Ultrasound Surgery for Fibroids

MR guided Focused Ultrasound Surgery (MRgFUS) is one of the more recent treatments available today to destroy uterine fibroids without affecting other tissues surrounding the fibroid.

Fibroids and MRgFUS

Fibroid tumors are lumps of tissue that grow on the wall of the uterus. A common occurrence, fibroids are present in close to 50% of the female population of childbearing age. While they may not present any problems to many women, some women have very difficult symptoms that require medical intervention to make life easier.

MRgFUS is non-invasive and is performed as an outpatient procedure for women who qualify as a candidate for this type of surgery. It uses high doses of focused ultrasound waves (HIFU) to blast the fibroid. The procedure is done in a magnetic resonance imaging (MRI) scanner which helps the doctor see inside the body in order to locate, guide and monitor the treatment.

Perhaps the best way to describe this type of surgery is to liken it to using a magnifying glass in order to focus the sun's rays on a single point to create a flame. The focused ultrasound energy is pointed at a small portion of the fibroid, raising the temperature to a place where it kills the cells (thermal ablation) without destroying any tissues in the vicinity. Energy is pulsed to the fibroid in small segments until the entire tumor is destroyed.

What is Agnetic Resonance Imaging?

Magnetic resonance imaging is an advanced type of technology that provides 3D imaging of internal organs without using radiation. A practitioner is able to virtually see inside the body clearly and is able to locate the fibroid tumor, treat it and follow the progress of the treatment without the need for scopes or incisions. Since everything is happening in real time, the feedback is immediate relative to temperature changes of the treated tumor so the doctor knows that it has been destroyed.

How Is MRgFUS Performed?

The procedure lasts about three hours and is performed entirely within the MRI scanner. The fibroids are first identified on MR images that are taken of the pelvic area while the patient is lying on her stomach on the table that slides into the scanner. After significant planning, high energy focused ultrasound waves heat a small portion on the fibroid up to 85 degrees C. During the period of the sonication or pulse, which lasts about 15 seconds, the progress of the treatment on temperature-sensitive images is reviewed. This process continues until the fibroid is totally destroyed, which could take as many as 50 sonications.

A sedative and pain medication is administered to help the patient relax and a safety stop button is given that allows the patient to stop the sonication immediately if the treatment becomes painful. The patient is conscious and in communication with the physician the entire time in order to give feedback.