What is MR guided Focused Ultrasound Surgery?

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Focused Ultrasound Surgery is a non-invasive, outpatient procedure which uses high doses of focused ultrasound waves (HIFU) to destroy uterine fibroids. The waves are guided by an MRI.

This procedure does not affect any other tissues around the fibroid and is conducted in a magnetic resonance imaging (MRI) scanner which helps your doctor "see" inside the body to guide, pinpoint and continuously monitor the treatment.



What is MR guided Focused Ultrasound Surgery?

MR guided Focused Ultrasound Surgery (MRgFUS) can be compared to using a magnifying glass to focus the sun's energy on a single point to burn a leaf. In this procedure, focused ultrasound energy is directed at a small area of the fibroid. The energy causes the temperature of the cells to rise high enough to cause thermal ablation (killing of the cells) without impacting other tissues. The procedure is repeated with pulses of energy until the entire area is treated.

Why is the MRI needed?

Magnetic resonance imaging (MRI) is an advanced diagnostic technology which provides 3D imaging of internal organs without radiation. The MRgFUS treatment uses the MR images to locate the fibroid and see what area has been treated, without making any incisions. Real time feedback is provided about temperature changes of the treated fibroid, making sure that the fibrotic (diseased) tissue has been ablated (destroyed).

What happens during the MR guided Focused Ultrasound procedure?

The procedure is done while the patient lies on her stomach on a specially-designed table that fits into the MRI scanner.

The doctor initially identifies the fibroid(s) on MR images taken of the pelvic area. Then, after outlining a treatment plan, high energy ultrasound waves are focused on a small area of the uterine fibroid which heats to a temperature of up to 85oC. During the pulse or sonication, which lasts about 15 seconds, the doctor monitors the progress and reviews images which are temperature-sensitive. Since each pulse treats a very small volume, this process will be repeated until the required area is treated, usually about 50 times. The procedure lasts about 3 hours depending upon the size and number of fibroids treated.

Following the treatment, the symptoms are relieved as the body gradually expels the treated tissue over a period of months.

What will I experience during the fibroid treatment?

Patients are given a sedative and pain medication before the procedure for relaxation. The treatment takes place with you lying on the patient table inside the MR scanner. Before beginning, the medical team will make sure you are comfortable. During the treatment they will be in the next room where you will be able to communicate with them with a special two-way communication system. The doctor will speak with you throughout the procedure, letting you know when images are being acquired (scanning) and when the system is sonicating (treatment).

It is normal to feel a warming sensation in the pelvic region during the treatment. You will be given a safety stop button that allows you to immediately halt the treatment if it becomes painful.

During the entire procedure you will be conscious and will provide feedback to the doctor. Afterwards, while the mild sedation wears off, you will rest in the clinic for a few hours,. You will then be able to go home and resume normal activity.

How do I know if I'm a candidate for MRgFUS?

If you require treatment for your fibroid related symptoms but want to avoid surgery and preserve your uterus, consult your doctor. You will relate information about your fibroid symptoms, general health and medical history. Your doctor will order routine blood tests, an internal gynecological examination and MR imaging of your fibroids. Based on the results of these examinations and tests, your doctor will decide if you are a candidate for non-invasive MRgFUS for your uterine fibroids.