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Uterine Fibroid Treatment Shows Promise

Noninvasive beam destroys growths and offers long-term relief, study finds

WEDNESDAY, Nov. 30, 2005 (HealthDay News) -- A noninvasive method of destroying uterine fibroids greatly eases women's symptoms up to a year after the procedure, U.S. researchers report.

Previous papers had shown symptom relief up to six months for the technique, known as magnetic resonance-guided, focused ultrasound surgery or "MRgFUS."

"This is basically continuing out the data," said Dr. Fiona M. Fennessy, an instructor of radiology at Harvard Medical School and a staff radiologist at Brigham and Women's Hospital, both in Boston. "Symptom reduction extends out to 12 months and probably longer."

Fennessy was lead author of a paper to be presented Friday at the Radiological Society of North America annual meeting, in Chicago.

Others say the latest findings should pave the way for more widespread use of the technology.

"It's very promising," said Dr. Kenneth Levey, director of the New York University Center for Pelvic Pain and Minimally Invasive Gynecologic Surgery. "It's fantastic therapy and a wonderful start."

Uterine fibroids are benign tumors of muscle and connective tissue inside the uterus. About a quarter of women aged 25 to 50 have such fibroids, and as many as 50 percent of black women have the growths.

Although some women will report no symptoms, fibroids can cause pain, heavy menstrual bleeding, frequent urination as a result of pressure on the bladder and even infertility and miscarriages.

"The gold standard for treating fibroids is a hysterectomy, but that is very invasive," Fennessy said.

In fact, fibroids are one of the most common reasons for having a hysterectomy, which involves the removal of the entire uterus.

Researchers have been trying to develop both minimally invasive and noninvasive methods to treat fibroids.

MRgFUS, which has been approved by the U.S. Food and Drug Administration and available at several centers in the United States, uses ultrasound to deliver heat to the fibroid tissue. The heat kills the fibroid tissue, while the MRI component of the procedure lets clinicians monitor the location of the ultrasound beam and track temperature changes.

"It's totally noninvasive. There's no incision, no blood. The patient just lies belly down on the scanner, the ultrasound probe is underneath the belly where the fibroid is, and the beam shoots right through from the skin or underneath the skin or right through," Fennessy explained.

Previous studies had shown symptom relief up to six months. The current trial studied followed 160 women with symptomatic fibroids who received MRgFUS out to a year. The women received slightly different treatments. One group received 120 minutes of directed treatment covering a volume of up to 33 percent of total fibroid volume. The other received 180 minutes on a volume of 33 percent of total volume in fibroids on the outer wall of the uterus and 50 percent of volume in other fibroids.

Women who had more fibroid tissue destroyed reported more symptom improvement.

"You create this big hole of dead tissue," Fennessy said. 'The bigger the amount of dead tissue, the greater relief in symptoms. The pressure effect of the fibroid is less."

Will this eventually become the gold standard for fibroid treatment?

That's debatable, Fennessy said.

"It will be a treatment for some women," she said. "For the woman who is not looking for invasive therapy, who wants to go into the hospital for three hours, go home, then go back to work the next day, she will have her symptoms reduced by at least half."

More information

For more on uterine fibroids, head to the National Women's Health Information Center.

SOURCES: Fiona M. Fennessy, M.D., Ph.D., instructor, radiology, Harvard Medical School, and staff radiologist, Brigham and Women's Hospital, both in Boston; Kenneth Levey, M.D., director, New York University Center for Pelvic Pain and Minimally Invasive Gynecologic Surgery, and assistant professor, ob/gyn, New York University School of Medicine, New York City; Nov. 30, 2005, presentation, Radiological Society of America annual meeting, Chicago
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