To evaluate the role of MRI:
diffusion-weighted imaging (DWI)
in assessing the response of uterine fibroids to high intensity focused ultrasound (HIFU) treatment.
Methods and Materials
From December 2008 to February 2010:
8 patients (mean age,
age range 46-52) with symptomatic uterine fibroids free of other pelvic pathology that required surgical intervention
all patients underwent HIFU
patients underwent MRI before and 6 months after treatment
MAGNETIC RESONANCE IMAGING (MRI):
multiplanar capacity and excellent soft tissue contrast resolution reflecting pathology
1.5-T MRI scanner and a multi-phased array coil (cardiac,
T2-weighted FSE in the sagittal,
axial; coronal planes when needed
Dynamic-contrast study (FSPGR)
DW imaging (b value=...
Size before treatment:
- Range : 5,2 cm to 15 cm
- Mean : 7.8 cm
Symptom presentation of 8 patients:
- abdominal pain,
The mean ADC value of fibroids before treatment was:
- 1,10 e-9
- range 0,42-1,40 e-9
The mean ADC value of fibroids after treatment increased andwas:
- 1.73 e-9
- range1,60-2,00 e-9
Median reduction in tumor size as a percentage of initial tumor volume at 6 months after HIFU treatment was of 65%
Mean fibroid enhancement before treatment was:...
HIFU ablation appears to be an effective and safe treatment in reducing uterine fibroids volume.
Both dynamic studyand DWI may serve as imaging tools to assess treatment response.
In spite of the expected reduction of ADC values related to coagulative necrosis,
we observed an increase of ADC values.
This data should be confirmed in a larger study group and can be a matter of speculation in understanding the cellular effect of HIFU.
Further studies are needed to understand the reliability of DWI and,
Quantitative Diffusion-Weighted Magnetic Resonance Imaging of Noral and Diseased Uterine Zones.
Acta Radiol 2009(3)
The role of dynamic contrast-enhanced and diffusion weighted magnetic resonance imaging in the female pelvis.
Eur J Radiol (2010),
BLOOD FLOW OCCLUSION VIA ULTRASOUND IMAGE-GUIDED HIGHINTENSITY FOCUSED ULTRASOUND AND ITS EFFECT ON TISSUE PERFUSION.
Ultrasound in Med.
J E KENNEDY,
High intensity focused ultrasound:...
Dr Virna Zampa,
Dr Valentina Vallini
Diagnostic and Interventional Radiology
Department of Oncology,
Transplants and Advanced Technologies in Medicine
University of Pisa
via Paradisa 2,