Myomectomy and MRI-directed cryotherapy

The purpose of this study was to identify alternatives to hysterectomy by transabdominal interventional magnetic resonance imaging-guided cryoablation. This represents a report of a prospective institutional review board-approved protocol to study interventional magnetic resonance imaging-guided cryoablation of uterine fibroid tumors. Women were selected on the basis of symptoms that were related to uterine fibroid tumors (bleeding, uterine pain, pelvic congestion, compression symptoms) and the absence of any desire for childbearing. Magnetic resonance imaging was performed before the procedure to measure the size and number of fibroid tumors, and follow-up magnetic resonance imaging determined the reduction of the lesion. Ten patients were originally included, and nine were treated and had substantial reduction in the uterine size (average, 65% volume reduction). The primary symptoms have either improved or resolved in eight of the nine women. This is the first reported review of interventional magnetic resonance imaging-directed cryotherapy of uterine fibroid tumors. This minimally invasive therapy produced shrinkage of the tumor in nine of our first ten patients.