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01-10-2014 | Interventional

Volumetric MR-guided high-intensity focused ultrasound versus uterine artery embolisation for treatment of symptomatic uterine fibroids: comparison of symptom improvement and reintervention rates

Authors: Marlijne E. Ikink, Robbert J. Nijenhuis, Helena M. Verkooijen, Marianne J. Voogt, Paul J. H. M. Reuwer, Albert J. Smeets, Paul N. M. Lohle, Maurice A. A. J. van den Bosch

Published in: European Radiology | Issue 10/2014

Abstract

Purpose

To compare the effectiveness of magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) with that of uterine artery embolisation (UAE) for treatment of uterine fibroids.

Methods

Between January 2010 and January 2013, 51 women with symptomatic uterine fibroids underwent MR-HIFU. Follow-up and MR imaging were compared to 68 women treated with UAE, who fulfilled eligibility criteria for MR-HIFU – e.g., size (≤ 12 cm) and number (≤ 5) of fibroids. We compared median symptom severity (tSSS), total health-realted quality of life (HRQoL) scores, and reintervention rates. The adjusted effect on symptom relief and HRQoL improvement was calculated using multivariable linear regression. Cox regression was applied to calculate the adjusted risk of reintervention between both treatments.

Results

Median tSSS improved significantly from baseline to three-month follow-up (P < 0.001) for both MR-HIFU (53.1 (IQR [40.6-68.8]) to 34.4 (IQR [21.9-46.9]) and UAE (65.3 (IQR [56.3-74.2]) to 21.9 (IQR [9.4-34.4]). In addition, significantly better HRQoL scores were observed after three months (P < 0.001). However, in multivariate analysis, UAE had a stronger effect on symptom relief and HRQoL improvement than MR-HIFU (P < 0.001). Patients treated with MR-HIFU had a 7.1 (95 % CI [2.00-25.3]; P = 0.002) times higher risk of reintervention within 12 months (18/51 vs. 3/68).

Conclusion

Both MR-HIFU and UAE result in significant symptom relief related to uterine fibroids. However, MR-HIFU is associated with a higher risk of reintervention.

Key Points

• This study compared outcomes between volumetric MR-HIFU and UAE for uterine fibroids.

• Both MR-HIFU and UAE result in significant symptom relief and quality of life improvement.

• UAE had a stronger positive effect on the clinical outcomes.

• Reintervention rate after MR-HIFU ablation was significantly higher than after UAE.

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Title: Volumetric MR-guided high-intensity focused ultrasound versus uterine artery embolisation for treatment of symptomatic uterine fibroids: comparison of symptom improvement and reintervention rates
Authors: Marlijne E. Ikink
Robbert J. Nijenhuis
Helena M. Verkooijen
Marianne J. Voogt
Paul J. H. M. Reuwer
Albert J. Smeets
Paul N. M. Lohle
Maurice A. A. J. van den Bosch
Publication date: 01-10-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 10/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3295-6

At a glance: The STEP trials

Springer Medicine

Volumetric MR-guided high-intensity focused ultrasound versus uterine artery embolisation for treatment of symptomatic uterine fibroids: comparison of symptom improvement and reintervention rates

Abstract

Purpose

Methods

Results

Conclusion

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Key Points

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