Ultraschallbasierte, MRT-gesteuerte Thermoablation von Uterusmyomen - erste Erfahrungen mit einer neuen, nichtinvasiven Behandlungsmethode
| Autor: | J.-W. Oestmann, T. Ehrenstein, C. Radke, L. Schuster, M. David |
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| Rok vydání: | 2002 |
| Předmět: | |
| Zdroj: | Geburtshilfe und Frauenheilkunde. 62:986-990 |
| ISSN: | 1438-8804 0016-5751 |
| DOI: | 10.1055/s-2002-35100 |
| Popis: | Purpose: High frequency focused ultrasound (HIFUS) is a new completely noninvasive therapeutic modality for the treatment of uterine myomas. Feasibility and morbidity were analyzed within the constraints of a phase II study. Patients and Methods: 11 pre- and postmenopausal women with a significantly enlarged uterus due to myomas were treated with MR-guided high frequency focused ultrasound (HIFUS; Fa. Insightec, Israel) as part of an international multicenter study. The objective was to estimate the feasibility and morbidity of the new modality (phase II). The diagnosis as established by clinical and ultrasound examination was in a first step verified by MR, then the potential access route was determined and larger necroses were excluded. In a second session the myomas were treated under MR guidance with HIFUS on an outpatient basis. 3 - 5 days after therapy the perfusion defect of the treated tumor volume was determined by MR. Within 30 days of HIFUS-therapy all patients had their uterus excised and examined pathologically. Results: The treatment could be completed as planned in 9 of 11 patients (duration of treatment 2 - 4 hours). In general the treatment was tolerated well. Minor pain was experienced during and some exhaustion was felt after therapy. In 1 patient therapy was impossible due to suboptimal localization of the myoma. In an-other patient treatment was not initiated because of metallic artifacts in an abdominal wall scar. The resulting necrosis as seen in the path specimen had three times the size of the treated volume within the myoma. In no case was necrosis detected outside the myoma. Conclusions: Uterine myomas can be treated by HIFUS noninvasively, reliably and without significant morbidity. A phase III study is under way to verify the efficiency of the modality. |
| Databáze: | OpenAIRE |
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