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Congress: ECR24
Poster Number: C-15745
Type: EPOS Radiologist (educational)
DOI: 10.26044/ecr2024/C-15745
Authorblock: B. P. Paner, S. G. F. Estanislao, S. D. L. Gosiaco; Taguig City/PH
Disclosures:
Bryian Pineda Paner: Nothing to disclose
Seth Gabriel Ferrer Estanislao: Nothing to disclose
Stacey Danica Lim Gosiaco: Nothing to disclose
Keywords: Abdomen, Genital / Reproductive system female, MR, Ablation procedures, Complications, Neoplasia
Learning objectives To describe the pre- and post-HIFU MRI findings of uterine fibroids, including features that can predict treatment outcome.To discuss the different MRI characteristics and types of uterine fibroids using the International Federation of Gynecologic Imaging (FIGO) classification.
Read more Background Fibroids or myomas are benign tumors of smooth muscle. They are the most common benign tumors of the reproductive organs in women of childbearing age. Treatment options for fibroids are surgery (hysterectomy or myomectomy), embolization and hormone therapy. Recently, HIFU is gaining popularity as another treatment option due to its non-invasive nature. MRI of the lower abdomen is required before and after HIFU; however, there is no guideline in the literature for interpreting these MRI studies.
Read more Findings and procedure details High Intensity Focused UltrasoundHIFU is a non-invasive, thermal ablation procedure in the treatment of uterine fibroids. It uses focused ultrasound beams directed towards the tumor to cause coagulative necrosis. HIFU has a shorter recovery period and can be done as an out-patient procedure compared to surgery.Non-perfused volume ratio (NPVR) is used to determine HIFU efficacy. It is defined as the ratio of the volume of the non-perfused area in post-ablation to the total volume of the fibroid.  Calculated by: volume of...
Read more Conclusion HIFU is a highly effective non-invasive treatment for uterine fibroids with less complications compared to other methods of management. It is an easily planned for procedure through FIGO classification-guided MRI interpretation, with post-treatment features easily monitored through assessment of T2 weighted and post-gadolinium enhanced MRI sequences. MR image interpretation likewise is able to provide possible predictors for treatment efficacy through assessment of T2 signals, enhancement pattern and overall fibroid size.
Read more References Gomez E, Nguyen MT, Fursevich D, Macura K, Gupta A. MRI-based pictorial review of the FIGO classification system for uterine fibroids. Abdom Radiol (NY). 2021;46(5):2146-2155. doi:10.1007/s00261-020-02882-z Bohlmann MK, Hoellen F, Hunold P, David M. High-Intensity Focused Ultrasound Ablation of Uterine Fibroids - Potential Impact on Fertility and Pregnancy Outcome. Geburtshilfe Frauenheilkd. 2014 Feb;74(2):139-145. doi: 10.1055/s-0033-1360311. PMID: 24741124; PMCID: PMC3973937. Szkodziak, P., Szkodziak, F., Trzeciak, K., & Czuczwar, P. (2017). Minimally invasive procedures in the management of uterine fibroids. Przeglad menopauzalny = Menopause...
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