoL score improvement was significantly better, and a significantly lower rate of reintervention was observed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Buttram VC Jr, Reiter RC (1981) Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril 36:433–445

    PubMed  Google Scholar 

  2. Vollenhoven BJ, Lawrence AS, Healy DL (1990) Uterine fibroids: a clinical review. Br J Obstet Gynaecol 97:285–298

    Article  PubMed  CAS  Google Scholar 

  3. Stewart EA (2001) Uterine fibroids. Lancet 357(9252):293–298

    Article  PubMed  CAS  Google Scholar 

  4. Fennessy FM, Kong CY, Tempany CM et al (2011) Quality-of-life assessment of fibroid treatment options and outcomes. Radiology 259:785–792

    Article  PubMed  Google Scholar 

  5. Scheurig-Muenkler C, Wagner M, Franiel T et al (2010) Effect of uterine artery embolization on uterine and leiomyoma perfusion: evidence of transient myometrial ischemia on magnetic resonance imaging. J Vasc Interv Radiol 21:1347–1353

    Article  PubMed  Google Scholar 

  6. Vo NJ, Andrews RT (2008) Uterine artery embolization: a safe and effective, minimally invasive, uterine-sparing treatment option for symptomatic fibroids. Semin Interv Radiol 25:252–260

    Article  Google Scholar 

  7. Ravina JH, Herbreteau D, Ciraru-Vigneron N et al (1995) Arterial embolisation to treat uterine myomata. Lancet 346(8976):671–672

    Article  PubMed  CAS  Google Scholar 

  8. Spies JB, Ascher SA, Roth AR et al (2001) Uterine artery embolization for leiomyomata. Obstet Gynecol 98:29–34

    Article  PubMed  CAS  Google Scholar 

  9. Spies JB, Myers ER, Worthington-Kirsch R et al (2005) The FIBROID Registry: symptom and quality-of-life status 1 year after therapy. Obstet Gynecol 106:1309–1318

    Article  PubMed  Google Scholar 

  10. Walker WJ, Pelage JP (2002) Uterine artery embolisation for symptomatic fibroids: clinical results in 400 women with imaging follow up. BJOG 109:1262–1272

    Article  PubMed  CAS  Google Scholar 

  11. Hesley GK, Felmlee JP, Gebhart JB et al (2006) Noninvasive treatment of uterine fibroids: early Mayo Clinic experience with magnetic resonance imaging-guided focused ultrasound. Mayo Clin Proc 81:936–942

    Article  PubMed  Google Scholar 

  12. Stewart EA, Rabinovici J, Tempany CM et al (2006) Clinical outcomes of focused ultrasound surgery for the treatment of uterine fibroids. Fertil Steril 85:22–29

    Article  PubMed  Google Scholar 

  13. Stewart EA, Gostout B, Rabinovici J et al (2007) Sustained relief of leiomyoma symptoms by using focused ultrasound surgery. Obstet Gynecol 110(2 Pt 1):279–287

    Article  PubMed  Google Scholar 

  14. Gorny KR, Woodrum DA, Brown DL et al (2011) Magnetic resonance–guided focused ultrasound of uterine leiomyomas: review of a 12-month outcome of 130 clinical patients. J Vasc Interv Radiol 22:857–864

    Article  PubMed  Google Scholar 

  15. Hindley J, Gedroyc WM, Regan L et al (2004) MRI guidance of focused ultrasound therapy of uterine fibroids: early results. AJR Am J Roentgenol 183:1713–1719

    Article  PubMed  Google Scholar 

  16. Fennessy FM, Tempany CM, McDannold NJ et al (2007) Uterine leiomyomas: MR imaging–guided focused ultrasound surgery—results of different treatment protocols. Radiology 243:885–893

    Article  PubMed  Google Scholar 

  17. Scheurig C, Gauruder-Burmester A, Kluner C et al (2006) Uterine artery embolization for symptomatic fibroids: short-term versus mid-term changes in disease-specific symptoms, quality of life and magnetic resonance imaging results. Hum Reprod 21:3270–3277

    Article  PubMed  CAS  Google Scholar 

  18. Spies JB, Allison S, Flick P et al (2004) Polyvinyl alcohol particles and trisacryl gelatin microspheres for uterine artery embolization for leiomyomas: results of a randomized comparative study. J Vasc Interv Radiol 15:793–800

    Article  PubMed  Google Scholar 

  19. Worthington-Kirsch R, Spies JB, Myers ER et al (2005) The fibroid registry for outcomes data (FIBROID) for uterine embolization: short-term outcomes. Obstet Gynecol 106:52–59

    Article  PubMed  Google Scholar 

  20. Chung AH, Hynynen K, Colucci V et al (1996) Optimization of spoiled gradient-echo phase imaging for in vivo localization of a focused ultrasound beam. Magn Reson Med 36:745–752

    Article  PubMed  CAS  Google Scholar 

  21. Funaki K, Fukunishi H, Sawada K (2009) Clinical outcomes of magnetic resonance–guided focused ultrasound surgery for uterine myomas: 24-month follow-up. Ultrasound Obstet Gynecol 34:584–589

    Article  PubMed  CAS  Google Scholar 

  22. Zhou YF (2011) High intensity focused ultrasound in clinical tumor ablation. World J Clin Oncol 2:8–27

    Article  PubMed  Google Scholar 

  23. Hengst SA, Ehrenstein T, Herzog H et al (2004) Magnetic resonance tomography guided focussed ultrasound surgery (MR-g HIFU) in tumor therapy—a new noninvasive therapy option. Radiologe 44:339–346

    Article  PubMed  CAS  Google Scholar 

  24. Spies JB, Coyne K, Guaou Guaou N (2002) The UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata. Obstet Gynecol 99:290–300

    Article  PubMed  Google Scholar 

  25. Harding G, Coyne KS, Thompson CL et al (2008) The responsiveness of the uterine fibroid symptom and health-related quality of life questionnaire (UFS-QOL). Health Qual Life Outcomes 12:99

    Article  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to T. J. Kroencke.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Froeling, V., Meckelburg, K., Scheurig-Muenkler, C. et al. Midterm Results after Uterine Artery Embolization Versus MR-Guided High-Intensity Focused Ultrasound Treatment for Symptomatic Uterine Fibroids. Cardiovasc Intervent Radiol 36, 1508–1513 (2013). https://doi.org/10.1007/s00270-013-0582-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-013-0582-6

Keywords

Navigation