Magnetic resonance-guided focused ultrasound myomectomy: safety, efficacy, subsequent fertility and quality-of-life improvements, a systematic review

Reprod Sci. 2014 Apr;21(4):465-76. doi: 10.1177/1933719113497289. Epub 2013 Jul 18.

Abstract

We performed a systematic review about studies reporting data of myomectomy performed by magnetic resonance-guided focused ultrasound (MRgFUS) technique in order to define its safety, feasibility, indications, complications, and impact on uterine fibroid symptom and health-related quality of life (UFS-QOL) and fertility. Outcomes were considered according to fibroids shrinkage, nonperfused volume (NPV), NPV ratio, and uterine fibroid symptoms assessed with UFS-QOL questionnaire (baseline 3, 4, 6, and 12 months). We analyzed 38 eligible studies reporting outcomes about 2500 patients (mean age 43.67 years). The MRgFUS results a safe, efficient, and cost-effective minimal invasive technique for treatment of uterine fibroids. Increasing experience, device improvements, and availability for a larger number of patients are enhancing the outcomes, while the obstetrical ones should be more extensively explored. The MRgFUS could be considered as a minimal invasive alternative to traditional surgical or radiological procedures for the treatment of symptomatic uterine myomas improving both QOL and subsequent fertility.

Keywords: MRgFUS; fertility preservation; high-intensity focused ultrasounds; magnetic resonance-guided focused ultrasounds; quality of life.; uterine myomas.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Female
  • Fertility*
  • High-Intensity Focused Ultrasound Ablation* / adverse effects
  • Humans
  • Leiomyoma / diagnosis
  • Leiomyoma / surgery*
  • Magnetic Resonance Imaging, Interventional*
  • Middle Aged
  • Quality of Life*
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Uterine Myomectomy / adverse effects
  • Uterine Myomectomy / methods*
  • Uterine Neoplasms / diagnosis
  • Uterine Neoplasms / surgery*