Focused Ultrasound
What is MRI-guided Focused Ultrasound (MRg-FUS)?
MRg-FUS is only available at a small number of medical facilities in the United States. It combines the imaging capability of magnetic resonance imaging (MRI) to target tumors (ex. fibroids) inside the body with a special ultrasound unit capable of delivering a beam of focused ultrasound energy. This energy is used to destroy the tumor while completely sparing the adjacent normal tissue.
During the treatment session, MRI images allow the treating physician to "see" inside the body and monitor the treated tumor in a completely noninvasive manner.
How is the procedure done for uterine fibroids?
Immediately prior to the procedure, the woman has a catheter inserted in an arm vein and a bladder catheter placed. She lies prone (i.e. on her stomach) for the duration of the procedure. The procedure can take up to 3-4 hours to complete. Intravenous sedation and pain medication are given to the patient to provide comfort and relaxation. There is a nurse with the patient in the scanner, along with the treating physician outside of the scanner throughout the entire procedure.
Individual pulses of focused ultrasound energy are deposited to the fibroid. These last for 20 seconds each and are given until the fibroid is completely treated. Afterwards, MR images are given until the fibroid is completely treated. Afterwards, MR images are obtained to evaluate the effectiveness of the treatment session.
What are the benefits of MRg-FUS for the treatment of fibroids?
MRg-FUS is a noninvasive alternative to treat fibroids. After the treatment session, patients will have a brief recovery period and then are discharged home. They should be able to resume their normal routine the next day.
Some patients will be treated for infertility due to their fibroids. These patients will be spared more invasive surgery. Other patients will be treated for symptoms due to their fibroids, most commonly heavy menstrual bleeding, pelvic pain, or increased urinary frequency. These patients may prefer the noninvasive nature of MRg-FUS over other options such as Uterine Fibroid Embolization (UFE) or surgical options such as myomectomy or hysterectomy.
What are the risks of MRg-FUS?
The incidence of complications during MRg-FUS is very low. The risks include skin burns, back or leg pain, nerve injury, vaginal discharge, and urinary tract infection. There is also a possibility that the treatment is unsuccessful and would require an alternative treatment. Finally, there is a chance that at a later time, more fibroids develop or grow requiring treatment.
How do I know if I am a candidate for MRg-FUS?
We evaluate each patient individually and discuss with you all of the available treatment options at the time of your initial office consultation.
For more information, call 770-801-4634.
John Lipman, MD, FSIR, serves as the director of The Center for Image-Guided Procedures. His practice, Atlanta Interventional Institute, is located on the campus of Emory-Adventist Hospital.