MR-Guided Focused Ultrasound Treatment of Uterine Fibroids

Part of the Medical Radiology book series (MEDRAD)


MR-guided focused ultrasound is a new completely non-invasive treatment of fibroids utilising very high energy ultrasound focused to a specific point in the body which causes local heating and therefore thermal ablation. This whole process can be targeted and guided by MR using online thermal mapping and completely MR compatible focused ultrasound equipment. The whole procedure can be carried out in a conventional MR scanner as an outpatient with minimal complications and minimal conscious sedation. No inpatient admission is required and patients can return to work within 24 hours of the procedure with very little associated pain and other morbidity. More than 5000 cases around the world have now been carried out using this approach with substantial success. This chapter describes the details of the process the inclusion and exclusion criteria and the side effects and rates of success with current equipment.


Uterine Artery Embolization Uterine Fibroid Focus Ultrasound Coagulative Necrosis Skin Burn 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. American College of Obstetricians and Gynaecologists (2008) ACOG practice bulletin. Alternative to hysterectomy in the management of leiomyomas. Obstet Gynaecol 112 (2 Pt 1):387–400Google Scholar
  2. Cline HE, Schenck JF, Hynynen K, Watkins RD, Souza SP, Jolesz FA (1992) MR-guided focused ultrasound surgery. J Comput Assist Tomogr 16:956–965PubMedCrossRefGoogle Scholar
  3. Day Baird D, Dunson DB, Hill MC, Cousins D, Schectman JM (2003) High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol 188(1):100–107CrossRefGoogle Scholar
  4. Flynn M, Jamison M, Datta S, Myers E (2006) Health care resource use for uterine fibroid tumors in the United States. Am J Obstet Gynecol 195(4):955–964PubMedCrossRefGoogle Scholar
  5. Hesley GK, Felmlee JP, Gebhart JB, Dunagan KT, Gorny KR, Kesler JB, Brandt KR, Glantz JN, Gostout BS (2006) Noninvasive treatment of uterine fibroids: early Mayo Clinic experience with magnetic resonance imaging-guided focused ultrasound. Mayo Clin Proc 81(7):936–942PubMedCrossRefGoogle Scholar
  6. Hindley J, Gedroyc WM, Regan L, Stewart E, Tempany C, Hynyen K, Mcdannold N, Inbar Y, Itzchak Y, Rabinovici J, Kim HS, Geschwind JF, Hesley G, Gostout B, Ehrenstein T, Hengst S, Sklair-Levy M, Shushan A, Jolesz F (2004) MRI guidance of focused ultrasound therapy of uterine fibroids: early results. AJR Am J Roentgenol 183(6):1713–1719PubMedGoogle Scholar
  7. Jolesz F, Hynynen K (2002) Magnetic resonance image guided focused ultrasound surgery. Cancer J 8(1):S100–S112PubMedGoogle Scholar
  8. Law P, Gedroyc WM, Regan L (1999) Magnetic-resonance-guided percutaneous laser ablation of uterine fibroids. Lancet 354(9195):2049–2050PubMedCrossRefGoogle Scholar
  9. Lynn JG, Zwemer RL, Chick AJ, Miller AE (1942) A new method for the generation and use of focused ultrasound in experimental biology. J Gen Physiol 26:179–193PubMedCrossRefGoogle Scholar
  10. Morita Y, Ito N, Hikida H, Takeuchi S, Nakamura K, Ohashi H (2008) Non-invasive magnetic resonance imaging-guided focused ultrasound treatment for uterine fibroids–early experience. Eur J Obstet Gynecol Reprod Biol 139(2):199–203PubMedCrossRefGoogle Scholar
  11. Rabinovici J, Inbar Y, Revel A, Zalel Y, Gomori JM, Itzchak Y, Schiff E, Yagel S (2007) Clinical improvement and shrinkage of uterine fibroids after thermal ablation by magnetic resonance-guided focused ultrasound surgery. Ultrasound Obstet Gynecol 30(5):771–777PubMedCrossRefGoogle Scholar
  12. Rabinovici J, David M, Fukunishi H, Morita Y, Gostout BS, Stewart EA (2010) for the MRgFUS Study Group. Pregnancy outcome after magnetic resonance-guided focused ultrasound surgery (MRgFUS) for conservative treatment of uterine fibroids. Fertil Steril 93(1):199–209PubMedCrossRefGoogle Scholar
  13. Smart OC, Hindley JT, Regan L, Gedroyc W (2006) Gonadotrophin releasing hormone and MR guided focused ultrasound surgery for uterine lleiomyomata. Obstet Gynecol 108(1):49–54PubMedCrossRefGoogle Scholar
  14. Stewart EA (2007) Uterine fibroids: the complete guide. Johns Hopkins University Press, BaltimoreGoogle Scholar
  15. Stewart EA, Gedroyc WM, Tempany CM, Quade BJ, Inbar Y, Ehrenstein T, Shushan A, Hindley JT, Goldin RD, David M, Sklair M, Rabinovici J (2003) Focused ultrasound treatment of uterine fibroid tumors: safety and feasibility of a noninvasive thermoablative technique. Am J Obstet Gynecol 189(1):48–54PubMedCrossRefGoogle Scholar
  16. Stewart EA, Gostout B, Rabinovici J, Kim HS, Regan L, Tempany CM (2007) Sustained relief of leiomyoma symptoms by using focused ultrasound surgery. Obstet Gynecol 110(2 Pt 1):279–287PubMedCrossRefGoogle Scholar
  17. ter Haar G (1999) Therapeutic ultrasound. Eur J Ultrasound 9:3–9PubMedCrossRefGoogle Scholar
  18. Walker CL, Stewart EA (2005) Uterine fibroids: the elephant in the room. Science 308(5728):1589–1592PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Division of RadiologyImperial Healthcare NHS trust, St Mary’s Hospital MRI UnitLondonUK

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