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First experience of real-time elastography with transvaginal approach in assessing response to MRgFUS treatment of uterine fibroids

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Abstract

Purpose

Definition of the role of real-time elastography (RTE) in the evaluation of response to treatment of uterine fibroids using MRgFUS in symptomatic patients.

Materials and methods

28 women with 34 symptomatic fibroids, selected for MRgFUS, were enrolled. The patients were preliminarily studied with MRI and suprapubic and transvaginal ultrasound examination including RTE; the follow-up was performed immediately after treatment, at 3 months and 12 months with the same technique. Each lesion was evaluated by looking for ultrasound parameters (volume, resistance index) and RTE strain ratio (SR). Before and after treatment, all patients completed three questionnaires for symptom evaluation (e.g., uterine fibroids symptoms and quality of life).

Results

Of the 27 treated fibroids, only 14 had an effective treatment with non-perfused volume (NPV) >70 %. After 3 months of treatment, 17/21 patients presented significant decrease of uterine bleeding. A positive correlation between %NVP and percentage of fibroid volume decrease was seen. Reduction of SR value from t0 to t2 was found in 19/27 fibroids, particularly significant in fibroids with NPV > 70 %. A significant positive correlation between the percentage of symptom decrease and %SR decrease was found. At the time of statistical analysis, 12/21 patients reached the 12-month follow-up: they showed a further reduction of SR.

Conclusion

RTE is a valid method able to support standard ultrasound examination in the evaluation of uterine fibroids, since it allows demonstrating the decrease of rigidity, which can be quantified with the SR parameter. It could be included in a pre-treatment multiparametric evaluation of patients looking for MRgFUS eligibility and in follow-up when it could assess the response to treatment.

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Authors and Affiliations

  1. Umberto I, Policlinico di Roma, Dipartimento di Scienze Radiologiche, Oncologiche ed Anatomopatologiche, Sapienza Università di Roma, Rome, Italy

    Chiara Marigliano, Giovanna Panzironi, Luisa Molisso, Alessandra Pizzuto, Federica Ciolina, Alessandro Napoli & Paolo Ricci

Authors
  1. Chiara Marigliano
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  2. Giovanna Panzironi
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  3. Luisa Molisso
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  4. Alessandra Pizzuto
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  5. Federica Ciolina
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  6. Alessandro Napoli
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  7. Paolo Ricci
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Correspondence to Chiara Marigliano.

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Conflict of interest

Chiara Marigliano declares that she has no conflict of interest. Giovanna Panzironi declares that she has no conflict of interest. Luisa Molisso declares that she has no conflict of interest. Alessandra Pizzuto declares that she has no conflict of interest. Federica Ciolina declares that she has no conflict of interest. Alessandro Napoli declares that he has no conflict of interest. Paolo Ricci declares that he has no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Marigliano, C., Panzironi, G., Molisso, L. et al. First experience of real-time elastography with transvaginal approach in assessing response to MRgFUS treatment of uterine fibroids. Radiol med 121, 926–934 (2016). https://doi.org/10.1007/s11547-016-0679-5

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  • DOI: https://doi.org/10.1007/s11547-016-0679-5

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