scholarly journals Percutaneous High Frequency Microwave Ablation of Uterine Fibroids: Systematic Review

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Anna Maria Ierardi ◽  
Valeria Savasi ◽  
Salvatore Alessio Angileri ◽  
Mario Petrillo ◽  
Sara Sbaraini ◽  
...  
Keyword(s):  
Microwave Ablation ◽  
Large Scale ◽  
Focused Ultrasound ◽  
Female Genital Tract ◽  
Uterine Fibroids ◽  
Surgical Approaches ◽  
Focused Ultrasound Surgery ◽  
Potential Efficacy ◽  
Prospective Trials ◽  
High Frequency Microwave

Uterine fibroids are the most common benign pelvic tumor of the female genital tract and tend to increase with age; they cause menorrhagia, dysmenorrhea, pelvic pressure symptoms, back pain, and subfertility. Currently, the management is based mainly on medical or surgical approaches. The nonsurgical and minimally invasive therapies are emerging approaches that to the state of the art include uterine artery embolization (UAE), image-guided thermal ablation techniques like magnetic resonance-guided focused ultrasound surgery (MRgFUS) or radiofrequency ablation (RF), and percutaneous microwave ablation (PMWA). The purpose of the present review is to describe feasibility results and safety of PMWA according to largest studies available in current literature. Moreover technical aspects of the procedure were analyzed providing important data on large scale about potential efficacy of PMWA in clinical setting. However larger studies with international registries and randomized, prospective trials are still needed to better demonstrate the expanding benefits of PMWA in the management of uterine fibroids.

Open Source Software Implementation of Anatomical Segmentation

2018 ◽  
Author(s):  
Maggie Hess
Keyword(s):  
Large Scale ◽  
Focused Ultrasound ◽  
Region Growing ◽  
Ground Truth ◽  
Clot Lysis ◽  
Focused Ultrasound Surgery ◽  
Manual Methods ◽  
Areas Of Interest ◽  
Seed Points ◽  
Viable Method

Purpose: Intraventricular hemorrhage (IVH) affects nearly 15% of preterm infants. It can lead to ventricular dilation and cognitive impairment. To ablate IVH clots, MR-guided focused ultrasound surgery (MRgFUS) is investigated. This procedure requires accurate, fast and consistent quantification of ventricle and clot volumes. Methods: We developed a semi-autonomous segmentation (SAS) algorithm for measuring changes in the ventricle and clot volumes. Images are normalized, and then ventricle and clot masks are registered to the images. Voxels of the registered masks and voxels obtained by thresholding the normalized images are used as seed points for competitive region growing, which provides the final segmentation. The user selects the areas of interest for correspondence after thresholding and these selections are the final seeds for region growing. SAS was evaluated on an IVH porcine model.  Results: SAS was compared to ground truth manual segmentation (MS) for accuracy, efficiency, and consistency. Accuracy was determined by comparing clot and ventricle volumes produced by SAS and MS. In Two-One-Sided Test, SAS and MS were found to be significantly equivalent (p < 0.01). SAS on average was found to be 15 times faster than MS (p < 0.01). Consistency was determined by repeated segmentation of the same image by both SAS and manual methods, SAS being significantly more consistent than MS (p < 0.05).  Conclusion: SAS is a viable method to quantify the IVH clot and the lateral brain ventricles and it is serving in a large- scale porcine study of MRgFUS treatment of IVH clot lysis.

scholarly journals Updated Costs of Uterine Fibroid Treatments Including Focused Ultrasound Surgery

2018 ◽  
Author(s):  
Bijan J. Borah ◽  
Elizabeth A. Stewart
Keyword(s):  
Magnetic Resonance ◽  
Focused Ultrasound ◽  
Treatment Options ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Invasive Treatment ◽  
Ultrasound Surgery ◽  
Non Invasive ◽  
Focused Ultrasound Surgery ◽  
Reproductive Age Women

Uterine leiomyomas (fibroids) affect 20–40% of reproductive age women and are the major indication for hysterectomy. Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) is a new, potentially disruptive, non-invasive and uterine-sparing treatment option that has been shown to yield similar or better clinical outcomes than other uterine-sparing interventions. However, the costs of MRgFUS and other minimally-invasive treatment options have not been studied using US practice data. This study attempts to fill this void. And since uterine fibroids are the first FDA-approved indication for MRgFUS treatment, this study may also have implications for other indications which are now investigational.

Benign disease of the uterus

2020 ◽  
pp. 609-624
Author(s):  
Sahana Gupta ◽  
Isaac Manyonda
Keyword(s):  
Focused Ultrasound ◽  
Treatment Options ◽  
Uterine Fibroids ◽  
Transvaginal Sonography ◽  
Benign Diseases ◽  
Endometrial Polyps ◽  
Focused Ultrasound Surgery ◽  
Effective Interventions ◽  
Outpatient Hysteroscopy ◽  
Dramatic Shift

The benign diseases of the uterus compromise endometrial polyps, adenomyosis, and uterine fibroids or leiomyomas. Polyps are often asymptomatic, or may cause intermenstrual bleeding, and recent technological developments allow for rapid diagnosis (transvaginal sonography) and treatment (outpatient hysteroscopy and polypectomy with or without local anaesthesia). Precious little progress has been made over the past few decades in the understanding of the pathophysiology of adenomyosis, or its effective management beyond hysterectomy. Until as recently as two decades ago, the only treatment options for fibroids were hysterectomy and myomectomy, but the advent of radiological interventions (uterine artery embolization and focused ultrasound surgery) has revolutionized uterine-preserving management options of fibroid disease, while the recent emergence of selective progesterone receptor modulators has, at long last, heralded effective medical therapy for fibroids. This rapid expansion in fertility-preserving treatments for fibroids could not have been more timely since in recent years there has been a dramatic shift in the demography of childbirth, with many women postponing childbirth to their late 30s and early 40s, when fibroids are more prevalent and more symptomatic. Parallel developments in assisted reproduction technology now allow women to achieve pregnancies at an age that was unthinkable three decades ago. Even when child bearing is not an issue, hysterectomy no longer need be the only effective treatment for the menstrual disturbance and other symptoms associated with benign diseases of the uterus—new minimally invasive procedures now allow for equally effective interventions that improve women’s quality of life.

Pregnancy outcome after magnetic resonance–guided focused ultrasound surgery (MRgFUS) for conservative treatment of uterine fibroids

2010 ◽  
Vol 93 (1) ◽  
pp. 199-209 ◽  
Author(s):  
Jaron Rabinovici ◽  
Matthias David ◽  
Hidenobu Fukunishi ◽  
Yutaka Morita ◽  
Bobbie S. Gostout ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Conservative Treatment ◽  
Pregnancy Outcome ◽  
Focused Ultrasound ◽  
Uterine Fibroids ◽  
Ultrasound Surgery ◽  
Focused Ultrasound Surgery
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