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Perfusion volume correlates, percentage of involution, and clinical efficacy at diverse follow-up survey times after MR-guided focused ultrasound surgery in uterine fibroids: first report in a Mexican mestizo population

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Abstract

Objectives

To evaluate the clinical efficacy of magnetic resonance-guided focused ultrasound surgery in a Mexican mestizo population.

Methods

This retrospective study included 159 women (mean age 37 ± 6.4 years, range 22–53 years) from 2008 to 2010. Two hundred sixty-eight symptomatic uterine fibroids were treated using MR-guided focused ultrasound surgery. Parameters included initial perfused volume, final perfused volume, non-perfused volume (NPV), and treated volume ratio (TVR). Follow-up up to 15 months assessed treatment efficacy and symptomatic relief. Non-parametric statistics and the Kaplan-Meier method were performed.

Results

T2-weighted hypointense fibroids showed a frequency of 93.6 %; isointense and hyperintense fibroids had frequencies of 5.60 and 1.1 %. There was a negative correlation between NPV and age (r = -0.083, p = 0.307) and treatment time (r = -0.253, p = 0.001). Median TVR was 96.0 % in small fibroids and 76.5 % in large fibroids. Involution of 50 % and 80 % was achieved at months 6–7 and month 11, respectively. Relief of symptoms was significant (p < 0.05).

Conclusions

Our data show that higher TVR attained immediately post-treatment of MRgFUS favours higher involution percentages at follow-up; however, careful patient selection and use of pretreatment imaging are important components for predicting success using MR-guided focused ultrasound surgery.

Key Points

• Type 1 fibroids were the most common (93.2 %).

• Age and treated volume were not correlated (r s   = -0.215, p = 0.165).

• Small fibroids achieved a higher treated volume than large (96.0 % vs. 76.5 %).

• A 50 % involution was achieved at 6-month follow-up for type-1 fibroid.

• A decrease of 80 % was reached at 11 months for type-1 fibroids.

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Acknowledgments

The scientific guarantor of this publication is Ernesto Roldan-Valadez. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.This article was supported in part by Medica Sur Clinic and Foundation.

Ana Luz Carrasco-Choque, MD, was enrolled as clinical fellow of the whole-body MRI program during 2009-2010. Ingrid Vivas-Bonilla, MD, was attending radiologist at the MRI unit from 2001 to 2009. Cecilia Romero-Trejo, MD, was attending radiologist at the MRI unit from 2005 to 2010.

Antonio R. Villa MD, PhD, provided statistical advice for the preparation of this manuscript.

One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Methodology: retrospective.

Conflicts of interest

The authors have no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Magnetic Resonance Unit, Medica Sur Clinic and Foundation, Mexico City, Mexico

    Ana Luz Carrasco-Choque, Yeni Fernandez-de Lara, Ingrid Vivas-Bonilla, Cecilia Romero-Trejo & Ernesto Roldan-Valadez

  2. Division de Investigacion, Facultad de Medicina, UNAM, Mexico City, Mexico

    Antonio R. Villa

  3. Coordination of Research and Innovation, Magnetic Resonance Unit, Medica Sur Clinic and Foundation, Puente de Piedra # 150. Toriello Guerra. Tlalpan, CP 14050, Mexico City, Mexico

    Ernesto Roldan-Valadez

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  1. Ana Luz Carrasco-Choque
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Correspondence to Ernesto Roldan-Valadez.

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Carrasco-Choque, A.L., Lara, Y.Fd., Vivas-Bonilla, I. et al. Perfusion volume correlates, percentage of involution, and clinical efficacy at diverse follow-up survey times after MR-guided focused ultrasound surgery in uterine fibroids: first report in a Mexican mestizo population. Eur Radiol 25, 2905–2912 (2015). https://doi.org/10.1007/s00330-015-3707-2

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