Purpose: Uterine fibroids are common tumours of the myometrium that cause significant morbidity and loss of productivity in women of childbearing age. We present a pilot study of magnetic resonance (MR) guided high intensity focussed ultrasound (FUS) treatment of uterine fibroids. We aim to show that this is a reasonable, safe and effective treatment that is acceptable to patients. 

Methods and Materials: 17 women with symptomatic uterine fibroids who were scheduled for hysterectomy underwent FUS thermal ablation of a fibroid using a transducer (ExAblate000, InSightec-TxSonics, Haifa, Israel) integral to the 1.5Tesla

magnet (GE Medical Systems, Milwaukee, WI). MR imaging was performed 72 hours after treatment and the women underwent hysterectomy within 30 days. Pathological correlation with the MR lesion was noted and all adverse events were recorded. The

study took place at two sites: St Mary's Hospital, London, UK and Brigham and Women's Hospital, Boston, MA. 

Results: All women were treated as day case patients with minimal discomfort. No women required admission. There were no major devise related adverse events. Adverse events considered to be device related include two first-degree skin burns each noted by the physician at 72hours. There were two women who reported nausea thought to be related to the conscious sedation and IV contrast respectively. Six of the first seven treatments were limited by technical difficulties and sub optimal lesions were created but these problems have not been seen in any of the subsequent treatments. 15 women have undergone hysterectomy and there is good correlation between the expected lesion and the pathological findings.

Conclusion: This system allows MR planning and thermal mapping of the deliver of FUS energy by fully integrating the transducer and the MR system. We have shown the treatment to be safe and acceptable. Further studies of this novel non-invasive system are warranted. This treatment modality may be applicable to other neoplastic conditions.