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What is MRgFus?

Imagine your doctor being able to see inside your body, find your fibroid and provide treatment, all without surgery.  This is the idea behind Magnetic Resonance-guided Focused Ultrasound or MRgFUS.

MRgFUS is an innovative and non-invasive method of treatment. It allows your doctor to see inside your body, find your fibroid and treat it without surgery.  Whilst lying in a Magnetic Resonance Imaging (MRI) scanner which provides real-time pictures of your pelvis, very high intensity ultrasound waves are focused to pre-determined spots on the fibroid allowing thermal destruction, or cell death, to take place.  The ultrasound used in this procedure is many times stronger than the ultrasound used in diagnostic imaging.  All of this can be done without any surgical incision and while you are fully conscious.

MRgFUS is an entirely non-invasive treatment which takes place as an outpatient procedure, with a maximum hospital stay of 5.5 hrs.  Unlike other fibroid treatments, MRgFUS patients usually return to work within one to two days.

In medical terms, the MRgFUS treatment works by using high intensity focused ultrasound to cause thermal destruction of fibroid tumours through coagulative necrosis.  The heating is monitored in real time using the thermometry properties of MRI so that the tissue damage is confined to the fibroid and does not affect the normal myometrium, the endometrium or the serosa. Importantly there have been no incidences of adhesions or ovarian failure.  Patients are treated in the outpatient setting using light sedation only and can be expected to return to work within 1-2 days.  Should a surgical or other invasive approach be undertaken, the patient may need to take up to six weeks off work for recovery.  Because cell death is by coagulative necrosis rather than ischaemic necrosis as in uterine artery embolisation, there is no infective morbidity or post-procedural pain associated with this treatment.

It is important to know that MRgFUS will not remove the fibroids from your body.  The treatment is designed to treat the symptoms of fibroids and improve your quality of life by reducing the activity of symptomatic fibroids.  The treatment is particularly successful with painful and prolonged heavy menstrual bleeding, pressure symptoms and urinary and bladder symptoms.  Once the fibroid is dead, it will remain in place, with a likely maximum shrinkage of not more than 50%.  Commonly shrinkage is in the region of 10-30%.  Shrinkage will not be visible immediately post-treatment but maximal shrinkage will be seen at six months after the procedure.  After MRgFUS, fibroid tissue does not leave the body via the vagina as in uterine artery embolisation, and this is why women do not experience the troublesome discharge associated with embolisation after treatment.  There are no known effects of the treated fibroids remaining in the body as uterine fibroids are known to be benign.

Of course, MRgFUS can only treat your medical condition as it presents to us at the time you are treated.  Because the womb is still intact, the environment that allows fibroids to grow is still intact, so it is possible that new fibroids will grow in the future or any fibroids not treated during your MRgFUS session will grow.  It may be possible for treated fibroids to grow back.  Treatment is designed to give relief to the distressing symptoms of this condition without surgery and cannot eliminate your chances of ever growing fibroids again.  However this is also the case for all other treatment options, with the exception of hysterectomy.

 

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