Our services at the MR Therapy Centre
Our services fall into three catagories listed below. Click on the links and the page will scroll to the relevant section:
1. Magnetic Resonance-guided Focused Ultrasound Treatment of Uterine Fibroids (MRgFUS)
2. Magnetic Resonance-guided Focused Ultrasound Research
3. Magnetic Resonance Imaging (MRI)
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Magnetic Resonance-guided Focused Ultrasound Treatment of Uterine Fibroids (MRgFUS)
MRgFUS is an innovative technique that can be used to target and destroy areas of abnormal tissue within the body. It is a minimally-invasive treatment which can be carried out instead of conventional surgery. Very high-power ultrasonic waves are accurately focused onto a small area of tumour approximately 2cm by 1cm. The cells within this area are heated rapidly to a level where the abnormal cells die. However, the tissue in front of and behind this focal spot are undamaged.
Magnetic Resonance Imaging (MRI) is used to delineate very accurately the target, and to guide the focused ultrasound beam to the region being treated, while making sure that no other structures are in the way that could possibly be damaged or alter the result. MR can also measure the temperature at the focal spot where the heating is occurring, so that the amount of tissue damage that is being produced by each pulse of ultrasound energy (called “sonications”) can be assessed. This information allows corrections and improvements to be made for each subsequent sonication. A significant area of destruction can be achieved by carrying out multiple repeat sonications which overlap.
At present, we are only offering private or Primary Care Trust funded treatment for uterine fibroids.
Uterine fibroids are the most common solid pelvic tumours that affect women during their reproductive years. Approximately 30% of these women suffer with significant symptoms including heavy bleeding, excessive pelvic pressure and pain leading to the need for symptomatic treatment (most commonly through surgery).
MRgFUS has been demonstrated to be a viable alternative for effectively treating uterine fibroids without the need for surgical invasion.
The procedure is conducted with the patient lying prone in a magnetic resonance imaging (MRI) scanner. MRI is necessary to visualise the location of the fibroid and the surrounding tissues and organs in the acoustic beam path, and to guide and continuously monitor the treatment without radiation. MRI also provides continuous real time temperature monitoring and feedback of temperature changes during treatment to confirm that the appropriate amount of energy is delivered to the correct location to ablate the fibroid.
Treatment planning uses volumetric MR images for three-dimensional visualisation of the targeted tissue and surrounding organs. The thermal dose to be delivered is determined during the planning phase, and continuously monitored during treatment. The patient is positioned on the treatment table with the pelvis directly over the phased array transducer integrated into the special patient table. Markers are placed on the planning images and monitored during treatment to ensure no patient movement.
The focused ultrasound energy is directed at a small volume of the fibroid, raising its temperature high enough to cause thermal ablation within a defined area. During treatment, the beam of focused ultrasound energy penetrates through soft tissue to ablate the targeted tissue. Multiple sonications are repeated until the entire volume is treated. As the treatment is performed, the MR thermal imaging system continuously measures temperature changes inside the body. As each succeeding treatment point is identified, the therapy system commands the imaging system to move the acoustic transducer and set the MR scanner to the right scanning coordinates. Following the treatment, anatomical MRI contrast enhanced images (using a special injected contrast agent called “gadolinium”) are used to evaluate treatment outcome.
Because of the need for real time quantitative information during treatment, the imaging system (MRI) and therapy system are completely integrated. The time required for this procedure ranges from 120-300 minutes with the physician present throughout the procedure. Recovery period is generally limited to 2 hours in the MR Therapy Centre post-procedure and 24 hours at home.
We have been very pleased with the symptomatic benefit afforded by this treatment with over 80% of women reporting symptomatic improvement on the uterine fibroid specific Quality of Life questionnaire. Furthermore, the incidence of post-treatment complications is very low. We have had none of the infective morbidity or post-procedural pain associated with other treatments such as uterine artery embolisation, nor any need for emergency hysterectomy. The MRgFUS system that we use has been awarded the CE mark for treatment of uterine fibroids and in October 2004 was approved by the Food and Drug Authority (FDA) in the USA for the same purpose.
Evidence on MRgFUS outcomes is accumulating, not only at St Mary’s, but in the USA, Europe and Asia where this procedure is becoming routine practice for uterine fibroid treatment. A summary of clinical trial information is available on this website.
We are able to accept private referrals to assess your suitability for MRgFUS treatment of your uterine fibroids. Further details are available here.
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Magnetic Resonance-guided Focused Ultrasound Research
St Mary’s Hospital and the MR Therapy Centre are currently conducting research using MRgFUS in the following areas:
1. Bone tumours
2. Soft tissue metastatic deposits
3. Enlarged spleen
4. Liver tumours which can be reached by MRgFUS
If you would like further information on partaking in these research studies, please email your name, age, location and diagnosis to: research@mrtherapycentre.com
Please note that we are no longer looking for participants for uterine fibroid research.
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Magnetic Resonance Imaging
Magnetic Resonance Imaging is an advanced diagnostic technique that uses a very strong magnetic field and radio waves to provide excellent cross-sectional images of internal organs and body tissues. MRI does not use ionising radiation and therefore has none of the potentially harmful side-effects of x-rays. MRI is an extremely versatile technique and can produce clear diagnostic images in virtually all areas of the body.
The MR Therapy Centre is able to offer all forms of diagnostic MRI scanning to private patients, including neurological and orthopaedic scans, a full range of body imaging, MR angiography, breast MR and diffusion imaging. All scans are reported by experienced radiologists from the Lindo Wing Radiology LLP group. All members of the group have substantive contracts with St Mary’s NHS Trust, and other prestigious London teaching hospital such as The National Hospital for Neurology and Neurosurgery, St Bartholomew’s and the Hammersmith Hospital. Your scan will always be reported by someone with specific expertise in the specialist area and will never be outsourced.
MRI requires highly specialised equipment and specialist staff. At the MR Therapy Centre we use GE 1.5 Tesla LX and HDX systems. We also have full access on-site to a GE interventional MRI scanner which is semi-open and is suitable for claustrophobic patients. Our technical staff are highly trained and experienced senior radiographers.
MRI scanning is available on an outpatient basis or through the private Lindo Wing at St Mary’s Hospital on an inpatient basis. Your physician, surgeon or general practitioner will be able to provide the necessary referral for you to undergo this investigation. We are unable to accept self-referrals.
