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Uterine Fibroids

Is HIFU right for me?

 

What is the clinical indication for MRI-HIFU?


MRI-HIFU is indicated for the ablation of uterine fibroids (leiomyomas) in pre-menopausal and peri-menopausal woman who wants to preserve her uterus.

 

 
How does MRI-HIFU work?
 
HIFU or High-Intensity-Focused-Ultrasound uses high-intensity ultrasound waves that are focused into a small area of between 4–16mm, to produce local heating, which kills the tumor cells. To ensure that this is done accurately, MRI is used, both to localize the area for ablation as well as to monitor the temperature rise during the treatment.
 
  • The process of killing the tumor cells is called “SONICATION”
  • This technique relies on very well researched heat-induced tissue necrosis (also called coagulative necrosis), which is achieved when the target fibroid is heated to a temperature at or beyond 57°C
  • Normal uterine muscle remains intact following the procedure
  • Principal determinants for procedure duration include size and location of the fibroid
  • An important prerequisite for the procedure is to ensure that ultrasound beam stays away from bowel loops and bone. Screening by MRI of pelvis helps with this evaluation

 

 
Which fibroids can be treated with MR-HIFU?
 
Most fibroids greater than 3 cm can be treated with MR-HIFU. This is decided on the basis of MRI findings performed when the patient first comes for counselling.
 
 
 
Any contraindications?
 
  • The presence of scar tissue and adhesions from previous surgery may create problems and sometimes be a contraindication
  • Technical issues primarily due to the location of the fibroid in relation to vital structures outside uterus, such as bowel loops and spine
  • Pregnancy
  • Standard contraindications for MRI such as non-MRI compatible implanted metallic devices or cardiac pacemaker
  • Patients on anti-coagulation therapy or has an underlying bleeding disorder
  • Patients with active pelvic infection

 

 
 Does the fibroid disappear? What happens?
 
The fibroid does not disappear. It however shrinks in size leading to a significant reduction in symptoms. Approximately 50-90% ablation is aimed for.