MR-guided focused ultrasound surgery: A novel non-invasive technique in the treatment of adenomyosis –18 month’s follow-up of 12 cases

Abstract

Background: Adenomyosis is a gynecological condition of the uterus, characterized by the presence of ectopic endometrial tissue in the myometrium. Hysterectomy, uterine artery embolization, and endometrial ablation therapy are the various surgical treatment options available for adenomyosis. A novel and globally upcoming technique is MR-guided focused ultrasound surgery “MRgFUS,” which is a promising non-invasive surgical treatment option. This study was carried out to determine the effectiveness of MRgFUS in the symptomatic management of adenomyosis. Subjects and Methods: This study was carried out as a long-term follow-up study among 12 cases of adenomyosis, which were treated by MR-guided focused ultrasound. In all these participant’s, three parameters – symptom severity score (SSS), menstrual pain score accessed using visual analogue score (VAS), and number of approximate pads used during menstruation were recorded prior to the treatment and on follow-up at 3, 9, and 18 months, respectively. The Friedman’s test was used to test the difference in the values of scores before and after treatment. Results: There was a significant improvement in the SSS, VAS, and the numbers of sanitary napkins used after surgery and sustained during the long-term follow-up. These values were statistically significant (P < 0.05). Conclusion: MRgFUS can be used in successful treatment of adenomyosis/focal adenomyoma by careful selection of the participant, good planning, and proper monitoring of the technique during ablation.

Keywords

• adenomyosis
• hifu
• high-intensity focused ultrasound
• long-term follow-up
• mr- guided focused ultrasound
• magnetic resonance-guided focused ultrasound
• sanitary pads