MRgFUS 

A noninvasive treatment option for uterine fibroids which is a noncancerous growth of the uterus is called focused ultrasound surgery (FUS).

Your doctor may perform a pelvic magnetic resonance imaging (MRI) scan before the treatment to determine whether you are a candidate for focused ultrasound surgery.

In this procedure, you will be inside an MRI scanner equipped with a high-energy ultrasound transducer.

This procedure is also called focused ultrasound ablation or magnetic resonance-guided focused ultrasound surgery.

The images in the MRI will give your doctor the locations of nearby structures to be avoided such as the bladder and bowel and the precise location of a uterine fibroid.

The ultrasound transducer delivers focused sound waves into the fibroid and will heat and destroy small areas of fibroid tissue until all of them are destroyed.

This procedure is done at specialized clinics because this is not yet widely available.

Here are the most common reasons to undergo a focused ultrasound surgery for uterine fibroids.

Focused ultrasound surgery:

• is done on an outpatient basis
• provides a noninvasive alternative to surgical treatment of fibroids
• eases symptoms that are related to uterine fibroids including pelvic pain, pressure, and heavy menstrual bleeding

This allows a rapid return to normal activities after the procedure.

This may not be a good choice for you if:

• you have a very large fibroid or you have many fibroids
• you have multiple abdominal scars making it difficult to find a safe path between the fibroid and the transducer
• you want to optimize future pregnancy

Long-term effects on a woman’s ability to be pregnant have not been studied adequately but a lot of cases in which women had successful pregnancies after this treatment.

Focused ultrasound surgery may result with potential risks, but rarely:

• damage to structures and tissues near the fibroid targeted for treatment
• burns to the skin on your abdomen
• blood clots in your legs or deep vein thrombosis
• nerve stimulation which can lead to temporary leg and back pain after the procedure

Other drawbacks include:

• less data on fertility and pregnancy than with other fibroid treatments
• less long-term data on safety and effectiveness than most other fibroid treatments

When you have focused ultrasound surgery:

• you may have additional treatment if your symptoms return
• you may have some fibroids that may not be able to be treated

In preparing for your focused ultrasound surgery for uterine fibroids, you must follow your doctor’s orders. This test uses a magnetic field to create detailed pictures of your body.

Avoid metal objects for this may interfere with the magnetic field used during the exam which can cause safety problem or affect the quality of the MRI, this may also damage electronic items.

Do not use any pieces of jewelry or electronic devices inside the room.

You should tell the technologist or your doctor if you have any metal or electronic devices inside your body such as metallic joint prostheses, implanted electronic devices; body piercings, dental implants, artificial heart valves or cochlear implants.

This is an outpatient procedure. Your doctor will ask you to shave your lower abdomen between your bellybutton and pubic bone.

Before the procedure:

• to inject contrast material for MRI as well as give you medications for relaxation and pain, you will have an IV line placed in your vein
• you will be asked if you want to have earplugs because there will be tapping sounds and other noises
• use special stockings to prevent blood clots
• to improve the visibility of the uterus, they will use a catheter inserted into your bladder

Here’s what you can expect before, during, and after your focused ultrasound surgery for uterine fibroids.

Depending on the number and size of fibroid that you have, treatment time varies. You will lie on a table and each portion of the fibroid is heated using focused ultrasound waves or sonications.

This MRI will determine if the fibroid has been heated enough to achieve the desired results and monitor tissue temperature.

Each sonication lasts up about 20 to 25 seconds and mostly it will take about 80 sonications during a treatment. More sonications may be needed depending on the size and number of fibroids that you have.

You will be asked if you have a feeling of discomfort so that your doctor will adjust the medication throughout the treatment. You will need someone to take you home after the procedure.

Your doctor may recommend over the counter nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol) for discomfort, you may return to your normal activities after you got home.

Understanding the results of your focused ultrasound surgery for uterine fibroids will be made possible by your doctor.

Your body will absorb the treated tissue gradually and naturally over the years.

It may show that the fibroid is still there in an ultrasound but an MRI will show that it has been treated already.

There is a significant improvement in the majority of the women within the first six months after focused ultrasound surgery.

After three years of follow-up, researchers report that women continue to have symptoms relief.