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MR-guided transvaginal cryotherapy of uterine fibroids with a horizontal open MRI system: initial experience
Michiko Dohi1, Junta Harada, Takuji Mogami
1Department of Radiology, Jikei University, Kashiwa Hospital, Chiba, Japan.
Purpose:
We evaluated the feasibility of MR-guided transvaginal cryotherapy for treating intramural, submucosal, and sub-serosal uterine fibroids with a horizontal open MRI system.
Materials And Methods:
Using an MR-compatible cryotherapy system and a horizontal magnetic open-configuration MR scanner, we performed transvaginal cryotherapies using a Cusco speculum on eight uterine fibroids whose longest diameter ranged from 2.9 to 10.0 cm. We assessed the ratio of pre-treatment to post-treatment volume of the uterine fibroids as well as the patients' symptoms (anemia, abdominal pain, dysfunctional uterine bleeding, etc.).
Results:
All procedures were carried out safely and accurately without any complications that required surgical treatment. MRI enabled clear visualization of the cryoneedle and freezing area as band-like and ellipsoid-like signal losses, respectively. The mean ratio of reduction in uterine fibroid volume was 31.0% at 9-12 months (0-75.0%). Symptoms caused by uterine fibroids improved in seven cases.
Conclusion:
This is the first report on a transvaginal approach to cryotherapy for uterine fibroids. MR-guided transvaginal cryotherapy appears to be feasible and promising as a minimally invasive therapy for symptomatic uterine fibroids.